A scoping review of training and deployment policies for human resources for health for maternal, newborn, and child health in rural Africa

Abstract

BackgroundMost African countries are facing a human resources for health (HRH) crisis, lacking the required workforce to deliver basic health care, including care for mothers and children. This is especially acute in rural areas and has limited countries’ abilities to meet maternal, newborn, and child health (MNCH) targets outlined by Millennium Development Goals 4 and 5. To address the HRH challenges, evidence-based deployment and training policies are required. However, the resources available to country-level policy makers to create such policies are limited. To inform future HRH planning, a scoping review was conducted to identify the type, extent, and quality of evidence that exists on HRH policies for rural MNCH in Africa.MethodsFourteen electronic health and health education databases were searched for peer-reviewed papers specific to training and deployment policies for doctors, nurses, and midwives for rural MNCH in African countries with English, Portuguese, or French as official languages. Non-peer reviewed literature and policy documents were also identified through systematic searches of selected international organizations and government websites. Documents were included based on pre-determined criteria.ResultsThere was an overall paucity of information on training and deployment policies for HRH for MNCH in rural Africa; 37 articles met the inclusion criteria. Of these, the majority of primary research studies employed a variety of qualitative and quantitative methods. Doctors, nurses, and midwives were equally represented in the selected policy literature. Policies focusing exclusively on training or deployment were limited; most documents focused on both training and deployment or were broader with embedded implications for the management of HRH or MNCH. Relevant government websites varied in functionality and in the availability of policy documents.ConclusionsThe lack of available documentation and an apparent bias towards HRH research in developed areas suggest a need for strengthened capacity for HRH policy research in Africa. This will result in enhanced potential for evidence uptake into policy. Enhanced alignment between policy-makers’ information needs and the independent research agenda could further assist knowledge development and uptake. The results of this scoping review informed an in-depth analysis of relevant policies in a sub-set of African countries.

Identifying and characterising health policy and system-relevant documents in Uganda: a scoping review to develop a framework for the development of a one-stop shop

“…Our findings especially, on the availability of the policy and system-relevant documents are supported by literature from previous studies in low- and middle-income countries [ 26 , 27 ]. We found out that apart from “other reports”, rapid response summaries were by far the most dominant type of documents produced, although most of them were produced in a particular period, from 2008 to 2013.…”

“…This may instead point to the fact that these documents were not readily on governmental and NGOs’ websites: an indication for lack of one-stop shops for knowledge sharing in the country. This is supported by findings from a study by Murphy [ 27 ], which demonstrated that information on training and deployment policies for health workers for maternal, newborn and child health in rural Africa was not available on governmental websites; it was instead readily located on the sites of institutions with a greater capacity for knowledge sharing. Generally, there was a noted increase in the number of documents from 6 documents per year in 2000 to 49 per year in 2011, dropping in the following years.…”

Association of the client-provider ratio with the risk of maternal mortality in referral hospitals: a multi-site study in Nigeria

“…To the best of our knowledge, this study is one of the first to quantitatively investigate this relationship, especially in regions with high rates of maternal death. Although there is evidence in the global literature that the increased density of human resources (especially nurses, specialists and non-specialist doctors) reduces maternal, infant and child mortality [ 19 , 20 ], there has been limited specific investigation in many African countries aimed at testing this relationship.…”

Motivations des agents obstétricaux qui décident d’exercer en milieu rural au Niger

“…Face à la pénurie inquiétantederessources humaines en Afrique, les recherchessur lesfacteursinfluençant la rétention desprofessionnelsdelasanté en milieu rural se sont multipliées. Elles ont toutes en grande partie tenté d'éclairer lesp rises de décisions politiques pour renforcer la place des ressources humaines au sein du système de santé [22][23][24]. Ces recherches s'accordentsur le fait que la motivation dans le cadrep rofessionnel est un phénomène complexe et dynamique car elle évolue dans le temps, change en fonction du contexte et est influencée par une multitude de facteurs situés à différents niveaux (macro : politiques,contexte institutionnel, conditions de vie), individuel (satisfactionp rofessionnelle, situation familiale, genre), organisationnel( conditions de travail) [12] mais essentiel à comprendrepour mettreenbranle lesréformes nécessairesenAfrique subsaharienne [13][14][15].…”