The state of strategic plans for the health workforce in Africa

Afriyie, Doris Osei; Nyoni, Jennifer; Ahmat, Adam

doi:10.1136/bmjgh-2018-001115

Cited by 59 publications

(61 citation statements)

References 22 publications

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“…In response to this, the WHO African Region developed a Road map for scaling up the health workforce, but progress has been mainly in developing strategies and plans. Afiriye et al 8 noted that a lot still needs to be done to primarily improve the quality of the human resource for health (HRH) strategies and ensure coordinated and effective implementation.…”

mentioning

confidence: 99%

Resilient health systems for attaining universal health coverage

et al. 2019

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confidence: 99%

Resilient health systems for attaining universal health coverage

et al. 2019

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“…Structures and capabilities for HRH governance are often under-developed and lacking in political support [3].…”

Section: Introductionmentioning

confidence: 99%

“…It is widely acknowledged that HRH development requires coordination of multiple stakeholders and levels of government [3][4][5]. Developing comprehensive national HRH policies is just one of the steps towards enabling good governance of, and bridging gaps in, HRH.…”

Section: Introductionmentioning

confidence: 99%

“…However, a review of HRH units in the ministries of health of 26 countries in the World Health Organization's (WHO) African region reported that most country-level HRH units are "poorly structured, not fit for purpose and lack the ability to influence policy directions" (4, p. 2). Another study showed that, in 2015, only 36% of countries in the African Region had national-level HRH policy [3].…”

Section: Introductionmentioning

confidence: 99%

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Looking back to look forward: a review of human resources for health governance in South Africa from 1994 to 2018

2020

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While South Africa has had a fairly consistent record of producing national-level strategic plans for human resources for health in the past 25 years, the country continues to face major problems of affordability, availability, distribution and management of its health workforce. There are several factors contributing to the state of health human resources in the country, but problems with governance stand out as one area requiring further research, analysis and critique. This paper presents a retrospective analysis of the historical patterns in national health human resources governance in South Africa, based on a desktop policy review spanning 25 years after democracy. The authors took a multi-pronged, iterative approach, reviewing policy documents alongside grey and published literature. This led to a timeline showing key legislation, relevant health system and human resource policies, interventions, reviews and evaluations from 1994 to 2018. The review identified three distinct periods that help to characterise the terrain of human resources for health governance over the concerned 25 years. Firstly, a foundational period, in which much of the constitutional and legislative groundwork was laid. Secondly, the HIV epidemic period, which presented a major disruption to the development of system wide governance interventions and improvements. Thirdly, the launch of National Health Insurance discussions and policy processes, which signalled a gradual return to a comprehensive systems focus in line with the founding principles of the first period. Using this periodisation, as well as a conceptual framework of health human resources governance functions based on international literature, the authors argue that South Africa has experienced both progress and challenges in human resources for health governance. This has affected the successful implementation of its policy and strategic planning over the past 25 years. Good governance for human resources for health requires capable stewardship, underpinned by an appropriate mix of technical and administrative skills and explicit political support. The review findings suggest that strengthening human resources for health governance roles, including fostering purposeful stewardship by the National Department of Health, may be key to shifting the terrain in the availability and performance of South Africa’s health workforce going forwards.

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“…The burden of epilepsy in Africa outweighs other regions in the world [ 2 ] with over 10 million people in Africa [ 3 ] and about 4.4 million people in sub-Saharan Africa [ 4 ] suffering from epilepsy. Yet, the region suffers from marked shortage of human resource with the lowest health worker density worldwide [ 5 , 6 ] and about 0.3 neurologists per million people [ 7 , 8 ]. This has initiated the idea of involving skilled staff to supervise and support lower level healthcare workers who provide frontline primary healthcare [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Calibration of the Epilepsy Questionnaire for Use in a Low-Resource Setting

Yaria

Ogunniyi

2020

Journal of Environmental and Public Health

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Background. Burden of epilepsy in sub-Saharan Africa is huge in the midst of shortage of human resource in its health sector. Using skilled staff to supervise and support lower level healthcare workers providing frontline primary healthcare is a pragmatic coping solution. But, lower level health providers face enormous challenges due to absent clinical algorithms or pragmatic rapid diagnostic tests. Objective. This study aimed to determine if the use of an epilepsy questionnaire in a traditional clinical setting would improve semiological details obtained and diagnostic accuracy. Methods. A prospective study was conducted involving patients diagnosed with epilepsy each with an eye witness who had regularly witnessed the seizures. Routine seizure history from clinical documentation and an interviewer-based questionnaire were compared. The data obtained were assessed for content, accuracy, intermethod and test-retest reliability. Results. Sixty-seven patients with a median age of 24 years were recruited. Routine seizure history had obtained less semiological details with inadequate description of nonmotor manifestations and lateralizing motor details. The questionnaire-obtained history showed higher accuracy for generalized onset seizure (0.83 vs. 0.56) and focal onset seizures (0.79 vs. 0.59). The questionnaire-obtained history also had good test-retest reliability for various semiological domains except automatisms. Conclusions. Routine seizure histories are not standardized. The use of a questionnaire goes a long way in improving semiology description in a low-resource setting and guides the health provider on what details to focus on. The use of epilepsy questionnaires should, therefore, be considered to improve semiology, especially in nonspecialist settings.

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The state of strategic plans for the health workforce in Africa

Cited by 59 publications

References 22 publications

Resilient health systems for attaining universal health coverage

Resilient health systems for attaining universal health coverage

Looking back to look forward: a review of human resources for health governance in South Africa from 1994 to 2018

Calibration of the Epilepsy Questionnaire for Use in a Low-Resource Setting

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