Solving the human resources for health crisis: research to inform policy in Africa

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This is a guest post by Esmé Lanktree* of the Global Health Research Initiative, and supplement editor of Human Resources for Health’s latest supplement.

Although there is widespread recognition of the human resources for health crisis in sub-Saharan Africa, there are different approaches to address it. Research allows us to test these approaches, to make better-informed decisions regarding the allocation of scarce resources, both financial and human, to optimize health service provision.

The Global Health Research Initiative’s Africa Health Systems Initiative – Support to African Research Partnerships (AHSI-RES) program funded ten research teams. Eight investigated innovative methods to reduce the strain on human resources and/or to expand services in areas lacking health personnel, while other teams focused on improving health information systems for better decision making.

An important component of all AHSI-RES-funded projects was the focus on research to policy; the use of research evidence to inform decisions from the local district level to national Ministries of Health.

Although influence on policy and practice usually requires a substantial investment of time and is difficult to demonstrate, there is already evidence that after a few short years, the teams featured in this supplement are contributing to shaping HRH practice in their respective countries, and internationally. In part, this can be attributed to the design of the program, which required African decision-makers to work closely with African researchers throughout the projects as co-principal investigators.

Burkina Faso’s Ministry of Health revised the conditions of the decentralized recruitment policy for health workers hired in rural areas, easing the restrictions on mobility between regions.

Upon the request of WHO’s Country Office in Uganda, the surgical task-shifting team attended the 5th WHO Global Initiative for Emergency and Essential Surgical Care (GIEESC) meeting in 2013 and are now vice-chairs of two subcommittees.

A review of evidence generated by the eye care project led to the rescheduling and review of a non-governmental organization’s training program in Malawi. The Kilimanjaro Centre for Community Ophthalmology is helping the Ministry of Health in Kenya to plan more effective evidence-based approaches to primary eye care.

The University of Zambia’s School of Medicine is revising its curriculum to adopt a competency-based approach and the government of Zambia is refining its human resources for health strategies following evaluation work by one team. This team involves a collaboration between Dalhousie University’s WHO/PAHO Collaborating Centre on Health Workforce Planning & Research and the University of Zambia’s School of Medicine. They have recently completed A Synthesis and Systematic Review of Policies on Training and Deployment of Human Resources for Health in Rural Africa which included both a scoping review and an in depth analysis of HRH policies in eight countries (Ethiopia, Ghana, Mali, Mozambique, Niger, Tanzania, Uganda, and Zambia).

Complementary articles by AHSI-RES-funded teams, which relate to the uptake and impact of research for evidence-based practice, were published in a supplement to BMC Health Services Research.

This HRH supplement features work on task-shifting and retention of health workers. Through the publishing of this collection of articles in Human Resources for Health, we hope to shed light on important work in the field, and through open access publishing, make the results accessible to all stakeholders, including policymakers from the local to the national level.

* Esmé Lanktree serves as Program Management Officer with the Global Health Research Initiative. The views expressed in this blog are those of the author alone and do not represent the views of the Global Health Research Initiative, the International Development Research Centre, the Canadian Institutes of Health Research, nor Foreign Affairs, Trade and Development Canada.