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Human Resources for Health


Building a Supportive Supervision System

Developed for the USAID Health Systems Strengthening II Project in Jordan, Initiatives Inc., 2014.

The Health Systems Strengthening (HSS) II Project worked to build the capacity of managerial and clinical staff to sustain improvements in Jordan’s health system. A strong supervision system can improve the effectiveness and sustainability of the processes and systems aimed at improving the quality of and access to high priority health services. This report describes the approach to building a supportive supervision system in the Jordanian Ministry of Health.

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See also: Jordan Health Systems Strengthening II Project

Human Resources Performance Improvement Summary Report

Developed for the USAID SUSTAIN Project, Initiatives Inc., 2014.

The USAID/SUSTAIN project works to improve HIV/AIDS service delivery in 18 regional referral and general hospitals that are part of Uganda’s MOH system. The project assists the MOH with the integration of HIV/AIDS services into general health services in the public healthcare system. This brief report presents key results from a human resources performance improvement (HRPI) activity that SUSTAIN conducted to address some of the challenges related to staffing and human resources (HR) management that affect productivity and efficiency in HIV counseling and testing (HTC) services.

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See also: SUSTAIN Project

Improving CHW Program Functionality, Performance and Engagement: Operations Research Results from Zambia

Developed for the USAID Health Care Improvement Project (HCI). Initiatives Inc., 2012.

Community health workers (CHWs) are making a substantial contribution to health service delivery the world over. They contribute to filling significant health human resources gaps and they are critical to achieving the Millennium Development Goals (MDGs). Many programs and countries have begun the large-scale deployment of community health workers to improve access to essential health services. Experience shows, however, that while crucial, community health worker programs are often fraught with significant human resources challenges. The USAID-funded Health Care Improvement Project (HCI) developed the Community Health Worker Assessment and Improvement Matrix (CHW AIM) to help assess and strengthen CHW program functionality. HCI conducted operations research in Zambia to test CHW AIM’s effectiveness as an improvement tool and to determine if associations exist among CHW program functionality, CHW performance and CHW engagement. This Research and Evaluation Report – Improving CHW Program Functionality, Performance and Engagement: Operations Research Results from Zambia – presents the findings of the CHW AIM operations research activity.


See also: Health Care Improvement Project

Revised National Tuberculosis Control Programme Preliminary Workload Review

Developed for the USAID Tuberculosis IQC Task Order 01 India Project (TB India). Initiatives Inc., 2011.

The India Revised National Tuberculosis Programme (RNTCP) is now striving toward a new target of universal access. The staffing implications of this scale-up are significant, and the Central TB Division (CTD) is concerned that RNTCP may exceed the capacity of its current staff. The purpose of this review was to examine the implications of scale-up of five categories of staff: senior treatment supervisors (STS), senior tuberculosis laboratory supervisors (STLS), data entry operators (DEOs), part-time accountants (PTAs), and information, education and communication (IEC) officers.


SUSTAIN Human Resource Assessment Summary Report

Developed for the USAID Strengthening Uganda’s Systems for Treating AIDS Nationally (SUSTAIN). Initiatives Inc./University Research Co., 2012.

The USAID-funded Strengthening Uganda’s Systems for Treating AIDS Nationally Project (SUSTAIN) is working to expand and improve the quality of HIV/AIDS services provided at 19 hospitals across Uganda. This human resources assessment was designed to provide data to help SUSTAIN develop an effective human resources sustainability plan. This report presents the findings of the SUSTAIN Human Resources Assessment.


See also: Sustain

Aligning and Clarifying Health Worker Tasks to Improve Maternal Care in Niger

Developed for the USAID Health Care Improvement Project (HCI). Initiatives Inc., 2011.

Throughout Africa, the human resources crisis in the public health system has become one of the biggest challenges in attaining the Millennium Development Goals (MDGs). In the face of difficult working environments and inadequate support, health workers are often unprepared and unable to meet the high demands placed on them; they lose motivation, become disengaged, or vacate their posts altogether. This report describes pioneering work in Niger by the USAID Health Care Improvement Project (HCI) to apply quality improvement methods to strengthen human resources management and performance at the facility- and district-management level to improve maternal care in the Tahoua Region.


CHW AIM: A Toolkit for Improving Community Health Worker Programs and Services

Developed for the Health Care Improvement Project (HCI) by Lauren Crigler, Rebecca Furth and Donna Bjerregaard, Initiatives Inc. and Kathleen Hill, University Research Co., 2011

The Community Health Worker Assessment and Improvement Matrix (CHW AIM) process was developed to help organizations assess and improve CHW program performance. CHW AIM includes a guided self-assessment and performance improvement process to help organizations identify program strengths and address gaps. Through discussion and review of practices, the process builds consensus and commitment to change, and offers guidance for improving functionality. The toolkit includes an introduction to the process, the CHW program functionality matrix, resources and materials to use during each stage (preparation, assessment and scoring, action planning, and follow-up), a facilitator’s guide, and a training guide. Download the CHW AIM Toolkit here.

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See also: USAID Health Care Improvement Project, 2011

Guidelines for Supportive Supervision in the Health Sector
including the Integrated Supportive Supervision Checklists (ISCLs)

Developed for the Ethiopian Ministry of Health under the Essential Services for Health in Ethiopia II Project. Initiatives Inc., 2008.

The Integrated Supportive Supervision Checklists (ISCLs) are designed to help guide a more holistic and constructive approach to supervision. The ISCLs measure performance against standards, highlight priority areas in need of support and guide action planning. While comprehensive and integrated, these tools are meant to be used in full only periodically, with more focused supervision being the norm. This is especially important in contexts where few staff are available for supervision and transportation to make supervision visits is difficult to obtain. Scoring systems were added to these checklists to help managers and supervisors identify areas most in need of support so they could target supervision and support activities on a limited number of issues. Leaders of the Regional Health Bureaus in all three regions supported by ESHE expanded the checklist to cover a wider range of issues, but radically shorter versions of the checklist are possible and desirable. Adaptation to other country contexts should consider the framework, approach and scoring methodologies represented in these checklists as they worked well, were appreciated by staff and managers and are relevant to a range of country contexts.

Human Resource Development Plan

Developed for the Ministry of Health in Jordan under the Human Resource Development Project by Jennifer Huddart, Initiatives Inc., 2005.

The goal of the Human Resource Assessment and Development project was to provide the Jordan Ministry of Health with the information to be able to make decisions about the future of their human resources and to have an understanding of the approaches and the tools which will help them to continue to monitor and plan for their human resources as circumstances change in the future. This report summarizes the key findings of the project, including a mapping of the central MOH, a baseline analysis, studies of MOH retention and management policies, and workforce projections. (These documents are also available individually, in hard copy only).



Rwanda Human Resources Assessment for HIV/AIDS Service Scale-Up

Prepared for the Quality Assurance Project by Rebecca Furth, Robert Gass, and Jean Kagubare, Initiatives Inc., 2005-06.

This series of reports emerged from a nine-month study of the human resources and HIV/AIDS situation in Rwanda. The purpose of the study was to assist the Government of Rwanda to determine how many staff, or what types and at what costs would be required to meet HIV/AIDS service delivery goals. The study documents include a Summary Report, containing highlights of study findings and recommendations; Phase 1 Report, documenting the national human resources situation; Phase 2 Report, detailing findings of sample site data collection at 20 different facilities across Rwanda; and Phase 3 Report, presenting analysis of staffing requirements and scenarios for HIV/AIDS scale-up.

Performance Improvement Review (PIR): Resources and Tools for NGOs & CBOs (Interactive CD)

Developed for the Zambia Integrated Health Programme (ZIHP) by Initiatives Inc., 2004.

The Performance Improvement Review is a self-directed process for improving the effectiveness, sustainability and quality of NGO programs. Guidance and tools for conducting PIRs have been packaged as a CD-ROM to make the materials more accessible to users. The tools address six different program areas: family planning; growth monitoring and promotion; HIV/AIDS (home-based care, VCT, and peer education); malaria; safe motherhood; and water and sanitation, and are designed for use by Program Managers, Donors, District Health Management Teams, and Trainers.


Zambia HIV/AIDS Workforce Study: Preparing for Scale-Up 

Developed for the Central Board of Health in Zambia under the USAID-funded Quality Assurance Project by Jenny Huddart, Rebecca Furth, Joyce V. Lyons, Initiatives Inc., 2004.

Anticipating massive scale-up of its HIV Voluntary Counseling and Testing (VCT), Prevention of Mother-to Child Transmission (P-MTCT), and Anti-Retroviral Therapy (ART) services with a Global Fund award, the Central Board of Health in Zambia commissioned a study of the human resource implications of its intended national expansion of current HIV/AIDS services. The research was carried out by Initiatives through the Quality Assurance Project.

The study collected data at 16 government, NGO, and private sites across Zambia that currently provide VCT, P-MTCT, and ART services, to determine the staffing and cost implications of scale-up. The study's approach and results will be of particular interest to individuals, programs, and countries concerned with the human resource implications of scaling up HIV/AIDS services.


The Health Sector Human Resource Crisis in Africa: An Issues Paper

Initial draft prepared for the Academy for Educational Development by Jenny Huddart, Initiatives Inc., 2002-2003.

This issues paper was prepared under the USAID-funded Support for Analysis and Research in Africa (SARA) project to discuss the human resources crisis in sub-Saharan Africa. The paper, initially drafted by Initiatives’ Vice President Jenny Huddart, was used as a background document for the meeting organized by the World Bank and WHO/AFRO on “Building Strategic Partnerships in Education in Health in Africa” held in Addis Ababa, Ethiopia in January/February 2002.


Human Resources Study: A Report Compiled from the Ministry of Health and Child Welfare, Zimbabwe

Jenny Huddart and Martha Musarurwa. Initiatives, Inc., February 1999.

This study was designed to assist the Zimbabwean Ministry of Health and Child Welfare (MOHCW), providing guidance for the provision of adequate numbers of properly qualified and well-motivated staff. The Study includes information regarding the present (1999) staffing situation and minimum staffing standards for the health sector in Zimbabwe. This information was compiled to enable the MOHCW to project the numbers of staff required in the next 10 years and the feasibility, in terms of professional training, of reaching the staffing targets within the decade.

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