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Results, Part 2 Print E-mail

Generating, organizing and communicating knowledge about human resources for health (HRH)

Improved workforce systems and outcomes. The Capacity Project worked with the Ministry of Health and health facilities in Zanzibar, mainland Tanzania and Kenya to design and pilot Work Climate Improvement (WCI) interventions that focused on the quality of the facility environment, worker wellness, the health worker-supervisor relationship and the patient-health worker relationship. In Zanzibar, the WCI initiative improved worker productivity by reducing the amount of time workers spent waiting for patients, reducing provider workload during weekends and improving community partnerships. In Kenya and Tanzania, the WCI initiative increased job satisfaction, knowledge about rights, overall service use and infection prevention controls, and created a culture of continuous learning among health workers and management.

Technical Leadership in HRH through Knowledge-Sharing. The Project completed the installation of the Uganda pilot HRH Knowledge Management Sharing System, which integrated the HRH Global Resource Center and HRH Action Framework websites, national iHRIS reports, local Ministry of Health resources and a secure, online collaborative workspace for Ministry employees. The Project developed an online library to house the Ministry of Health resources to include in the Knowledge Management Sharing System, which makes these documents publicly available for the first time.

HRH Global Resource Center (GRC) Launches New Features. In response to user feedback, the GRC launched new features to provide better opportunities for user interaction and learning. The new components include a rating system for resources, a tutorial on how to use the site, a latest resources page and a new Subject Guide series to introduce major HRH issues and help users find information in the GRC. In the last year of the Project, the site received an average of 30,000 visitors per month from 174 countries. The GRC newsletter had more than 500 subscribers and 70 websites linked to the GRC. The collection contains over 2,000 resources, including articles from 184 journals and resources from more than 400 publishers. The GRC produced monthly resource spotlights and weekly news articles, including original interviews on topics such as health information systems.

HRH Technical Briefs Supplant Knowledge Gaps. Responding to gaps in the knowledge base, the Project published technical briefs and other resources on key HRH topics including HRH strategic planning, HR information systems data quality, data-driven decision-making and HRH projection models; retention and productivity study reports; and monthly focused descriptions of featured Project work.

Health Workforce Retention Data Guide Country Interventions and Policies. The Project created an ambitious retention initiative that identifies best practices, supports the collection and use of workforce data and implements and tests a set of practices. In Uganda, the Project conducted a retention study and supported human resources information system development to strengthen retention planning. In Tanzania, the Project presented research on national retention interventions’ effectiveness to the Ministry of Health, and district-level planners developed retention strategies adapted to local needs to improve the work climate and increase health worker satisfaction.

IUD Learning Package Enhances Trainers Family Planning Toolkits. The Project developed and published IUD Guidelines for Family Planning Service Programs: A Problem-Solving Reference Manual, along with a course handbook for participants and course notebook for trainers. Tools from the IUD package are included in the MAQ Initiative’s IUD toolkit for global use.

Workplace Violence Study Findings Guide Gender Policies. The ministries of labor, health and gender and the Health Workers Union in Rwanda used findings from a survey of health facility workers to create policies and programs to protect workers from interpersonal violence and gender discrimination. The Project sponsored a national dissemination meeting, which brought together 72 participants representing all focal institutions for the study as well as USAID and other partners. The focal institutions identified actions that will contribute to the elimination of gender-based violence in the workplace. Following the national dissemination meeting, focal persons met to plan next steps for implementing the workplace violence study recommendations. Terms of reference were developed for creating a policy to prevent workplace violence and a meeting was held with the minister of public service and labor, who will take leadership in this important activity.

Community of Practice Strengthens Pre-Service Curricula. The Capacity Project’s Learning for Performance approach, applied in Rwanda, Mali and Senegal, was designed to shorten the time required for training and improve job performance by providing guidelines and tools that focus curricula on priority performance outcomes. The Global Alliance for Pre-Service Education (GAPS) community of practice, with 273 members from 50 countries representing Africa, Asia and Central America, explored pre-service strengthening; shared experiences and strategies; and provided cutting-edge materials for practitioners. The GAPS website, housed within the WHO/Implementing Best Practices Knowledge Gateway, contains educational and clinical resources and served as a forum for guided discussions.

iHRIS Open Source Software Recognized as Best Practice. The Capacity Project designed the Open Source iHRIS Manage software to help countries strengthen and sustain human resources information systems (HRIS) for workforce planning, tracking and management without having to pay costly fees. Countries can download free software from the Project’s HRIS website feature, which provides demonstrations, software and lessons learned. The Project has introduced HRIS in over 15 African countries. Also, participants at WHO’s “Framework for Interoperability for Public Health Tools” meeting in Geneva, held in June 2008, recognized the Project’s Open Source iHRIS software as a best practice.

Major Upgrades to iHRIS Software Released. The Project released the 3.1 versions of iHRIS Manage (an HR management system) and iHRIS Qualify (a training, certification and licensure tracking database) software products. These products allow users to design and share customized reports to better analyze data. The Project also released iHRIS Plan 1.0, the workforce planning and modeling software. It was pilot tested in Namibia, and will incorporate feedback from users into subsequent releases of the software.

Flexible, Customizable HRIS Responds to Field Needs. In response to field needs from postwar zones of Southern Sudan and Rwanda that lack reliable Internet access, and to support decentralized HR information management, the Project created an offline, desktop version of its iHRIS software. Regional Health Management Teams in Swaziland used the Ministry of Health’s Access-based HRIS for regional health planning, discovering a heavy dependence on mission nurses and a number of posts that had remained unfilled for years.

Practitioners Test HRH Data-Driven Decision-Making Approach. A key challenge facing developing countries is to effectively translate HRH data and evidence into policy and practice. The Capacity Project developed a pilot approach to support data-driven decision-making and tested it in a three-day workshop in Uganda. HRH practitioners used local HR data to learn the skills and approaches needed to make data-driven decisions. The Ministry of Health is now prepared to provide evidence-based biannual HR reporting to the Joint Review Committee, which oversees national finance, to advocate for funds to strengthen HRH. The Project is refining the approach for application in other countries.

Health Worker Hiring Model Speeds Deployment, Increases Access to Care. A mid-term evaluation found that the Kenya Emergency Hiring Plan (EHP), a flexible, rapid-response staffing and training model, has deployed large numbers of health workers in a fraction of the usual time and increased family planning and HIV service access in high-need rural areas. The Government of Kenya transitioned the original EHP workers to permanent public service status, and plans to use the EHP model, which employs transparent recruiting and hiring, for future rapid hiring needs. Tanzania and Liberia requested assistance from the Capacity Project to replicate the plan.

Study Illuminates HIV Stigma’s Influence on Health Workers’ Self-Care. A qualitative study to identify HIV-infected health workers’ barriers to care found that their own forms of HIV stigma—including professional embarrassment, perceptions that HIV prevention efforts were for patients only and fear of judgment by colleagues and patients—would prevent them from disclosing their HIV status. The Swaziland Nurses Association and partners identified the study’s key lessons—such as the need to address stigma issues unique to health workers, desire for comprehensive rather than HIV-targeted services and the need for options in providers and sites for services—to use in designing acceptable services for health workers.

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