Tackling the human resources for health crisis: A view from RESYST

We know that there is a health worker crisis in Africa. We’ve heard that nurses and midwives are part of the solution. So, what do we do about it? At the African Medical & Research Foundation (AMREF), we are actively engaged in health programmes and policy formulation with Ministries of Health across Africa. Our health research portfolio prioritises health systems strengthening. As part of the DFID-funded RESYST Research Programme Consortium we have been looking at training for nurses and midwives in Africa.

Whilst there are many/an increasing number of private nurse training institutions in Kenya/low and middle-income countries, little is known about the curriculum and content of the courses and the quality of the teaching, and also whether these institutions seek to address human resource challenges and public health needs in their local environments (such as a lack of health workers in rural areas).

Resilient and responsive health systems

RESYST is an international consortium led by the London School of Hygiene & Tropical Medicine that conducts health systems and policy research in Africa and Asia, to help countries find sustainable solutions to their health systems questions. During the week beginning 16th September, the consortium held its third annual meeting, hosted by the Health Strategy and Policy Institute in Hanoi, Vietnam.

Workshop poster Credit: Lucy Gilson

The meeting focused on RESYST’s major research themes: (1) health workforce, (2) health governance and (3) financing for health systems. As part of the research, two learning sites are being developed in Kenya and South Africa, and longitudinal studies of nurse cohorts are being conducted in Thailand, South Africa and also in India. Under the health workforce theme, led by Duane Blaauw and Mylene Lagarde, AMREF and IHPP are examining the emerging role of private sector nursing training institutions, in conjunction with the Nursing Council of Kenya, the Uganda Nurses and Midwives Council and the Thai Nursing Council. The active engagement of the nursing councils in these three countries helps keep the research relevant to policy-makers and dramatically improves the likelihood that findings will be adopted by national governments.

Some of the best aspects of the face-to-face meetings have been dialogues across the research teams. AMREF’s work has benefitted substantially from IHPP’s experience in Thailand and Duane’s advice from the University of the Witwatersrand in Johannesburg. By the next RESYST annual meeting in August 2014, we expect to be comparing datasets, discussing analytical approaches and planning policy briefs and publications based on evidence about nursing training in East Africa and Thailand.

We also had excellent presentations on gender perspectives in health systems research, led by Sally Theobald of REBUILD (another DFID Research Programme Consortium) and Pamoja Communication’s Kate Hawkins. We collaborated on developing a theory of change for integrating gender into our research and have already modified some research plans to incorporate this week’s discussions on gender.

Midwife examining pregnant woman Credit: AMREF

Planning for the future

AMREF expects its engagement with RESYST to strengthen the evidence we can bring to decision-makers in Africa. Our research on the training of nurses in Kenya and Uganda is a start – we are looking to these kinds of research networks to enhance the evidence we can generate from our 150 health projects across the African continent, and to bring that evidence to health practitioners who need it. For a non governmental organisation like AMREF being part of the RESYST network provides an exciting opportunity which we hope will lead to real and significant change on the ground.

By Ravi Ram, AMREF

Dr. Ravi M. Ram is the Head of Monitoring and Evaluation for AMREF Headquarter, in Nairobi, Kenya. He is responsible for M&E systems across AMREF’s 150 health projects in Africa, focusing on strategic direction and planning, programme quality and impact assessments, use of evidence to influence health policy and practice, and health systems research on human resources for health and mHealth.

Many thanks to our colleagues from HSPI in Hanoi, particularly Dr. Mai Oanh and Dr. Khuong Anh Tuan, and to the Government of Vietnam for providing a wonderful environment in Hanoi and for hosting the RESYST meeting.

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