Partnering to Build Human Resources for Health Capacity in Africa: A Descriptive Review of the Global Health Service Partnership’s Innovative Model for Health Professional Education and Training From 2013-2018

Abstract

Several Sustainable Development Goals (SDGs) (3, 16, 17) point to the need to systematically address massive shortages of human resources for health (HRH), build capacity and leverage partnerships to reduce the burden of global illness. Addressing these complex needs remain challenging, as simple increases in absolute numbers of healthcare providers trained is insufficient; substantial investment into long-term high-quality training programs is needed, as are incentives to retain qualified professionals within local systems of care delivery. We describe a novel HRH initiative, the Global Health Service Partnership (GHSP), involving collaboration between the US government (President’s Emergency Plan for AIDS Relief [PEPFAR], Peace Corps), 5 African countries, and a US-based non-profit, Seed Global Health. GHSP was formed to enlist US health professionals to assist in strengthening teaching and training capacity and focused on pre-and in-service medical and nursing education in Malawi, Tanzania, Uganda, Eswatini and Liberia. From 2013-2018, GHSP sent 186 US health professionals to 27 institutions in 5 countries, helping to train 16 280 unique trainees of all levels. Qualitative impacts included cultivating a supportive classroom learning environment, providing a pedagogical bridge to clinical service, and fostering a supportive clinical learning and practice environment through role modeling, mentorship and personalized learning at the bedside. GHSP represented a novel, multilateral, public-private collaboration to help address HRH needs in Africa. It offers a plausible, structured template for engagement and partnership in the field.

How Were Return-of-Service Schemes Developed and Implemented in Botswana, Eswatini and Lesotho?

“…The governance of RoS schemes in these three Southern African countries therefore presented a perfect opportunity for multiple Ministries to work together to improve the lives and livelihoods of their citizens. This research therefore provides valuable lessons on the dos and don'ts of collaborative governance, as it shows that multisectoral collaboration is a non-negotiable necessity in ensuring health systems' efficiency and good health outcomes but is not sufficient by itself [62][63][64]. As Adeleye et al [62] advised, success requires intentional, strategic and coordinated efforts of sectors.…”

“…The fact that the policies have not changed over many years makes it easier to preserve institutional memory and transfer from one generation of administrators to the next. However, it is important to recognise that policies are only as relevant as the existing laws, trends, practices and technologies of the day; if any of those change, then they need to be reviewed [2,63]. This is evidenced by the recent equalisation in the treatment of male and female in-service beneficiaries in Botswana, where the policy discriminated against pregnant women [29].…”

Running Return of Service Schemes in Southern Africa: Lessons from Botswana, Eswatini and Lesotho

“…The governance of RoS schemes in these three Southern African countries therefore presence a perfect opportunity for multiple Ministries to work together to improve the lives and livelihoods of their citizens. This research therefore provides valuable lessons on the dos and don'ts of collaborative governance as it shows that multisectoral collaboration is a non-negotiable necessity in ensuring health systems' efficiency and good health outcomes but is not sufficient by itself [47][48][49]. As Adeleye et al [47] advised, success requires intentional, strategic and coordinated efforts of sectors.…”

“…The fact that the policies have not changed over many years makes it easier to preserve institutional memory and transfer from one generation of administrators to the next. However, it is important to recognise that policies are only as relevant as the existing laws, trends, practices and technologies of the day, if any of those change then they need to be reviewed [2,48]. As evidenced by the recent equalisation in the treatment of men and women in-service beneficiaries in Botswana, where the policy discriminated against pregnant women[29].…”

Identifying the strengths, weaknesses, opportunities and threats (SWOT) of return-of-service bursary schemes for health workforce capacity: a qualitative study of Botswana, Lesotho and Eswatini

“…6 The HRH global strategy is aligned with the United Nation's Sustainable Development Goal (SDG) 3, which advocates for a substantial increase to health financing and the recruitment, development and training and retention of the health workforce (target 3c) especially in LMICs. [6][7][8] Governments need reliable support and partnerships from the international community and the tertiary education sector to ensure that there is adequate funding and available training platforms for this needed increase in production of the health workforce. 9 As the world gears up for the SDG interactive Dialogue and Summit in March and September 2023, respectively, it is important to review some of the health workforce strategies used by some LMICs.…”