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.
See also: Jordan Health Systems Strengthening II Project
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.
See also: SUSTAIN Project
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
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)
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
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
Developed for the Health Care
Improvement Project (HCI) by Lauren Crigler, Rebecca Furth and Donna
Bjerregaard, Initiatives Inc. and Kathleen Hill, University Research
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
See also: USAID Health Care Improvement Project, 2011
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.
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).
Prepared for the Quality Assurance Project by Rebecca Furth, Robert Gass, and Jean Kagubare, Initiatives Inc.,
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
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.
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.
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
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.