Analysis of adequacy levels for human resources improvement within primary health care framework in Africa

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Abstract

Human resources in health care system in sub-Saharan Africa are generally picturing a lack of adequacy between expected skills from the professionals and health care needs expressed by the populations. It is, however, possible to analyse these various lacks of adequacy related to human resource management and their determinants to enhance the effectiveness of the health care system. From two projects focused on nurse professionals within the health care system in Central Africa, we present an analytic grid for adequacy levels looking into the following aspects:

- adequacy between skills-based profiles for health system professionals, quality of care and service delivery (health care system /medical standards), needs and expectations from the populations,

- adequacy between allocation of health system professionals, quality of care and services delivered (health care system /medical standards), needs and expectations from the populations,

- adequacy between human resource management within health care system and medical standards,

- adequacy between human resource management within education/teaching/training and needs from health care system and education sectors,

- adequacy between basic and on-going education and realities of tasks expected and implemented by different categories of professionals within the health care system body,

- adequacy between intentions for initial and on-going trainings and teaching programs in health sciences for trainers (teachers/supervisors/health care system professionals/ directors (teaching managers) of schools...).

This tool is necessary for decision-makers as well as for health care system professionals who share common objectives for changes at each level of intervention within the health system. Setting this adequacy implies interdisciplinary and participative approaches for concerned actors in order to provide an overall vision of a more broaden system than health district, small island with self-rationality, and in which they operate.

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Health policy and systems research agendas in developing countries

Miguel A González-Block (2004)

Background Health policy and systems research (HPSR) is an international public good with potential to orient investments and performance at national level. Identifying research trends and priorities at international level is therefore important. This paper offers a conceptual framework and defines the HPSR portfolio as a set of research projects under implementation. The research portfolio is influenced by factors external to the research system as well as internal to it. These last include the capacity of research institutions, the momentum of research programs, funding opportunities and the influence of stakeholder priorities and public opinion. These dimensions can vary in their degree of coordination, leading to a complementary or a fragmented research portfolio. Objective The main objective is to identify the themes currently being pursued in the research portfolio and agendas within developing countries and to quantify their frequency in an effort to identify current research topics and their underlying influences. Methods HPSR topics being pursued by developing country producer institutions and their perceived priorities were identified through a survey between 2000 and 2002. The response to a call for letters of intent issued by the Alliance in 2000 for a broad range of topics was also analyzed. The institutions that were the universe of this study consisted of the 176 institutional partners of the Alliance for Health Policy and Systems Research producing research in low and middle income countries outside Europe. HPSR topics as well as the beneficiaries or issues and the health problems addressed were content analyzed. Topics were classified into 19 categories and their frequency analyzed across groups of countries with similar per capita income. Agendas were identified by analyzing the source of funding and of project initiation for projects under implementation. Results The highest ranking topic at the aggregate level is "Sector analysis", followed by "Disease burden" and "Management and organization". Categories at the bottom of this ranking are "Equity", "Policy process", "Economic policy and health" and "Information systems". "Disease burden" is more often funded than other topics for which there is more demand or perceived priority. Analysis suggests few although important differences across priorities, demand for funding and actual project funding. The donors' agenda coincides most with the ranking of research topics overall. Ranking across country income groups shows important differences. Topics that gain prominence in low income countries are "Disease burden" and "Accessibility". In lower middle income countries "Insurance" gains prominence. In upper middle income countries "Decentralization/local health systems", "Equity" and "Policy process" are more prominent. "Program evaluation" is the most consistently ranked topic across income regions, showing a neutral influence by donors, governments or researchers. Conclusions The framework proposed offers a basis to identify and contrast research needs, projects and products at the international level and to identify the actor agendas and their influence. Research gaps are suggested when comparing topic ranking against the challenges to health system strengthening and scaling up of disease control programs. Differences across per capita income groups suggests the need for differentiated priority setting mechanisms guiding international support. Data suggests that stakeholders have different agendas, and that donors predominate in determining the research portfolio. High-level consensus building at the national and international levels is necessary to ensure that the diverse agendas play a complementary role in support of health system objectives. The Ministerial Summit for Health Research to be held in Mexico in November 2004 should be an opportunity to analyze further data and to commit funding for priorities identified through sharing and discussion of agendas.

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Better health in Africa : Experience and lessons learned.

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L'internationalisation de la santé entre culturalisme et universalisme

D. FASSIN, D Fassin (1997)

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Journal

Journal ID (nlm-ta): Health Res Policy Syst

Title: Health Research Policy and Systems

Publisher: BioMed Central (London )

ISSN (Electronic): 1478-4505

Publication date Collection: 2005

Publication date (Electronic): 2 December 2005

Volume: 3

Page: 8

Affiliations

[1 ]Department of Epidemiology and Health Promotion, School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium

[2 ]UMR PRODIG, Paris, France

[3 ]Institut Supérieur d'Enseignement Infirmier (ISEI), Brussels, Belgium

[4 ]Centre de Pédagogie Universitaire, Université Catholique de Mons (FUCAM), Belgium

[5 ]Education Department, Université Catholique de Louvain (UCL), Belgium

Article

Publisher ID: 1478-4505-3-8

DOI: 10.1186/1478-4505-3-8

PMC ID: 1318454

PubMed ID: 16321167

SO-VID: 3f66c9af-2ad2-4c97-bac6-9ad08eb21845

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Analysis of adequacy levels for human resources improvement within primary health care framework in Africa

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Most cited references 28

Health policy and systems research agendas in developing countries

Better health in Africa : Experience and lessons learned.

L'internationalisation de la santé entre culturalisme et universalisme

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