Challenges and facilitators of implementation of an information communication and technology (ICT)-based human resources management tool in the government health sector in Bangladesh: protocol for an exploratory qualitative research study

IntroductionTo improve human resources for health (HRH) management in Bangladesh, the directorate general of health services (DGHS) introduced a new information and communications technology (ICT) tool, named ‘human resources information system (HRIS)’, to process real-time HRH data of all facilities under the DGHS. However, synchronisation is a major concern since multiple authorities are involved in the implementation of the tool at different tiers of the health system. Introducing ICT tools in healthcare organisations has always proved challenging as evidence from low-income and middle-income countries suggests. The knowledge gap in terms of factors that support or constrain the successful implementation of the HRIS in Bangladesh will be investigated in this exploratory study to identify ways of engaging the key stakeholders in a better way for an effective use of the tool.Methods and analysisDesk review and qualitative data collection methods will be used to address the study objectives. Key informant interviews and in-depth interviews will be conducted to explore perspectives of policy-makers, programme managers, service providers and other stakeholders to understand the barriers to implementing HRIS in the context of Bangladesh. We plan to organise stakeholder consultation workshops to validate the qualitative study findings and to seek suggestions for ensuring a successful implementation of the HRIS. Framework analysis will be applied to analyse qualitative data, and an outline with the definitions of a priori codes guided by the policy engagement framework will be prepared. Besides, emerging themes will also be identified. A data display matrix will be prepared to summarise and interpret the findings for policy review.Ethics and disseminationThe research review committee and the ethical review committee of icddr,b have approved the research protocol. Findings from the study will be communicated through national and international forums, conferences, policy briefs and peer-reviewed journal publications.

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The role of information technology in strengthening human resources for health

Health Education ◽

10.1108/he-02-2013-0008 ◽

2013 ◽

Vol 114 (1) ◽

pp. 67-79 ◽

Cited By ~ 5

Author(s):

Nicole Sarkis ◽

Lillian Mwanri

Keyword(s):

Information Technology ◽

Health Services ◽

Human Resources ◽

Health Professionals ◽

Service Providers ◽

Health Workers ◽

Human Resources For Health ◽

English Literature ◽

Content Type ◽

The Pacific

Purpose – The purpose of this paper is to discuss innovative ways of addressing human resources for health (HRH) shortage in the Pacific, supported by a review of the literature and the Pacific Open Learning Health Network (POLHN), a programme created in response to the Pacific's HRH concern. Design/methodology/approach – A systematic search was conducted of English literature between 1990 and 2012. A number of key words, singly and/or in combination, were used to search for articles on ProQuest and PubMed. Original articles were identified and reference lists scrutinised to obtain additional literature. Due to the paucity of information, only narrative review was conducted and themes emerging from the literature identified and critically reviewed. Findings – There is a worldwide HRH shortage and a need to improve the skills of the health workforce to respond to changing population health needs. Continuing education (CE) through use of information technology (IT) is a means to strengthen HRH. POLHN is one example of an initiative to improve health worker skills and motivation. Technological change is increasingly common place in society. To make sense of these changes, practitioners can look for common themes in successful technological innovations of interactivity; information access, creation or sharing; communication; and simplicity. To ensure effective regulation of CE and IT there is a need to incorporate qualitative as well as quantitative measures, to prioritise the creation of quality, relevant, and appropriate resources and to facilitate access and active participation by health workers. Originality/value – The paper highlights the complexity of HRH shortage as a global problem, which demands multiple initiatives to respond to the shortage in the pursuit of skilled, equitable and just delivery of health services and distribution of health service providers. One initiative that has worked elsewhere is professional development of health professionals through the provision of CE using IT. Online learning offers a pathway to address HRH shortage and overcomes challenges posed by distance, limited infrastructure and in small remote communities. POLHN contributes to improved skills and knowledge among health professionals who can, as a result, deliver better health services in a region as geographically dispersed and isolated as the Pacific.

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Unpacking the policy landscape for implementing an Information Communication Technology (ICT) based in Human Resources Management tool in government health sector in Bangladesh: Findings from a policy review

10.21203/rs.3.rs-156412/v1 ◽

2021 ◽

Author(s):

Dipika Shankar Bhattacharyya ◽

Goutam Kumar Dutta ◽

Iffat Nowrin ◽

Sohana Shafique ◽

Md. Zahidul Islam ◽

...

Keyword(s):

Human Resources ◽

Human Resources For Health ◽

Qualitative Content Analysis ◽

Human Resources Management ◽

Health Sector ◽

Policy Coordination ◽

Management Tool ◽

Monitoring Strategy ◽

Digital Tool ◽

Resources Management

Abstract Introduction: In Bangladesh, to address the challenges of ensuring adequate human resources for health (HRH), the government began implementing a digital tool for HRH management in 2017. However, evidence suggests institutionalizing such tools in low-and-middle-income-countries are impeded by policy aspects like implementation strategy and poor regulatory framework. We aimed to explore factors in the current policy landscape that might facilitate and challenge the implementation of the tool in Bangladesh.Methods: We conducted a review of policies related to ICT implementation and human resources management in health sector in Bangladesh using qualitative content analysis method. Twelve policies have been identified and comprehensive reading was done to ascertain common themes and patterns. A document analysis matrix was developed to synthesize and help interpreting the findings. Results: Regarding facilitators, strong upstream level commitments were reflected in the content of policies in terms of setting out specific objectives, targets, timeline, and budget allocation. However, lack of explicit monitoring strategy and extent of stakeholders’ engagement was not well-defined, ultimately create chances for making downstream implementation disjointed. In addition, effective coordination among stakeholders and different HRH and ICT policies could be strengthened. Discussion: Findings support the current discourse that national commitment plays a vital role in integration of ICTs in health services. However, well-defined monitoring strategy and inter-ministry and intra-ministry policy coordination is crucial.

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Health Education Policies to Maximize the Effectiveness of Human Resources for Health Programs in Low-Income Countries

Journal of General Internal Medicine ◽

10.1007/s11606-016-3934-5 ◽

2016 ◽

Vol 32 (5) ◽

pp. 497-499 ◽

Cited By ~ 2

Author(s):

Cameron Page ◽

Vincent Sugira

Keyword(s):

Health Education ◽

Human Resources ◽

Low Income ◽

Human Resources For Health ◽

Health Programs ◽

Low Income Countries ◽

Education Policies

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Reflections on Health Workforce Development Comment on "Health Professional Training and Capacity Strengthening Through International Academic Partnerships: The First Five Years of the Human Resources for Health Program in Rwanda"

International Journal of Health Policy and Management ◽

10.15171/ijhpm.2018.129 ◽

2018 ◽

Vol 8 (4) ◽

pp. 245-246 ◽

Cited By ~ 4

Author(s):

Gilles Dussault

Keyword(s):

Human Resources ◽

Workforce Development ◽

Low Income ◽

Professional Training ◽

Health Program ◽

Human Resources For Health ◽

Low Income Countries ◽

Health Professional Training ◽

Health Workforce Development

This commentary addresses the statement that "the authors believe that the HRH [Human Resources for Health] Program can serve as a model for other initiatives that seek to address the shortage of qualified health professionals in low-income countries and strengthen the long-term capacity of local academic institutions." I adopt the position of the devil’s advocate and ask whether a country, with a profile comparable to Rwanda’s, should adopt this twinning model. I suggest that the alignment with population and other capacity development needs should be the main criteria of decision.

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The complex remuneration of human resources for health in low-income settings: policy implications and a research agenda for designing effective financial incentives

Human Resources for Health ◽

10.1186/s12960-015-0058-7 ◽

2015 ◽

Vol 13 (1) ◽

Cited By ~ 21

Author(s):

Maria Paola Bertone ◽

Sophie Witter

Keyword(s):

Human Resources ◽

Low Income ◽

Financial Incentives ◽

Research Agenda ◽

Human Resources For Health ◽

Policy Implications

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HEV study protocol : design of a cluster-randomised, blinded trial to assess the safety, immunogenicity and effectiveness of the hepatitis E vaccine HEV 239 (Hecolin) in women of childbearing age in rural Bangladesh

BMJ Open ◽

10.1136/bmjopen-2019-033702 ◽

2020 ◽

Vol 10 (1) ◽

pp. e033702 ◽

Cited By ~ 5

Author(s):

K Zaman ◽

Susanne Dudman ◽

Kathrine Stene-Johansen ◽

Firdausi Qadri ◽

Md Yunus ◽

...

Keyword(s):

Pregnant Women ◽

Public Health Problem ◽

Diarrhoeal Disease ◽

Hepatitis E ◽

Ethical Review ◽

Research Review ◽

Women Of Childbearing Age ◽

Review Committee ◽

Childbearing Age ◽

Rural Bangladesh

IntroductionHepatitis E virus (HEV) is a leading cause of acute viral hepatitis in the developing world and is a public health problem, in particular among pregnant women, where it may lead to severe or fatal complications. A recombinant HEV vaccine, 239 (Hecolin; Xiamen Innovax Biotech, Xiamen, China), is licensed in China, but WHO calls for further studies to evaluate the safety and immunogenicity of this vaccine in vulnerable populations, and to evaluate protection in pregnancy. We are therefore conducting a phase IV trial to assess the effectiveness, safety and immunogenicity of the HEV 239 vaccine when given in women of childbearing age in rural Bangladesh, where HEV infection is endemic.Methods and analysisEnrolment of a target of approximately 20 000 non-pregnant women, aged 16–39 years, started on 2 October 2017 in Matlab, Bangladesh. Sixty-seven villages were randomised by village at a 1:1 ratio to receive either the HEV vaccine or the control vaccine (hepatitis B vaccine). A 3-dose vaccination series at 0, 1 and 6 months is ongoing, and women are followed up for 24 months. The primary outcome is confirmed HEV disease among pregnant women. After vaccination, participants are requested to report information about clinical hepatitis symptoms. Participants who become pregnant are visited at their homes every 2 weeks to collect information about pregnancy outcome and to screen for clinical hepatitis. All suspected hepatitis cases undergo laboratory testing for diagnostic evaluation. The incidence of confirmed HEV disease among pregnant and non-pregnant women will be compared between the HEV vaccinated and control groups, safety and immunogenicity of the vaccine will also be evaluated.Ethics and disseminationThe protocol was reviewed and approved by the International Centre for Diarrhoeal Disease Research, Bangladesh Research Review Committee and Ethical Review Committee, and the Directorate General of Drug Administration in Bangladesh, and by the Regional Ethics Committee in Norway. This article is based on the protocol version 2.2 dated 29 June 2017. We will present the results through peer-reviewed publications and at international conferences.Trial registration numberThe trial is registered at clinicaltrials.gov with the registry name “Effectiveness Trial to Evaluate Protection of Pregnant Women by Hepatitis E Vaccine in Bangladesh” and the identifierNCT02759991.

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Looking back to look forward: a review of human resources for health governance in South Africa from 1994 to 2018

Human Resources for Health ◽

10.1186/s12960-020-00536-1 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Manya Van Ryneveld ◽

Helen Schneider ◽

Uta Lehmann

Keyword(s):

South Africa ◽

Human Resources ◽

National Health ◽

Health Workforce ◽

Human Resources For Health ◽

Successful Implementation ◽

Health Governance ◽

Health Human Resources ◽

The Past ◽

Epidemic Period

AbstractWhile South Africa has had a fairly consistent record of producing national-level strategic plans for human resources for health in the past 25 years, the country continues to face major problems of affordability, availability, distribution and management of its health workforce. There are several factors contributing to the state of health human resources in the country, but problems with governance stand out as one area requiring further research, analysis and critique. This paper presents a retrospective analysis of the historical patterns in national health human resources governance in South Africa, based on a desktop policy review spanning 25 years after democracy. The authors took a multi-pronged, iterative approach, reviewing policy documents alongside grey and published literature. This led to a timeline showing key legislation, relevant health system and human resource policies, interventions, reviews and evaluations from 1994 to 2018. The review identified three distinct periods that help to characterise the terrain of human resources for health governance over the concerned 25 years. Firstly, a foundational period, in which much of the constitutional and legislative groundwork was laid. Secondly, the HIV epidemic period, which presented a major disruption to the development of system wide governance interventions and improvements. Thirdly, the launch of National Health Insurance discussions and policy processes, which signalled a gradual return to a comprehensive systems focus in line with the founding principles of the first period. Using this periodisation, as well as a conceptual framework of health human resources governance functions based on international literature, the authors argue that South Africa has experienced both progress and challenges in human resources for health governance. This has affected the successful implementation of its policy and strategic planning over the past 25 years. Good governance for human resources for health requires capable stewardship, underpinned by an appropriate mix of technical and administrative skills and explicit political support. The review findings suggest that strengthening human resources for health governance roles, including fostering purposeful stewardship by the National Department of Health, may be key to shifting the terrain in the availability and performance of South Africa’s health workforce going forwards.

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Human research review committee requirements in medical journals

Clinical & Investigative Medicine ◽

10.25011/cim.v31i1.3141 ◽

2008 ◽

Vol 31 (1) ◽

pp. 49 ◽

Cited By ~ 7

Author(s):

Scott R. Freeman ◽

Kristy Lundahl ◽

Lisa M. Schilling ◽

J. Daniel Jensen ◽

Robert P. Dellavalle

Keyword(s):

English Language ◽

Human Subjects ◽

Ethics Committee ◽

Ethical Review ◽

Research Review ◽

Review Committee ◽

Ethical Guidelines ◽

Medical Journals ◽

Human Research ◽

Approval Letter

Purpose: Independent ethical review committees safeguard participants in human research. The purpose of this study was to describe the current ethical guidelines for human research requirements in the Instructions to Authors of the English language medical journals previously studied in 1995. Methods: The instructions to authors of English language medicine journals from the Abridged Index Medicus were searched for any policies regarding guidance on the ethical treatment of human subjects in research. Results: More medical journals require independent ethics committee approval of human research now [84/101 (83%)] than 10 years ago [48/102 (47%) (P < 0.001)], and most journals continue to require that this disclosure appear in the manuscript [71/84 (85%) vs. then 37/48 (77%) (P=0.29)]. Fewer medical journal instructions to authors provide no ethical guidelines for human research now [8/101 (8%)] than 10 years ago [25/102 (24%) (P < 0.001)]. No journal required submission of the study approval letter or of the approved protocol. Conclusions: Although medicine journals increasingly require disclosure statements of independent ethics committee approval for human research, they fail to verify such approval beyond taking authors for their word.

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