Rebuilding human resources for health: a case study from Liberia

Varpilah, S. Tornorlah; Safer, Meredith; Frenkel, Erica; Baba, Duza; Massaquoi, Moses; Barrow, Genevieve

doi:10.1186/1478-4491-9-11

Cited by 50 publications

(68 citation statements)

References 3 publications

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“…A similar comprehensive and systemic approach in Liberia, another 'post'-conflict state, focused on nurses and proved to be effective in expanding service coverage. 29 Cambodian Taskforces strengthened coordination at the decision-making level and collaboration at the implementation level. The approach enhanced linkages between the components of the 'House Model' contributing to HRH system development.…”

Section: Discussionmentioning

confidence: 99%

Addressing the human resources crisis: a case study of Cambodia’s efforts to reduce maternal mortality (1980–2012)

et al. 2013

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ObjectiveTo identify factors that have contributed to the systematic development of the Cambodian human resources for health (HRH) system with a focus on midwifery services in response to high maternal mortality in fragile resource-constrained countries.DesignQualitative case study. Review of the published and grey literature and in-depth interviews with key informants and stakeholders using an HRH system conceptual framework developed by the authors (‘House Model’; Fujita et al, 2011). Interviews focused on the perceptions of respondents regarding their contributions to strengthening midwifery services and the other external influences which may have influenced the HRH system and reduction in the maternal mortality ratio (MMR).SettingThree rounds of interviews were conducted with senior and mid-level managers of the Ministries of Health (MoH) and Education, educational institutes and development partners.ParticipantsA total of 49 interviewees, who were identified through a snowball sampling technique.Main outcome measuresScaling up the availability of 24 h maternal health services at all health centres contributing to MMR reduction.ResultsThe incremental development of the Cambodian HRH system since 2005 focused on the production, deployment and retention of midwives in rural areas as part of a systematic strategy to reduce maternal mortality. The improved availability and access to midwifery services contributed to significant MMR reduction. Other contributing factors included improved mechanisms for decision-making and implementation; political commitment backed up with necessary resources; leadership from the top along with a growing capacity of mid-level managers; increased MoH capacity to plan and coordinate; and supportive development partners in the context of a conducive external environment.ConclusionsLessons from this case study point to the importance of a systemic and comprehensive approach to health and HRH system strengthening and of ongoing capacity enhancement and leadership development to ensure effective planning, implementation and monitoring of HRH policies and strategies.

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Section: Discussionmentioning

confidence: 99%

Addressing the human resources crisis: a case study of Cambodia’s efforts to reduce maternal mortality (1980–2012)

et al. 2013

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“…Agreements to curb this "poaching" [15] have been called for and some attempts made [2,13]. However, resolution of migration by this means is unlikely, as even if medical migration from resource-constrained countries was halted, although this would alleviate the shortage of human resources for health, it would not solve the problem entirely [19]. Similarly, while incentives (both financial and nonfinancial) would reduce the current distribution inequities in the global health workforce, such incentives, even if forthcoming, would be insufficient to achieve an equitable distribution alone.…”

Section: Discussionmentioning

confidence: 99%

A Descriptive, Cross-Sectional Study of Ugandan Students in Health Care Education regarding Postgraduate Migration and Future Practice

Kasangaki

Macnab

Gagnon³

2012

ISRN Education

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A growing challenge of globalization is the migration of many healthcare trainees to richer nations when they complete their education. This loss of intellectual capital compromises the ability of low-income countries to provide adequate health care. Despite recognition of this loss most African nations keep no track of those they train. Effective investment in health care demands retention of this resource; the ability to direct healthcare providers where needed; understanding of local factors driving migration, choices regarding postgraduate training abroad, and future practice preference. Self-administered questionnaires were distributed to a random sample of 200 Uganda College of Health Sciences students for anonymous completion; 141/200 (70.5%) were completed; 84% of respondents intended to pursue postgraduate studies abroad; 63% to migrate within five years of graduation; 57% to work in urban areas. While partly due to global trends and awareness of international opportunities, this negative trend of migration and shunning rural practice is also influenced by sociopolitical and educational elements within Uganda. One option (adopted elsewhere) is mandatory practice in government community health centers for a period following graduation. But the ethics, consequences, and implications of current international migratory trends need to be addressed locally and by the global medical education community.

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“…There is a general shortage of skilled health workers who are not equitably distributed thus leaving a vast proportion of the rural population under-served [15]. Health workforce crisis persists despite 37% increase in core health professionals (Doctors, Nurses, Midwives and Physician Assistants) from 6.3 per 10,000 population in 2010 to 8.6 per 10,000 population in 2015, and due to persistent inequity in the distribution of health workers (Figure 2).…”

Section: Overview Of the Health Systemmentioning

confidence: 99%

“…Health workforce crisis persists despite 37% increase in core health professionals (Doctors, Nurses, Midwives and Physician Assistants) from 6.3 per 10,000 population in 2010 to 8.6 per 10,000 population in 2015, and due to persistent inequity in the distribution of health workers (Figure 2). Health facilities experienced frequent stockout of medical supplies and the supply chain management was dysfunctional and fragmented [15].…”

Section: Overview Of the Health Systemmentioning

confidence: 99%

Setting the Scene for Post-Ebola Health System Recovery and Resilience in Liberia: Lessons Learned and the Way Forward

Zolia¹,

Musa²,

Wesseh³

et al. 2017

Health Syst Policy Res

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Following the devastation caused by the 2014 Ebola outbreak in Liberia there remains much to be done for the health system to fully recover and become resilient against any future public health threat. Liberia is a post-conflict setting having experienced prolonged years of civil conflict that weakened the health system. With the decline in the incidence of new Ebola cases in late 2014 and the progressive draw down of the emergency and humanitarian response resources from early 2015, the government of Liberia moved to set the scene for the health system's recovery and resilience through the development of a comprehensive seven-year Investment Plan for building a resilient health system (2015-2021). The Plan aims to ensure universal health coverage, guarantee health security and improve health outcomes for the population of Liberia, while complementing the National Health Policy and Plan (2011-2021). The plan requires the investment of 1.7 billion US dollars over a period of seven years and realignments that the Government of Liberia alone does not currently have the capacity to undertake without long term external support. This paper describes the experience of Liberia in the development of the Investment Plan for building a resilient health system following the 2014-15 Ebola crisis, the approaches, process and realignments that were undertaken, lessons learned, and the way forward. It aims to provide lessons for countries recovering from crises, on how to manage their system recovery efforts.

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Rebuilding human resources for health: a case study from Liberia

Cited by 50 publications

References 3 publications

Addressing the human resources crisis: a case study of Cambodia’s efforts to reduce maternal mortality (1980–2012)

Addressing the human resources crisis: a case study of Cambodia’s efforts to reduce maternal mortality (1980–2012)

A Descriptive, Cross-Sectional Study of Ugandan Students in Health Care Education regarding Postgraduate Migration and Future Practice

Setting the Scene for Post-Ebola Health System Recovery and Resilience in Liberia: Lessons Learned and the Way Forward

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