Maximizing the benefit of health workforce secondment in Botswana: an approach for strengthening health systems in resource-limited settings

Grignon, Jessica; Ledikwe, Jenny H.; Makati, Ditsapelo; Nyangah, Robert; Sento, Baraedi; Semo, Bazghina-werq

doi:10.2147/rmhp.s61473

Cited by 6 publications

(5 citation statements)

References 22 publications

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“…The capacity of the Zimbabwe government to fund healthcare has been eroded, leading to costs of healthcare services surpassing HCUs' capacity, especially at rural health facilities charging user fees. These findings were similar to those of another study conducted in Zimbabwe, 33 which showed that vacant positions for nurses at rural health facilities were frozen because of a lack of financial resources and that HCU fees were introduced despite HCUs not being able to afford to pay the fees.…”

Section: Outputssupporting

confidence: 89%

“…Material resources like medicines or drugs, medical accessories such as bandages, surgical blades and cotton wool, and medical equipment like microscopes are needed for the comprehensive provision of healthcare at health facilities. 33 The unavailability of these materials compromises the effective delivery of healthcare, as nurses (46.7%) cannot provide the healthcare and treatment needed by HCUs (59.95%). This then inevitably increases the disease burden in communities.…”

Section: Discussionmentioning

confidence: 99%

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Accessibility of healthcare in rural Zimbabwe: The perspective of nurses and healthcare users

Mangundu

Roets

Rensberg

2020

African Journal of Primary Health Care & Family Medicine

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BackgroundEnsuring the well-being of citizens is the goal of all healthcare delivery systems, 1 where individuals have the right to access good-quality healthcare. Allocating the relevant and required resources (e.g. financial resources) contributes to the accessibility of health facilities, essential medical drugs and competent and adequately trained health workers, as well as medical supplies. 2 In developing countries like Zimbabwe, access to healthcare services is often influenced by long distances and travel times to health facilities, the availability of financial resources to travel or pay for care and the availability of medical drugs as well as competent healthcare workers. 3 For example, in Zimbabwe, people in rural areas often have to walk between 10 km and 50 km to access the nearest health facility. 3 Access can be further impeded by a lack of infrastructure, such as dirty roads that are not maintained, resulting in poor road conditions and potholes that create barriers to transport. 4 In Zimbabwe, because of economic challenges, bridges that have collapsed because of rain are not repaired, hindering travelling of patients during critical times 5 and negatively affecting the timely delivery of medical drugs and medical supplies to rural health centres.Even where healthcare services are available and affordable, access to medical drugs is limited. 6,7 There is often a shortage in the supply of medical drugs, especially in the rural parts of Zimbabwe. It is evident that the economic crisis in Zimbabwe has also led to a shortage of medical supplies and equipment in public health facilities, leaving professional nurses with limited options to provide treatment. 8Background: Accessibility of healthcare in rural areas is globally impeded by physical, material, human, financial and managerial resources and societal barriers in the healthcare system. Developing countries like Zimbabwe are significantly affected. Aim:The aim of this article was to share the perspectives of nurses and healthcare users (HCUs) in the rural areas of Zimbabwe with regard to the accessibility of healthcare. Setting:The study was conducted at 45 rural health facilities in Chegutu district, Mashonaland West province and Masvingo district in Masvingo province, Zimbabwe.Methods: A self-administered questionnaire (for professional nurses) and a structured interview questionnaire (for HCUs) were utilised to gather data in a cross-sectional survey. Two districts were randomly sampled from 59 districts. All nurses working in 45 public health facilities in the selected two districts, who were willing and available to participate, were included. Ninety nurses participated in the study. The HCUs were selected through a multistage sampling technique. The sample size for HCUs was calculated by using Dobson's formula, and 445 HCUs were included via convenience sampling. Results:Nurses reported challenges such as work overload because of staffing shortages (55%) and the supply of necessary medical drugs that lacked consistency in both the quantit...

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Section: Outputssupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Accessibility of healthcare in rural Zimbabwe: The perspective of nurses and healthcare users

Mangundu

Roets

Rensberg

2020

African Journal of Primary Health Care & Family Medicine

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“…The kinds of health worker skills required to address HIV and AIDS are not unique when compared to the skills needed to address a broad range of other health issues. For instance, within the hospital setting, the same skills needed to ensure efficient administration of and adherence to HIV and AIDS treatment are the same types of skills required to deliver other types of health programs (Callaghan et al, 2010;Marseille et al, 2002;Semo et al, 2014). Investing in the human resources infrastructure needed to deliver HIV and AIDS related services, therefore, has the potential to lead to a health system's improved ability to more efficiently provide other services (Banati and Moatti, 2008;Callaghan et al, 2010;Hanefeld and Musheke, 2009;McCourt and Awases, 2007).…”

Section: Ownership and Health Systems Implications Of Hiv And Aids Ghismentioning

confidence: 99%

Confronting ‘scale-down’: Assessing Namibia's human resource strategies in the context of decreased HIV/AIDS funding

Cairney

Kapilashrami

2014

Global Public Health

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In Namibia, support through the Global Fund and President's Emergency Plan for AIDS Relief has facilitated an increase in access to HIV and AIDS services over the past 10 years. In collaboration with the Namibian government, these institutions have enabled the rapid scale-up of prevention, treatment and care services. Inadequate human resources capacity in the public sector was cited as a key challenge to initial scale-up; and a substantial portion of donor funding has gone towards the recruitment of new health workers. However, a recent scale-down of donor funding to the Namibian health sector has taken place, despite the country's high HIV and AIDS burden. With a specific focus on human resources, this paper examines the extent to which management processes that were adopted at scale-up have proven sustainable in the context of scale-down. Drawing on data from 43 semi-structured interviews, we argue that human resources planning and management decisions made at the onset of the country's relationship with the two institutions appear to be primarily driven by the demands of rapid scale-up and counter-productive to the sustainability of interventions.

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“…Secondments can therefore provide a positive way of motivating people and increasing work satisfaction, whilst enhancing best practice, collaborative working partnerships, knowledge and skills [ 70 ]. Although the practice of secondment is generally known as a strategy for skills development for mutual organisational and individual benefit, there is, however, a gap in the literature regarding practical implementation considerations and critical success factors related to the use of secondment as a global strategy to promote evidence-informed health policy development and implementation strategy [ 71 ]. This merits further consideration in future studies.…”

Section: Discussionmentioning

confidence: 99%

Improving maternal and child health policymaking processes in Nigeria: an assessment of policymakers’ needs, barriers and facilitators of evidence-informed policymaking

Uneke

Sombié

Keita

et al. 2017

Health Res Policy Sys

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BackgroundIn Nigeria, interest in the evidence-to-policy process is gaining momentum among policymakers involved in maternal, newborn and child health (MNCH). However, numerous gaps exist among policymakers on use of research evidence in policymaking. The objective of this study was to assess the perception of MNCH policymakers regarding their needs and the barriers and facilitators to use of research evidence in policymaking in Nigeria.MethodsThe study design was a cross-sectional assessment of perceptions undertaken during a national MNCH stakeholders’ engagement event convened in Abuja, Nigeria. A questionnaire designed to assess participants’ perceptions was administered in person. Group consultations were also held, which centred on policymakers’ evidence-to-policy needs to enhance the use of evidence in policymaking.ResultsA total of 40 participants completed the questionnaire and participated in the group consultations. According to the respondents, the main barriers to evidence use in MNCH policymaking include inadequate capacity of organisations to conduct policy-relevant research; inadequate budgetary allocation for policy-relevant research; policymakers’ indifference to research evidence; poor dissemination of research evidence to policymakers; and lack of interaction fora between researchers and policymakers. The main facilitators of use of research evidence for policymaking in MNCH, as perceived by the respondents, include capacity building for policymakers on use of research evidence in policy formulation; appropriate dissemination of research findings to relevant stakeholders; involving policymakers in research design and execution; and allowing policymakers’ needs to drive research. The main ways identified to promote policymakers’ use of evidence for policymaking included improving policymakers’ skills in information and communication technology, data use, analysis, communication and advocacy.ConclusionTo improve the use of research evidence in policymaking in Nigeria, there is a need to establish mechanisms that will facilitate the movement from evidence to policy and address the needs identified by policymakers. It is also imperative to improve organisational initiatives that facilitate use of research evidence for policymaking.Electronic supplementary materialThe online version of this article (doi:10.1186/s12961-017-0217-5) contains supplementary material, which is available to authorized users.

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Maximizing the benefit of health workforce secondment in Botswana: an approach for strengthening health systems in resource-limited settings

Cited by 6 publications

References 22 publications

Accessibility of healthcare in rural Zimbabwe: The perspective of nurses and healthcare users

Accessibility of healthcare in rural Zimbabwe: The perspective of nurses and healthcare users

Confronting ‘scale-down’: Assessing Namibia's human resource strategies in the context of decreased HIV/AIDS funding

Improving maternal and child health policymaking processes in Nigeria: an assessment of policymakers’ needs, barriers and facilitators of evidence-informed policymaking

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