Qualified Health Workers Research Articles

Analysis of the Needs and Development of Health Service Personnel at the Simalingkar Health Center in Medan City

The need and development of health service personnel as an integral part of health development is directed to meet the needs of the number and type of qualified health workers in providing all kinds of health service needs. This study aims to determine the needs of health workers both quantity and quality at the Simalingkar Health Center in Medan City. This research includes Descriptive Research with a qualitative approach, to find and obtain information about the analysis of energy needs at the Simalingkar Health Center in Medan City. The data and information obtained are then compared with the capabilities currently possessed with those expected for planning managers in the preparation of labor analysis of each work unit associated with the description and specifications of work at the Simalingkar Health Center in Medan City. The types of data used in this study are primary data and secondary data. Primary data are obtained through interviews and observations, while secondary data are obtained through tracing official records (documentation). The results showed that the preparation of health worker planning has been carried out so that the analysis of energy needs both in quantity and quality has been well planned. The number of health workers for the implementation of health services is quite sufficient at the Simalingkar Health Center in Medan City. Where health service personnel at Puskesmas have met the standards, or by the Minister of Health Regulation Number 75 of 2014. That way, the needs and development of health workers are well implemented.

A blended learning using contextual teaching learning: strengthening nursing students’ procedural knowledge and interprofessional collaboration

Introduction:The level of knowledge about the types of teaching instruction through blended learning in nursing education is still lacking. This study aims to develop blended learning using contextual learning and evaluate its effect on procedural knowledge and interprofessional collaboration. Methods: A quasi-experimental study was conducted from January to March 2022. The total participants were 96 students from one of the nursing departments in Indonesia, who were equally divided into experimental and control groups. The experimental group received a blended learning method with a combination of contextual learning for 400 minutes for four meetings. Meanwhile, 48 students in the control group received traditional blended learning. Mann-Whitney U test to compare between treatment and control groups. The instrument used to measure the interprofessional education variable was the Nurse–Physician Collaboration Scale and procedural knowledge was measured through a test of 25 multiple choice questions about procedural knowledge. Results: The implementation of blended learning based on contextual teaching significantly increased their procedural knowledge (pre M = 43.30 vs post M = 79.00), and interprofessional collaboration (pre M = 58.08 vs post M = 83.79) with p-value < 0.01. Conclusions: Blended learning using contextual learning was effective for increasing procedural knowledge and interprofessional collaboration in nursing students. The application of this instruction is highly recommended for nursing departments in higher education institutions as an effort to achieve qualified health workers for sustainable development and well-being.

MANAGEMENT OF MIGRATION OF PERSONNEL IN HEALTHCARE WITH AN EMPHASIS ON NURSES AND TECHNICIANS IN THE REPUBLIC OF CROATIA

Active management of personnel in healthcare is a dynamic process that needs to be decided by the guidelines of the healthcare reform. Health personnel is considered the greatest and most important potential of health care, the basic intention is to strengthen health personnel of all profiles in accordance with the needs of society. The importance of the role of nurses in providing care in hospitals and long-term care facilities under normal circumstances was particularly pronounced during the COVID-19 pandemic. The lack of high- and middle-level health workers is not an isolated phenomenon in Croatia but also exists at the level of the entire EU, therefore the description of jobs and responsibilities increases according to the level of education. The aim of this work is to analyze the management of human resources in healthcare with an emphasis on senior and middle staff, and here we mean nurses and technicians. The scientific contribution of this work is manifested in the detection of socio-political and economic causes of the failure to train an adequate number of qualified health workers, as well as insufficient steps in their attraction and retention.

The Correlation Of Preeclampsia, Age, And Type Of Delivery In Postpartum Hemorrhage

The number of maternal deaths in Semarang City in 2021 was 21 cases out of 22,030 live births, or around 95.32 deaths per 100,000 live births, with the causes of death dominated by bleeding (14.29%) and hypertension (9.52%). Postpartum hemorrhage is caused by four main factors known as the 4T: tone, trauma, tissue, and thrombin. This study was conducted to determine the relationship between preeclampsia, maternal age, and type of delivery with the incidence of postpartum hemorrhage at Central General Hospital Dr. Kariadi Semarang in 2020–2022. The study was an analytic observational quantitative research with a retrospective case control study. The study was conducted in February 2023 with a total sample of 100 samples divided into case (total sampling) and control (simple random sampling) groups with a ratio of 1: 1 for each group. Statistical tests used Chi-square and odds ratio (OR) tests. The results showed that there was no relationship between preeclampsia and the incidence of postpartum hemorrhage (p-value = 0.063; OR = 0.347), there was a relationship between maternal age and the incidence of postpartum hemorrhage (p-value = 0.011; OR = 3.455), and there was a relationship between the type of delivery and postpartum hemorrhage (p-value = 0.012; OR = 2.923). The community can be expected to play an active role in integrated service post cadre activities and ante natal care assistance. Health workers and educational institutions also need to improve their knowledge and skills to form qualified health workers through certified training.

Community knowledge, attitude, practices and beliefs associated with persistence of malaria transmission in North-western and Southern regions of Tanzania

BackgroundDespite significant decline in the past two decades, malaria is still a major public health concern in Tanzania; with over 93% of the population still at risk. Community knowledge, attitudes and practices (KAP), and beliefs are key in enhancing uptake and utilization of malaria control interventions, but there is a lack of information on their contribution to effective control of the disease. This study was undertaken to determine KAP and beliefs of community members and service providers on malaria, and how they might be associated with increased risk and persistence of the disease burden in North-western and Southern regions of Tanzania.MethodsThis was an exploratory study that used qualitative methods including 16 in-depth interviews (IDI) and 32 focus group discussions (FGDs) to collect data from health service providers and community members, respectively. The study was conducted from September to October 2017 and covered 16 villages within eight districts from four regions of mainland Tanzania (Geita, Kigoma, Mtwara and Ruvuma) with persistently high malaria transmission for more than two decades.ResultsMost of the participants had good knowledge of malaria and how it is transmitted but some FGD participants did not know the actual cause of malaria, and thought that it is caused by bathing and drinking un-boiled water, or consuming contaminated food that has malaria parasites without warming it. Reported barriers to malaria prevention and control (by FGD and IDI participants) included shortage of qualified health workers, inefficient health financing, low care-seeking behaviour, consulting traditional healers, use of local herbs to treat malaria, poverty, increased breeding sites by socio-economic activities and misconceptions related to the use of bed nets and indoor residual spraying (IRS). Among the misconceptions, some participants believed that bed nets provided for free by the government came with bedbugs while others reported that free bed nets caused impotence among men.ConclusionDespite good knowledge of malaria, several risk factors, such as socio-economic and behavioural issues, and misconceptions related to the use of bed nets and IRS were reported. Other key factors included unavailability or limited access to health services, poor health financing and economic activities that potentially contributed to persistence of malaria burden in these regions. Relevant policies and targeted malaria interventions, focusing on understanding socio-cultural factors, should be implemented to reduce and finally eliminate the disease in the study regions and others with persistent transmission.

Preparedness to assume professional roles: experiences of recently qualified radiographers: A qualitative study.

Recently qualified health workers including radiographers struggle with workplace integration. Similarly, in our local context, undocumented complaints were received from the various heads of departments and radiologists regarding recently qualified radiographers' ability to fully assume their professional roles. In light of the complaints, this study sought to explore and describe the lived experiences of recently qualified radiographers from one local University on their readiness to assume their professional roles. A qualitative, descriptive research design with a phenomenological approach was used to conduct the study. Ten (10) diagnostic radiographers who graduated between 2018 and 2020 from the local university were sampled using the snowball sampling technique. Telephonic interviews were conducted using a semi-structured interview guide. Data were analysed using Tesch's open coding method. The findings of this study have shown a combination of positive and negative experiences by recently qualified radiographers. The positive experiences (satisfactory work engagement) emanate from increased confidence and creativity, responsibility consciousness and teamwork. Negative experiences (reality shock and professional role conflict) emanated from excessive workload, patient care impediments, the burden of student supervision and lack of professional trust. Though the recently qualified radiographers from our local University experienced some contextual challenges upon assuming their professional roles, they appeared well-prepared for their clinical roles. Standardised induction and mentorship programmes should be implemented to facilitate the transition process from student to qualified radiographer.

PELAKSANAAN ASUHAN KEBIDANAN KOMPREHENSIF PADA NY. E UMUR 27 TAHUN DI PUSKESMAS SEKAR BIRU KABUPATEN BANGKA BARAT

The process of pregnancy, childbirth, postpartum, and having a baby is a physiological thing for every woman. Complications of pregnancy could be happened in the form of mild or severe complications that can cause pain, disability, and even death for both mother and baby. For this reason, pregnant women are recommended to carry out antenatal care or pregnancy check at least 6 times. The aim of this Final Project was to provide comprehensive midwifery care starting from pregnancy, childbirth, newborns, and family planning using SOAP documentation. This study was conducted in February-April 2022 using data collection methods through interviews and observations. The midwifery care provided to Mrs. E includes pregnancy check-ups 2 times, delivery once, postpartum and newborn visits 4 times, and family planning counseling once. At 38 weeks 5 days of gestation, Mrs. E gave birth at the Sekar Biru health center with a normal delivery. Mrs. E’s baby was born spontaneously and immediately cried with male quality and birth weight 3100 grams and birth length 50 cm. when the baby was a week old, Mrs. E turned out to have given formula milk as an alternative to breast milk. Based on research that has been done, it can be concluded that there are some gaps between theory and practice . Therefore, students are expected to continue to apply quality midwifery care management in order to become competent and qualified health workers.

Evolution of assisted deliveries at primary healthcare centres in an unstable security context in Mali

IntroductionIn Mali, healthcare systems are severely affected by conflict. However, several studies suggest a lack of knowledge about its impact on maternal healthcare. Frequent and repeated attacks increase insecurity, limit...

Enumeration of the Public Health Workforce in New York State: Workforce Changes in the Wake of COVID-19.

The governmental public health workforce in the United States has faced staffing shortages for over a decade that have been exacerbated by the COVID-19 pandemic. To assess this critical issue, the Region 2 Public Health Training Center collaborated with the New York State Association of County Health Officials to enumerate the city and county public health workforce in New York State. The organizations used an online survey to: (1) count employees and full-time equivalent (FTEs) staff in local health departments in 2021; (2) assess workforce trends since the COVID-19 pandemic; and, (3) identify challenges local health departments encounter in recruiting and retaining qualified public health workers. To assess trends, findings were compared with secondary data from 2019. Despite playing a central role in COVID-19 mitigation, local health departments experienced no overall increase in staffing in 2021 compared to 2019, with many health departments experiencing large increases in vacant positions. Recruitment challenges include noncompetitive salaries, difficulties finding qualified candidates, and lengthy hiring processes. This study complements accumulating evidence indicating that long-term investment in local public health infrastructure is needed to bolster the workforce and ensure that communities are protected from current and future health threats.

Online Recruitment Processes, Online Selection and Human Resources Development: A Significant Influence on Quality of Health Personnel

Background and Purpose Health workers are the main key to the success of achieving health development goals. As a very decisive first step for the availability of qualified health workers, the recruitment and selection process for health workers and the development of human resources is carried out. The purpose of this study was to analyze the effect of the recruitment, selection, and development of human resources together or partially on the quality of work of health workers at Citra Sundari Hospital. Method; The research method used is a quantitative approach with an associative correlation type. The population of this study was all health workers at Citra Sundari Hospital. The sample of this study was 80 health workers. The proposed hypothesis has an influence on the recruitment process, a system of selection and development of human resources independently or jointly on the quality of work of health workers. Results; The process of recruitment, selection, and development of human resources together partially affect the quality of work of health workers at Citra Sundari Hospital. Implications; The results of this study provide direction and input related to the recruitment, selection, and development of human resources so that hospitals have quality health workers.

Improving Post-discharge Practice of Kangaroo Mother Care: Perspectives From Communities in East-Central Uganda.

IntroductionKangaroo mother care (KMC) is among the most cost-effective and easily accessible solutions for improving the survival and wellbeing of small newborns. In this study, we examined the barriers and facilitators to continuity of KMC at home following hospital discharge in rural Uganda.MethodsWe conducted this study in five districts in east-central Uganda, within six hospitals and at the community level. We used a qualitative approach, with two phases of data collection. Phase 1 comprised in-depth interviews with mothers who practiced KMC with their babies and caretakers who supported them and key informant interviews with health workers, district health office staff, community health workers, and traditional birth attendants. We then conducted group discussions with mothers of small newborns and their caretakers. We held 65 interviews and five group discussions with 133 respondents in total and used a thematic approach to data analysis.ResultsIn hospital, mothers were sensitized and taught KMC. They were expected to continue practicing it at home with regular returns to the hospital post-discharge. However, mothers practiced KMC for a shorter time at home than in the hospital. Reasons included being overburdened with competing domestic chores that did not allow time for KMC and a lack of community follow-up support by health workers. There were increased psycho-social challenges for mothers, alongside some dangerous practices like placing plastic cans of hot water near the baby to provide warmth. Respondents suggested various ways to improve the KMC experience at home, including the development of a peer-to-peer intervention led by mothers who had successfully done KMC and community follow-up of mothers by qualified health workers and community health workers.ConclusionDespite wide acceptance of KMC by health workers, challenges to effective implementation persist. Amid the global and national push to scale up KMC, potential difficulties to its adherence post-discharge in a rural, resource-limited setting remain. This study provides insights on KMC implementation and sustainability from the perspectives of key stakeholders, highlighting the need for a holistic approach to KMC that incorporates its adaptability to community settings and contexts.

Investigating the Potential for Clinical Decision Support in Sub-Saharan Africa With AFYA (Artificial Intelligence-Based Assessment of Health Symptoms in Tanzania): Protocol for a Prospective, Observational Pilot Study.

BackgroundLow- and middle-income countries face difficulties in providing adequate health care. One of the reasons is a shortage of qualified health workers. Diagnostic decision support systems are designed to aid clinicians in their work and have the potential to mitigate pressure on health care systems.ObjectiveThe Artificial Intelligence–Based Assessment of Health Symptoms in Tanzania (AFYA) study will evaluate the potential of an English-language artificial intelligence–based prototype diagnostic decision support system for mid-level health care practitioners in a low- or middle-income setting.MethodsThis is an observational, prospective clinical study conducted in a busy Tanzanian district hospital. In addition to usual care visits, study participants will consult a mid-level health care practitioner, who will use a prototype diagnostic decision support system, and a study physician. The accuracy and comprehensiveness of the differential diagnosis provided by the diagnostic decision support system will be evaluated against a gold-standard differential diagnosis provided by an expert panel.ResultsPatient recruitment started in October 2021. Participants were recruited directly in the waiting room of the outpatient clinic at the hospital. Data collection will conclude in May 2022. Data analysis is planned to be finished by the end of June 2022. The results will be published in a peer-reviewed journal.ConclusionsMost diagnostic decision support systems have been developed and evaluated in high-income countries, but there is great potential for these systems to improve the delivery of health care in low- and middle-income countries. The findings of this real-patient study will provide insights based on the performance and usability of a prototype diagnostic decision support system in low- or middle-income countries.Trial RegistrationClinicalTrials.gov NCT04958577; http://clinicaltrials.gov/ct2/show/NCT04958577International Registered Report Identifier (IRRID)DERR1-10.2196/34298

Implementing a health labour market analysis to address health workforce gaps in a rural region of India

BackgroundHuman Resources for Health (HRH) are essential for making meaningful progress towards universal health coverage (UHC), but health systems in most of the developing countries continue to suffer from serious gaps in health workforce. The Global Strategy on Human Resources for Health—Workforce 2030, adopted in 2016, includes Health Labor Market Analysis (HLMA) as a tool for evidence based health workforce improvements. HLMA offers certain advantages over the traditional approach of workforce planning. In 2018, WHO supported a HLMA exercise in Chhattisgarh, one of the predominantly rural states of India.MethodsThe HLMA included a stakeholder consultation for identifying policy questions relevant to the context. The HLMA focused on state HRH at district-level and below. Mixed methods were used for data collection and analysis. Detailed district-wise data on HRH availability were collected from state’s health department. Data were also collected on policies implemented on HRH during the 3 year period after the start of HLMA and changes in health workforce.ResultsThe state had increased the production of doctors but vacancies persisted until 2018. The availability of doctors and other qualified health workers was uneven with severe shortages of private as well as public HRH in rural areas. In case of nurses, there was a substantial production of nurses, particularly from private schools, however there was a lack of trusted accreditation mechanism and vacancies in public sector persisted alongside unemployment among nurses. Based on the HLMA, pragmatic recommendations were decided and followed up. Over the past 3 years since the HLMA began an additional 4547 health workers including 1141 doctors have been absorbed by the public sector. The vacancies in most of the clinical cadres were brought below 20%.ConclusionThe HLMA played an important role in identifying the key HRH gaps and clarifying the underlying issues. The HLMA and the pursuant recommendations were instrumental in development and implementation of appropriate policies to improve rural HRH in Chhattisgarh. This demonstrates important progress on key 2030 Global Strategy milestones of reducing inequalities in access to health workers and improving financing, retention and training of HRH.

Evaluating the potential cost-effectiveness of microarray patches to expand access to hepatitis B birth dose vaccination in low-and middle-income countries: A modelling study.

Timely birth dose vaccination is key for achieving elimination of hepatitis B, however, programmatic requirements for delivering current vaccine presentations to births outside of health facilities inhibits coverage within many low-and middle-income countries (LMICs). Vaccine technologies in development such as microarray patches (MAPs) could assist in overcoming these barriers, but procurement could incur higher per-dose commodity costs than current ten-dose (US$0.34) and single-dose (US$0.62) vial presentations, necessitating an evaluation of the economic value proposition for MAPs. Within 80 LMICs offering universal hepatitis B birth dose vaccination, the cost-effectiveness of using MAPs to expand coverage was evaluated using a mathematical model. We considered three potential per dose MAP prices (US$1.65, US$3.30, and US$5.00), and two potential MAP use-cases: (1) MAPs are used by lay-health workers to expand birth dose coverage outside of health facility settings, and (2) MAPs are also preferred by qualified health workers, replacing a proportion of existing coverage from vaccine vials. Analysis took the health system perspective, was costed in 2020 US$, and discounted at 3% annually. Across minimal (1% additional coverage) and maximal (10% additional and 10% replacement coverage) MAP usage scenarios, between 2.5 (interquartile range [IQR]: 1.9, 3.1) and 38 (IQR: 28,44) thousand DALYs were averted over the estimated 2020 birth cohort lifetime in 80 LMICs. Efficiency of MAPs was greatest when used to provide additional coverage (scenario 1), on average saving US$88.65 ($15.44, $171.22) per DALY averted at a price of US$5.00 per MAP. Efficiency was reduced when used to replace existing coverage (scenario 2); however, at prices up to US$5.00 per MAP, we estimate this use-case could remain cost-effective in at least 73 (91%) modelled LMICs. Our findings suggest even at higher procurement costs, MAPs are likely to represent a highly cost-effective or cost-saving mechanism to expand reach of birth dose vaccination in LMICs.

The political economy of priority-setting for health in South Sudan: a case study of the Health Pooled Fund

BackgroundIn fragile and conflict affected settings (FCAS) such as South Sudan, where health needs are immense, resources are scarce, health infrastructure is rudimentary or damaged, and government stewardship is weak, adequate health intervention priority-setting is especially important. There is a scarcity of research examining priority-setting in FCAS and the related political economy. Yet, capturing these dynamics is important to develop context-specific guidance for priority-setting. The objective of this study is to analyze the priority-setting practices in the Health Pooled Fund (HPF), a multi-donor fund that supports service delivery in South Sudan, using a political economy perspective.MethodsA multi-method study was conducted combining document review, 30 stakeholder interviews, and an examination of service delivery. An adapted version of the Walt and Gilson policy analysis triangle guided the study’s design and analysis.ResultsPriority-setting in HPF occurs in a context of immense fragility where health needs are vast, service delivery remains weak, and external funding is essential. HPF's service package gives priority to the health of mothers and children, gender-sensitive programming, immunization services, and a community health initiative. HPF is structured by a web of actors at national and local levels with pronounced power asymmetries and differing vested interests and ideas about HPF’s role. Priority-setting takes place throughout program design, implementing partner (IP) contract negotiation, and implementation of the service package. In practice the BPHNS does not provide adequate guidance for priority-setting because it is too expansive and unrealistic given financial and health system constraints. At the local level, IPs must manage the competing interests of the HPF program and local health authorities as well as challenging contextual factors, including conflict and shortages of qualified health workers, which affect service provision. The resulting priority-setting process remains implicit, scarcely documented, and primarily driven by donors’ interests.ConclusionThis study highlights power asymmetries between donors and national health authorities within a FCAS context, which drive a priority-setting process that is dominated by donor agendas and leave little room for government ownership. These findings emphasize the importance of paying attention to the influence of stakeholders and their interests on the priority-setting process in FCAS.

An overview of health workforce education and accreditation in Africa: implications for scaling-up capacity and quality

BackgroundFor countries to achieve universal health coverage, they need to have well-functioning and resilient health systems. Achieving this requires a sufficient number of qualified health workers and this necessitates the importance of investments in producing and regulating health workers. It is projected that by 2030, Africa would need additional 6.1 million doctors, nurses, and midwives. However, based on the current trajectory, only 3.1 million would be trained and ready for service delivery. To reduce current shortages of the health workforce, Africa needs to educate and train 3.0 million additional health workers by 2030. This study was conducted to describe the distribution and ownership of the health training institutions, production of health workers, and the availability of accreditation mechanisms for training programmes in the WHO African Region.MethodsA cross-sectional study was conducted using a standardized questionnaire from January 2018 to April 2019. All the 47 countries in the Region were invited to complete a structured questionnaire based on available secondary information from health sector reports, annual HRH reports, country health workforce profiles, and HRH observatories and registries.ResultsData from 43 countries in the World Health Organization African Region in 2018 show that there were 4001 health training institutions with 410, 1469 and 2122 being medical, health sciences, and nursing and midwifery schools, respectively, and 2221, 1359 and 421 institutions owned by the public, private for-profit and private not-for-profit sectors, respectively. A total of 148 357 health workers were produced in Region with 40% (59, 829) being nurses and midwives, 19% (28, 604) other health workers, and 14% (20 470) physicians. Overall, 31 countries (79%) in the Region have an accreditation framework for the health training institutions and seven countries do not have any accreditation mechanism.ConclusionTo achieve universal health coverage, matching of competencies with population needs, as well as increasing capacities for health worker production to align with demand (numbers and skill-mix) for improved service delivery should be prioritized, as this would improve the availability of skilled health workforce in the Region.

A comparison of health system responses to COVID-19 in Bulgaria, Croatia and Romania in 2020

This article compares the health system responses to COVID-19 in Bulgaria, Croatia and Romania from February 2020 until the end of 2020. It explores similarities and differences between the three countries, building primarily on the methodology and content compiled in the COVID-19 Health System Response Monitor (HSRM). We find that all three countries entered the COVID-19 crisis with common problems, including workforce shortages and underdeveloped and underutilized preventive and primary care. The countries reacted swiftly to the first wave of the COVID-19 pandemic, declaring a state of emergency in March 2020 and setting up new governance mechanisms. The initial response benefited from a centralized approach and high levels of public trust but proved to be only a short-term solution. Over time, governance became dominated by political and economic considerations, communication to the public became contradictory, and levels of public trust declined dramatically. The three countries created additional bed capacity for the treatment of COVID-19 patients in the first wave, but a greater challenge was to ensure a sufficient supply of qualified health workers. New digital and remote tools for the provision of non-COVID-19 health services were introduced or used more widely, with an increase in telephone or online consultations and a simplification of administrative procedures. However, the provision and uptake of non-COVID-19 health services was still affected negatively by the pandemic. Overall, the COVID-19 pandemic has exposed pre-existing health system and governance challenges in the three countries, leading to a large number of preventable deaths.

Management of Biohazards and Pandemics: COVID-19 and Its Implications in the Construction Sector

This paper investigates the impact of biohazards and pandemics on construction workers’ health and well-being. A proper selection of control methods for biohazards and pandemics like COVID-19 pandemic will result in improved public health conditions. Occupational risks in the construction industry are also examined, with a focus on biohazards and pandemics, their containment, and the implications for health and safety. A safer work environment in the construction industry is encouraged. In this study, some statistical methods were used to analyse the data obtained from sampled questionnaire. According to the findings, fewer people in poor developing countries get routine check-ups compared to developed countries. The construction industries studied have little or no insurance plans for staff. It also demonstrates that personal protective equipment (PPE) such as nasal masks, helmets, hand gloves, and work aprons can assist in the control of biohazards in the construction sector, such as asthma, cancer, and asbestosis. There should be safety awareness programmes, conferences, and seminars, as well as first-aid kits and HSE and qualified health workers on all building sites. In addition, the government should examine the site for the usage of PPEs and verify that records of family/personal medical history are maintained.

Assessment of Staffing Needs for Frontline Health Workers in Selected Maternal and Child Health Services in 3 Countries of Sub-Saharan West Africa: Cote d'Ivoire, Burkina Faso, and Niger.

Sub-Saharan African countries health systems are generally faced with shortages and inequitable distribution of qualified health workers. The application of provider-population ratio or fixed staff establishments, not considering variation in workload, given contextual variations in service utilization rates, cannot adequately match the human resource needs of different health facilities. The Workload Indicators of Staffing Need (WISN) method uses workload to determine staffing needs in a given facility. The aim of this study was to assess the current workload and staffing needs of maternal and child health services in 12 primary healthcare facilities from Burkina Faso, Niger, and Cote d'Ivoire. We employed the WISN methodology, using document reviews, in-depth interviews with health providers, and observations, to obtain the data needed for estimating the required number of staff in a given facility. Then, we calculated both the WISN difference (current-required staff), and the WISN ratio (current staff/required staff). Using the WISN ratio, we assessed the work pressure that health workers experience. The results showed a shortage of health workers in most services in Cote d'Ivoire and Niger (WISN ratio <1), in contrast to Burkina Faso where services were either adequately staffed or overstaffed (WISN ratio ⩾1). The workload pressure was generally high or very high in Cote d'Ivoire, while in Niger, it was very high in maternity services but rather low in dispensary ones. There was also a geographic discrepancy in health workers staffing, rural areas services being more understaffed, with a higher workload pressure as compared to urban areas ones. This study results strengthens the body of knowledge on the shortage of health workforce in sub-Saharan Africa French speaking countries. Policies and strategies to increase students training capacities and the application of regular WISN studies for a better staff distribution are necessary to address the human resource needs of health facilities in these countries.

Accreditation of private midwifery and nursing schools in Mali: a local sustainable solution to increasing the supply of qualified health workers

BackgroundThe World Health Organization’s Global Strategy on Human Resources for Health (HRH) emphasizes the importance of dynamic and effective health worker regulation for achieving the health-related Sustainable Development Goals, with the establishment of education standards and quality assurance of education programs being critical. Governments in West Africa have struggled to address the problems within their higher education systems for health professionals, and it is now generally acknowledged that private institutions can play a crucial role in revitalizing the region’s outdated universities. However, the rapid expansion of private schools raises concerns about the quality of education and adequacy of regulatory mechanisms. The USAID-funded Mali HRH Strengthening Activity, led by IntraHealth International, assisted Mali’s Ministry of Health and Social Development to deliver targeted HRH interventions to improve the quality of education in private universities, better manage available health workers, and initiate a decentralized strategy for health worker recruitment and motivation.Case presentationIn 2018, the HRH activity leveraged the West African Health Organization (WAHO)’s accreditation system to support 10 private nursing schools to introduce WAHO’s regionally accepted, competency-based curriculum in reproductive, maternal, newborn, and child health. The project undertook a 10-step process to work alongside private nursing and midwifery schools to assess their current status against WAHO regional standards, implement action plans to address identified gaps, and support the institutions toward accreditation. As a result, eight schools in Mali are now accredited compared to only three at project inception.ConclusionsThis case study underscores the importance of private school accreditation in Mali to improve the quality of health worker training through a standardized local curriculum. By supporting existing regulatory bodies that oversee accreditation, local capacity for initial accreditation of private nursing schools has been increased. Engaging universities in a partnership that shows the benefits of accreditation while maintaining a focus on the need to protect communities is critical to success. If the global community is to meet the WHO’s predicted health worker shortfall, then private education providers will need to be part of the solution. Robust and engaging health worker education accreditation systems are an essential part of that future.