Voices from the Capacity Project

“Health workers are the backbone of health service delivery,” says Francis Ntalazi, assistant commissioner of human resources management in Uganda’s Ministry of Health. Yet when the Capacity Project began five years ago, many countries had a long way to go in planning, developing and supporting the health workforce.

In Southern Sudan, for example, planning was hindered by lack of information on who was working where. “We did not know how many health workers were practicing in the country,” said Dr. Monywiir Arop Kuol, undersecretary of health. “HR systems and structures did not exist.”

In Mali, workforce development was less than ideal—matrones attend the majority of births but weren’t trained in a lifesaving practice to prevent postpartum hemorrhage. “Many women were lost,” said matrone Berthé Aissata Touré.

And in Kenya, health workers weren’t always supported to do their best and be motivated to remain on the job. “Work schedules weren’t well organized,” said Dr. Muriuki Meme of Hola District Hospital, “and the management was not friendly towards the staff.”

In 47 countries and through ten country offices, the Capacity Project strengthened human resources to implement quality health programming. The focus was threefold: improving workforce planning to ensure that the right type and number of health workers are deployed to the right locations; developing better education and training programs so that health workers have the knowledge and skills to meet the needs of their communities; and strengthening systems to support workforce performance and encourage workers to remain on the job.

On September 23, the Project presented its results at the World Bank in Washington, DC. Leadership and staff joined IntraHealth International’s Pape Gaye and representatives from USAID, global partners, ministries of health and other organizations to highlight successes in planning, developing and supporting the health workforce.

Dr. Susan Brems, deputy assistant administrator of USAID’s Bureau for Global Health, presented the keynote address. “Because of their importance to improved health outcomes, human resources for health will have a pivotal role under President Obama’s Global Health Initiative,” she said.

Announcing the Global Health Initiative in May, President Obama said, “We cannot simply confront individual preventable illnesses in isolation. The world is interconnected, and that demands an integrated approach to global health.” He added that “we will not be successful in our efforts to end deaths from AIDS, malaria and tuberculosis unless we do more to improve health systems around the world.”

“The Capacity Project has made significant contributions that have laid the groundwork for future work in health systems strengthening,” Brems affirmed, and cited several examples: collaborative development of the HRH Action Framework; development of the HRH Global Resource Center; strengthening of HR information systems; extensive technical assistance in HR management and workforce development; improvements in workforce support systems; and results in family planning/reproductive health and HIV/AIDS.

“The momentum is building,” Brems noted, “and great opportunities currently exist for improving the global health workforce.” The afternoon plenary focused on the unfinished agenda and a call to action.

In Southern Sudan, Dr. Monywiir takes a look back. “In 2005, we faced enormous challenges,” he recalls. “The contribution of Capacity Project has led to the recognition of the Ministry of Health HR unit and programs as the best among all government ministries in Southern Sudan.”

In Mali, Touré and other matrones received training in active management of the third stage of labor and were authorized to conduct the lifesaving practice. “It has allowed us to save many women’s lives,” she reports happily.

And in Kenya, a workplace climate initiative improved performance and morale. Weekly trainings for continuing education, for example, help workers feel supported in their development. “It’s really motivating staff,” says Habia Joyce, a nurse in Hola District. “Even when people are off they come for the sessions.” Adds Dr. Mohamed Sheikh of Ijara District, “Even the community sees a big improvement!”

After all, improved health care is what it’s all about, and it takes a workforce. “Positive health impact is our North Star,” Brems pointed out. “Let us look forward with great anticipation to continuing the momentum as we all work together to advance innovations,” she concluded, “always keeping our sights on the North Star of better health outcomes.”

[September 2009. Print a PDF version.]

The Capacity Project, funded by the United States Agency for International Development (USAID) and implemented by IntraHealth International and partners (IMA, Jhpiego, LATH, MSH, PATH, TRG), helps developing countries strengthen human resources for health to better respond to the challenges of implementing and sustaining quality health programs.

The Voices from the Capacity Project series is made possible by the support of the American people through USAID. The contents are the responsibility of IntraHealth International and do not necessarily reflect the views of USAID or the United States Government.