Malawi’s emergency program for resources Humans Malawi has had a medical school only since the 1990s and therefore suffers from a chronic shortage of doctors, nurses and other specialized professionals, a situation exacerbated by the brain drain and AIDS. A health services survey carried out in 2003 indicated that out of about 617 health services in the country, only 10
percent met the requirements for providing essential health services according to the criterion of service availability and staff qualification levels. After the government launched the Package Essential Health in 2004, it became evident that improving staffing levels is the biggest challenge to overcome to implement that package. The government and partners then created a human resources program to: • Improve incentives for staff recruitment and maintenance through the offer of top salaries
Expand the capacity of internal training
temporarily using international doctors and nurse tutors Obtain international technical assistance to improve the capacity and management skills and create the system for monitoring and evaluating the flow of human resourcesSource: Adapted from reference29166 Opportunities for newborns born in AfricaFORMAR – Produce more professionals, especially specialized professionals
- Increase the capacity of training schools, which may require recourse to private educational institutions. Áfricado Sul, for example, is planning to hand over to
- NGOs and private education organizations accredited by the Health Directorate, the training of thousands of skilled
- health workers. The Health Directorate also defined, in a rigorous manner, what are the expected results of these competencies, which are based on a standardized training curriculum.
It is necessary to accelerate these deformation initiatives to resolve the human resources crisis. Promote North-South partnerships for training health professionals quickly. childcare, or abroad Increase budgetary funds to save lives – in order to solve the human resources crisis in Africa, a significant increase in budgetary funds for health is requiredRETER – Retain professionals Improve wages and terms and conditions of employment contracts •
Improve staff motivation through incentives and job dissatisfaction (prestige, wages, working conditions, promotion, performance-based pay) 31 • Provide HIV prevention services and care and support and treat infected workers • Allow work hours flexible working conditions for families and HIV positive people. BOX IV.6 The second care revolution primary health care – an opportunity for
SMNIA first primary health care
revolution ended with the 1978 Alma Ata Declaration, which provided health care for all in the year 2000 through primary health care as the primary vehicle and focusing on maternal health and Infantile (SMI). Many reasons contributed to this vehicle failing, including the lack of concentration sustained in it, due to the fact that global health policy was later oriented towards the eradication of diseases. In addition,
TCS was assigned multiple tasks, but they were subject to little or no monitoring, or even little or no pay. Despite the massive wave of workers who have been trained, there are few careful assessments published. After a series of vertical programs, including the ongoing polio eradication, the intense HIV-related activities, malaria and tuberculosis have come to occupy a prominent place in health services, and attentions are now moving towards the acceptance of MNCH services as the main pillar of health care.
- Communities and TCS are being looked at again as vital agents forIn sub-Saharan Africa, the human resources crisis has accelerated the speed of policy changes in the
- sense of the TCS; Ethiopia, for example, is training 30,000 community-based Health Extension
Workers to dedicate themselves exclusively to MNCH, malaria and HIV.36 Kenya, Ghana and South Africa are planning national programs for TCS . Nigeria is also improving the capacity of Community Health Extension Workers with a curriculum that includes life saving skills within the MNCH. However, a search for available literature to guide policies reveals that there are no studies on the impact of these measures.
Most evaluations refer to the process
and not to the impact, and many refer to programs of special interest, such as increased coverage of insecticide-treated mosquito nets, the vaccineMANTER – Making better use of available workers • Using good management techniques, such as a clear description of tasks, matching skills to tasks, and balancing competencies in the nude ma team3
- Ensure specialized and stimulating monitoring of personnel • Replace personnel to reflect the patterns of their use and fill priority jobs; prepare budgets for subsistence allowances that compensate the weight of rural
- jobs • Increase efficiency by improving the skills of existing staff through in-service courses and distance learning courses. In South Africa, for example, an innovative
- method that used a distance learning package helped to improve the skills of more than 30,000 midwives and cost about $ 5 per person.32; 33 •
Teamwork to support and delegate tasks, appropriate policies and legislation, such as, for example, Mozambique, where surgical assistants can perform cesarean hysterectomies.34 In Ghana, nursing assistants perform many of the simplest tasks, thus allowing nurses and midwives to focus on more specialized tasks • To explore the best possible use of TCS to bring health care as close as possible to the populations.
The current “second revolution in primary health care” (Box IV.6) in Africa provides an opportunity to incorporate health interventions. High-impact MNCH in TCS tasks and training personnel in several countries – but it is necessary to learn from the first revolution primary health care.35 Donons sa chance à chaque nouveau-né de l’Afrique 167IV against measles, or the eradication of the Guinea worm, for example.
Few publications discuss the evaluation of the processes of MNCH services, such as the promotion of breastfeeding and nutrition, and no text was found that referred to integrated child health or MNCH programs, although these programs are being improved. In several African countries there are programs such as the Accelerated Program for Child Survival, conducted by UNICEF and financed by the Canadian International Development Agency,