Analysis of human resources for health strategies and policies in 5 countries in Sub-Saharan Africa, in response to GFATM and PEPFAR-funded HIV-activities

Hdl Handle:
http://hdl.handle.net/10147/304929
Title:
Analysis of human resources for health strategies and policies in 5 countries in Sub-Saharan Africa, in response to GFATM and PEPFAR-funded HIV-activities
Authors:
Cailhol, Johann; Craveiro, Isabel; Madede, Tavares; Makoa, Elsie; Mathole, Thubelihle; Parsons, Ann N; Van Leemput, Luc; Biesma, Regien; Brugha, Ruairi; Chilundo, Baltazar; Lehmann, Uta; Dussault, Gilles; Van Damme, Wim; Sanders, David
Citation:
Globalization and Health. 2013 Oct 25;9(1):52
Issue Date:
25-Oct-2013
URI:
http://dx.doi.org/10.1186/1744-8603-9-52; http://hdl.handle.net/10147/304929
Abstract:
Abstract Background Global Health Initiatives (GHIs), aiming at reducing the impact of specific diseases such as Human Immunodeficiency Virus (HIV), have flourished since 2000. Amongst these, PEPFAR and GFATM have provided a substantial amount of funding to countries affected by HIV, predominantly for delivery of antiretroviral therapy (ARV) and prevention strategies. Since the need for additional human resources for health (HRH) was not initially considered by GHIs, countries, to allow ARV scale-up, implemented short-term HRH strategies, adapted to GHI-funding conditionality. Such strategies differed from one country to another and slowly evolved to long-term HRH policies. The processes and content of HRH policy shifts in 5 countries in Sub-Saharan Africa were examined. Methods A multi-country study was conducted from 2007 to 2011 in 5 countries (Angola, Burundi, Lesotho, Mozambique and South Africa), to assess the impact of GHIs on the health system, using a mixed methods design. This paper focuses on the impact of GFATM and PEPFAR on HRH policies. Qualitative data consisted of semi-structured interviews undertaken at national and sub-national levels and analysis of secondary data from national reports. Data were analysed in order to extract countries’ responses to HRH challenges posed by implementation of HIV-related activities. Common themes across the 5 countries were selected and compared in light of each country context. Results In all countries successful ARV roll-out was observed, despite HRH shortages. This was a result of mostly short-term emergency response by GHI-funded Non-Governmental Organizations (NGOs) and to a lesser extent by governments, consisting of using and increasing available HRH for HIV tasks. As challenges and limits of short-term HRH strategies were revealed and HIV became a chronic disease, the 5 countries slowly implemented mid to long-term HRH strategies, such as formalisation of pilot initiatives, increase in HRH production and mitigation of internal migration of HRH, sometimes in collaboration with GHIs. Conclusion Sustainable HRH strengthening is a complex process, depending mostly on HRH production and retention factors, these factors being country-specific. GHIs could assist in these strategies, provided that they are flexible enough to incorporate country-specific needs in terms of funding, that they coordinate at global-level and minimise conditionality for countries.
Item Type:
Article
Language:
en
Keywords:
HIV INFECTION; HEALTH POLICY

Full metadata record

DC FieldValue Language
dc.contributor.authorCailhol, Johannen_GB
dc.contributor.authorCraveiro, Isabelen_GB
dc.contributor.authorMadede, Tavaresen_GB
dc.contributor.authorMakoa, Elsieen_GB
dc.contributor.authorMathole, Thubelihleen_GB
dc.contributor.authorParsons, Ann Nen_GB
dc.contributor.authorVan Leemput, Lucen_GB
dc.contributor.authorBiesma, Regienen_GB
dc.contributor.authorBrugha, Ruairien_GB
dc.contributor.authorChilundo, Baltazaren_GB
dc.contributor.authorLehmann, Utaen_GB
dc.contributor.authorDussault, Gillesen_GB
dc.contributor.authorVan Damme, Wimen_GB
dc.contributor.authorSanders, Daviden_GB
dc.date.accessioned2013-11-04T12:40:42Z-
dc.date.available2013-11-04T12:40:42Z-
dc.date.issued2013-10-25-
dc.identifier.citationGlobalization and Health. 2013 Oct 25;9(1):52en_GB
dc.identifier.urihttp://dx.doi.org/10.1186/1744-8603-9-52-
dc.identifier.urihttp://hdl.handle.net/10147/304929-
dc.description.abstractAbstract Background Global Health Initiatives (GHIs), aiming at reducing the impact of specific diseases such as Human Immunodeficiency Virus (HIV), have flourished since 2000. Amongst these, PEPFAR and GFATM have provided a substantial amount of funding to countries affected by HIV, predominantly for delivery of antiretroviral therapy (ARV) and prevention strategies. Since the need for additional human resources for health (HRH) was not initially considered by GHIs, countries, to allow ARV scale-up, implemented short-term HRH strategies, adapted to GHI-funding conditionality. Such strategies differed from one country to another and slowly evolved to long-term HRH policies. The processes and content of HRH policy shifts in 5 countries in Sub-Saharan Africa were examined. Methods A multi-country study was conducted from 2007 to 2011 in 5 countries (Angola, Burundi, Lesotho, Mozambique and South Africa), to assess the impact of GHIs on the health system, using a mixed methods design. This paper focuses on the impact of GFATM and PEPFAR on HRH policies. Qualitative data consisted of semi-structured interviews undertaken at national and sub-national levels and analysis of secondary data from national reports. Data were analysed in order to extract countries’ responses to HRH challenges posed by implementation of HIV-related activities. Common themes across the 5 countries were selected and compared in light of each country context. Results In all countries successful ARV roll-out was observed, despite HRH shortages. This was a result of mostly short-term emergency response by GHI-funded Non-Governmental Organizations (NGOs) and to a lesser extent by governments, consisting of using and increasing available HRH for HIV tasks. As challenges and limits of short-term HRH strategies were revealed and HIV became a chronic disease, the 5 countries slowly implemented mid to long-term HRH strategies, such as formalisation of pilot initiatives, increase in HRH production and mitigation of internal migration of HRH, sometimes in collaboration with GHIs. Conclusion Sustainable HRH strengthening is a complex process, depending mostly on HRH production and retention factors, these factors being country-specific. GHIs could assist in these strategies, provided that they are flexible enough to incorporate country-specific needs in terms of funding, that they coordinate at global-level and minimise conditionality for countries.-
dc.language.isoenen
dc.subjectHIV INFECTIONen_GB
dc.subjectHEALTH POLICYen_GB
dc.titleAnalysis of human resources for health strategies and policies in 5 countries in Sub-Saharan Africa, in response to GFATM and PEPFAR-funded HIV-activitiesen_GB
dc.typeArticleen
dc.language.rfc3066en-
dc.rights.holderJohann Cailhol et al.; licensee BioMed Central Ltd.-
dc.description.statusPeer Reviewed-
dc.date.updated2013-10-30T16:09:02Z-
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