scholarly journals Filling the Gaps in the Pharmacy Workforce in Post-Conflict Areas: Experience from Four Countries in Sub-Saharan Africa

2021 ◽  
Vol 18 (15) ◽  
pp. 8132
Author(s):  
Anabelle Wong ◽  
Kevin K. C. Hung ◽  
Mzwandile Mabhala ◽  
Justin W. Tenney ◽  
Colin A. Graham
Keyword(s):  
Brain Drain ◽  
Health Workforce ◽  
South Sudan ◽  
Sub Saharan Africa ◽  
Health Coverage ◽  
Health Workforce Retention ◽  
Post Conflict ◽  
Pharmacy Workforce ◽  
Workforce Retention ◽  
Sub Saharan

Background: While the pharmacy workforce is the third largest professional healthcare group worldwide, the pharmacy workforce landscape remains unclear in post-conflict areas in sub-Saharan Africa. Method: Key informants were selected for semi-structured interviews due to their role in providing pharmacy services in the selected country: the Central African Republic (CAR), the Democratic Republic of Congo (DRC), Ethiopia, and South Sudan. Transcripts from the interviews were anonymized, coded, and analyzed. Results: Nine participants were recruited (CAR: 2; DRC: 2; Ethiopia: 2; South Sudan: 3), and all except two were pharmacists. Conflict-specific challenges in pharmacy service delivery were identified as the following: unpredictable health needs and/or mismatched pharmaceutical supply, transport difficulties due to insecure roads, and shortage of pharmacy workforce due to brain drain or interrupted schooling. Barriers to health workforce retention and growth were identified to be brain drain as a result of suboptimal living and working conditions or remuneration, the perception of an unsafe work environment, and a career pathway or commitment duration that does not fit the diaspora or expatriate staff. Conclusion: To tackle the barriers of pharmacy health workforce retention and growth, policy solutions will be required and efforts that can bring about long-term improvement should be prioritized. This is essential to achieve universal health coverage and the targets of the sustainable development goals for conflict affected areas, as well as to “leave no one behind”.

Delivering water services during protracted armed conflicts: How development agencies can overcome barriers to collaboration with humanitarian actors

2019 ◽  
Vol 101 (912) ◽  
pp. 1067-1089
Author(s):  
Edoardo Borgomeo
Keyword(s):  
Service Delivery ◽  
Armed Conflict ◽  
Armed Conflicts ◽  
Sub Saharan Africa ◽  
Contributing Factors ◽  
Emergency Relief ◽  
Organizational Goals ◽  
Post Conflict ◽  
Development Agencies ◽  
Sub Saharan

AbstractThis note discusses the challenges of water service delivery before, during and after protracted armed conflict, focusing on barriers that may impede successful transition from emergency to development interventions. The barriers are grouped according to three major contributing factors (three “C”s): culture (organizational goals and procedures), cash (financing practices) and capacity (know-how). By way of examples, the note explores ways in which development agencies can overcome these barriers during the three phases of a protracted armed conflict, using examples of World Bank projects and experiences in the Middle East and Sub-Saharan Africa. Before the crisis, development agencies need to work to prevent armed conflict. In a situation of active armed conflict or when conflict escalates, development agencies need to remain engaged as much as possible, as this will speed up post-conflict recovery. When conflict subsides, development agencies need to balance the relative effort placed on providing urgently needed emergency relief and water supply and sanitation services with the effort placed on re-establishing sector oversight roles and capacity of local institutions to oversee and manage service delivery in the long term.

Land conflicts and social differentiation in eastern Uganda

2017 ◽  
Vol 55 (3) ◽  
pp. 395-422 ◽  
Author(s):  
Matt Kandel
Keyword(s):  
Large Scale ◽  
Local Level ◽  
Sub Saharan Africa ◽  
Social Differentiation ◽  
Land Conflicts ◽  
Current Period ◽  
Post Conflict ◽  
Sub Saharan ◽  
Historical Developments ◽  
Eastern Uganda

ABSTRACTRising competition and conflict over land in rural sub-Saharan Africa continues to attract the attention of researchers. Recent work has especially focused on land governance, post-conflict restructuring of tenure relations, and large-scale land acquisitions. A less researched topic as of late, though one deserving of greater consideration, pertains to how social differentiation on the local-level shapes relations to land, and how these processes are rooted in specific historical developments. Drawing on fieldwork conducted in Teso sub-region of eastern Uganda, this paper analyses three specific land conflicts and situates them within a broad historical trajectory. I show how each dispute illuminates changes in class relations in Teso since the early 1990s. I argue that this current period of socioeconomic transformation, which includes the formation of a more clearly defined sub-regional middle class and elite, constitutes the most prominent period of social differentiation in Teso since the early 20th century.

scholarly journals Remittances and the Brain Drain: Evidence from Microdata for Sub-Saharan Africa

2018 ◽  
Vol 55 (7) ◽  
pp. 1455-1476 ◽  
Author(s):  
Julia Bredtmann ◽  
Fernanda Martínez Flores ◽  
Sebastian Otten
Keyword(s):  
Brain Drain ◽  
Sub Saharan Africa ◽  
Sub Saharan ◽  
The Brain

scholarly journals Remote health workforce turnover and retention: what are the policy and practice priorities?

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
John Wakerman ◽  
John Humphreys ◽  
Deborah Russell ◽  
Steven Guthridge ◽  
Lisa Bourke ◽  
...  
Keyword(s):  
Health Workforce ◽  
Staff Turnover ◽  
Retention Strategies ◽  
Remote Areas ◽  
Health Workforce Retention ◽  
Workforce Retention ◽  
Fit For Purpose ◽  
Workforce Turnover ◽  
Very High ◽  
Remote Health

Abstract Background Residents of remote communities in Australia and other geographically large countries have comparatively poorer access to high-quality primary health care. To inform ongoing policy development and practice in relation to remote area health service delivery, particularly in remote Indigenous communities, this review synthesizes the key findings of (1) a comprehensive study of workforce turnover and retention in remote Northern Territory (NT) of Australia and (2) a narrative review of relevant international literature on remote and rural health workforce retention strategies. This synthesis provides a valuable summary of the current state of international knowledge about improving remote health workforce retention. Main text Annual turnover rates of NT remote area nurses (148%) and Aboriginal health practitioners (80%) are very high and 12-month stability rates low (48% and 76%, respectively). In remote NT, use of agency nurses has increased substantially. Primary care costs are high and proportional to staff turnover and remoteness. Effectiveness of care decreases with higher turnover and use of short-term staff, such that higher staff turnover is always less cost-effective. If staff turnover in remote clinics were halved, the potential savings would be approximately A$32 million per annum. Staff turnover and retention were affected by management style and effectiveness, and employment of Indigenous staff. Review of the international literature reveals three broad themes: Targeted enrolment into training and appropriate education designed to produce a competent, accessible, acceptable and ‘fit-for-purpose’ workforce; addressing broader health system issues that ensure a safe and supportive work environment; and providing ongoing individual and family support. Key educational initiatives include prioritising remote origin and Indigenous students for university entry; maximising training in remote areas; contextualising curricula; providing financial, pedagogical and pastoral support; and ensuring clear, supported career pathways and continuing professional development. Health system initiatives include ensuring adequate funding; providing adequate infrastructure including fit-for-purpose clinics, housing, transport and information technology; offering flexible employment arrangements whilst ensuring a good ‘fit’ between individual staff and the community (especially with regard to cultural skills); optimising co-ordination and management of services that empower staff and create positive practice environments; and prioritising community participation and employment of locals. Individual and family supports include offering tailored financial incentives, psychological support and ‘time out’. Conclusion Optimal remote health workforce stability and preventing excessive ‘avoidable’ turnover mandates alignment of government and health authority policies with both health service requirements and individual health professional and community needs. Supportive underpinning policies include: Strong intersectoral collaboration between the health and education sectors to ensure a fit-for-purpose workforce;A funding policy which mandates the development and implementation of an equitable, needs-based formula for funding remote health services;Policies that facilitate transition to community control, prioritise Indigenous training and employment, and mandate a culturally safe work context; andAn employment policy which provides flexibility of employment conditions in order to be able to offer individually customised retention packages There is considerable extant evidence from around the world about effective retention strategies that contribute to slowing excessive remote health workforce turnover, resulting in significant cost savings and improved continuity of care. The immediate problem comprises an ‘implementation gap’ in translating empirical research evidence into actions designed to resolve existing problems. If we wish to ameliorate the very high turnover of staff in remote areas, in order to provide an equitable service to populations with arguably the highest health needs, we need political and executive commitment to get the policy settings right and ensure the coordinated implementation of multiple strategies, including better linking existing strategies and ‘filling the gaps’ where necessary.

scholarly journals Tracking Public Health Workforce Retention: Observations From CDC’s Public Health Associate Program

2019 ◽  
Vol 109 (9) ◽  
pp. 1202-1204 ◽  
Author(s):  
Corinne J. Wigington ◽  
Laura T. Colman ◽  
Robyn K. Sobelson ◽  
Andrea C. Young
Keyword(s):  
Public Health ◽  
Health Workforce ◽  
Public Health Workforce ◽  
Health Workforce Retention ◽  
Workforce Retention

OP109 The Need For Building Pharmacists’ Health Technology Assessment Capacity; The Nigerian Scenario

2019 ◽  
Vol 35 (S1) ◽  
pp. 26-26
Author(s):  
Otuto Amarauche Chukwu ◽  
Chizaram Chukwu
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Developed Countries ◽  
Sub Saharan Africa ◽  
Health Coverage ◽  
Healthcare Decision ◽  
Healthcare Decision Making ◽  
Sub Saharan

IntroductionThe role of Health technology assessment (HTA) as a systematic approach in the evaluation of health interventions and technologies is becoming increasingly important as the quest for attaining universal health coverage globally continues to increase. Some developed countries in Europe and the Americas now apply HTA extensively in healthcare policy decisions, however, developing regions and countries like sub-Saharan Africa and Nigeria respectively, seem not to be making significant progress in this area. Given that evidence suggests that Nigeria and indeed several countries in sub-Saharan Africa are performing poorly on most healthcare indices as the region continues to be ravaged by predictable and avoidable epidemics and disease outbreaks, the need to build HTA capacity has never been more paramount.MethodsA review of HTA capability in Nigeria was done. Pharmacists in Nigeria's Capital were randomly sampled. Semi-structured questionnaires were administered. Descriptive statistics were used in data analysis. P values less than 0.05 were considered to be significant.ResultsIn Nigeria, there is no institution tasked with undertaking HTA and there seems to be limited knowledge, capacity and awareness on the issue. Pharmacists, being the most accessible healthcare professionals according to evidence, are a key group that could play an active role in HTA and its implementation in developing countries like Nigeria. However, out of 322 pharmacists randomly sampled, 93 percent were not aware of HTA and its application in healthcare decision-making.ConclusionsThere is no paucity of healthcare programs and plans in Nigeria but they seem to fail due to lack of evidence-based assessment, decision-making and implementation. Hence, there is an increasing need to raise awareness on the importance of HTA in healthcare decision-making; strengthen HTA capacity by developing and sustaining institutional capacity and adequate human resource for HTA; and creating regional annexes of HTA organizations in Africa.

scholarly journals Measuring the availability and geographical accessibility of maternal health services across sub-Saharan Africa

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
A. S. Wigley ◽  
N. Tejedor-Garavito ◽  
V. Alegana ◽  
A. Carioli ◽  
C. W. Ruktanonchai ◽  
...  
Keyword(s):  
Universal Health Coverage ◽  
National Level ◽  
District Level ◽  
Sub Saharan Africa ◽  
World Health ◽  
Health Coverage ◽  
Availability Analysis ◽  
Sub Saharan ◽  
Geographical Accessibility ◽  
Universal Health

Abstract Background With universal health coverage a key component of the 2030 Sustainable Development Goals, targeted monitoring is crucial for reducing inequalities in the provision of services. However, monitoring largely occurs at the national level, masking sub-national variation. Here, we estimate indicators for measuring the availability and geographical accessibility of services, at national and sub-national levels across sub-Saharan Africa, to show how data at varying spatial scales and input data can considerably impact monitoring outcomes. Methods Availability was estimated using the World Health Organization guidelines for monitoring emergency obstetric care, defined as the number of hospitals per 500,000 population. Geographical accessibility was estimated using the Lancet Commission on Global Surgery, defined as the proportion of pregnancies within 2 h of the nearest hospital. These were calculated using geo-located hospital data for sub-Saharan Africa, with their associated travel times, along with small area estimates of population and pregnancies. The results of the availability analysis were then compared to the results of the accessibility analysis, to highlight differences between the availability and geographical accessibility of services. Results Despite most countries meeting the targets at the national level, we identified substantial sub-national variation, with 58% of the countries having at least one administrative unit not meeting the availability target at province level and 95% at district level. Similarly, 56% of the countries were found to have at least one province not meeting the accessibility target, increasing to 74% at the district level. When comparing both availability and accessibility within countries, most countries were found to meet both targets; however sub-nationally, many countries fail to meet one or the other. Conclusion While many of the countries met the targets at the national level, we found large within-country variation. Monitoring under the current guidelines, using national averages, can mask these areas of need, with potential consequences for vulnerable women and children. It is imperative therefore that indicators for monitoring the availability and geographical accessibility of health care reflect this need, if targets for universal health coverage are to be met by 2030.

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