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An assessment of staffing needs at a HIV clinic in a Western Kenya using the WHO workload indicators of staffing need WISN, 2011.
Human Resources For Health. 2017 Jan 26; 15(1):9.BACKGROUND: An optimal number of health workers, who are appropriately allocated across different occupations and geographical regions, are required to ensure population coverage of health interventions. Health worker shortages in HIV care provision are highest in areas that are worst hit by the HIV epidemic. Kenya is listed among countries that experience health worker shortages (<2.5 health workers per 1000 population) and have a high HIV burden (HIV prevalence 5.6 with 15.2% in Nyanza province). We set out to determine the optimum number of clinicians required to provide quality consultancy HIV care services at the Jaramogi Oginga Odinga Teaching and Referral Hospital, JOOTRH, HIV Clinic, the premier HIV clinic in Nyanza province with a cumulative client enrolment of PLHIV of over 20,000 persons. CASE PRESENTATION: The World Health's Organization's Workload Indicators of Staffing Needs (WISN) was used to compute the staffing needs and sufficiency of staffing needs at the JOOTRH HIV clinic in Kisumu, Kenya, between January and December 2011. All people living with HIV (PLHIV) who received HIV care services at the HIV clinic at JOOTRH and all the clinicians attending to them were included in this analysis. The actual staffing was divided by the optimal staff requirement to give ratios of staffing excesses or shortages. A ratio of 1.0 indicated optimal staffing, less than 1.0 indicated suboptimal staffing, and more than 1 indicated supra optimal staffing. The HIV clinic is served by 56 staff of various cadres. Clinicians (doctors and clinical officers) comprise approximately one fifth of this population (n = 12). All clinicians (excluding the clinic manager, who is engaged in administrative duties and supervisory roles that consumes approximately one third of his time) provide full-time consultancy services. To operate at maximum efficiency, the clinic therefore requires 19 clinicians. The clinic therefore operates with only 60% of its staffing requirements. CONCLUSIONS: Our assessment revealed a severe shortage of clinicians providing consultation services at the HIV clinic. Human resources managers should oversee the rational planning, training, retention, and management of human resources for health using the WISN which is an objective and reliable means of estimating staffing needs.
MMWR. Morbidity and Mortality Weekly Report. 2016 Feb 12; 65(5):115-9.Blood transfusion is a life-saving medical intervention; however, challenges to the recruitment of voluntary, unpaid or otherwise nonremunerated whole blood donors and insufficient funding of national blood services and programs have created obstacles to collecting adequate supplies of safe blood in developing countries (1). Since 2004, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) has provided approximately $437 million in bilateral financial support to strengthen national blood transfusion services in 14 countries in sub-Saharan Africa and the Caribbean* that have high prevalence rates of human immunodeficiency virus (HIV) infections. CDC analyzed routinely collected surveillance data on annual blood collections and HIV prevalence among donated blood units for 2011-2014. This report updates previous CDC reports (2,3) on progress made by these 14 PEPFAR-supported countries in blood safety, summarizes challenges facing countries as they strive to meet World Health Organization (WHO) targets, and documents progress toward achieving the WHO target of 100% voluntary, nonremunerated blood donors by 2020 (4). During 2011-2014, overall blood collections among the 14 countries increased by 19%; countries with 100% voluntary, nonremunerated blood donations remained stable at eight, and, despite high national HIV prevalence rates, 12 of 14 countries reported an overall decrease in donated blood units that tested positive for HIV. Achieving safe and adequate national blood supplies remains a public health priority for WHO and countries worldwide. Continued success in improving blood safety and achieving WHO targets for blood quality and adequacy will depend on national government commitments to national blood transfusion services or blood programs through increased public financing and diversified funding mechanisms for transfusion-related activities.
Toronto, Canada, International Council of AIDS Service Organizations [ICASO], 1998 Jun. 16 p.Over the past few years, the International Council of AIDS Service Organizations (ICASO) and its component networks and organizations have undertaken a process to determine how best to highlight human rights activities within the work it does on HIV/AIDS. This process included the ICASO Inter-Regional Consultation on Human Rights, Social Equity and HIV/AIDS, which was held in Toronto, Canada, in March 1998. This consultation constituted the first ever international meeting specifically focussing on HIV/AIDS and human rights, social equity and community networking issues. The plan described in this document is an important milestone in this process. It is part of ICASO’s ongoing efforts to provide a framework that will be useful in the work of community-based HIV/AIDS organizations. The consultation also formally endorsed the International Guidelines on HIV/AIDS and Human Rights issued by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the Office of the United Nations High Commissioner on Human Rights. Participants to the Consultation believe that the Guidelines provide a platform for the development of activities and initiatives, including advocacy education. Community-based organizations (CBOs) would need to prioritize and select specific issues they feel are critical to their efforts in prevention of HIV/AIDS, and in the care and support of those living and affected by HIV/AIDS. Section 2.0 of the document describes the links between human rights and HIV/AIDS. Section 3.0 outlines a framework for the work ICASO will be doing over the next several years in the area of human rights, social equity and HIV/AIDS. The framework consists of guiding principles, role statements, goals, objectives, activities and structures. The framework has been prepared primarily from a global perspective. Finally, Section 4.0 contains work-plans from three of the five regions of ICASO (Asia/Pacific, Africa, and Latin America and the Caribbean) showing how human rights issues will be incorporated into their work. (excerpt)
Precis. 1999 Winter; (176):1-6.Over the past 15 years, the World Bank has provided policy advice and project support to Zimbabwe, which has proven valuable to the country's health sector. However, the impact of health system performance and health outcomes has been undermined by economic stagnation and a devastating AIDS epidemic. According to Joint UN Programme on HIV/AIDS, 26% of the adult population in Zimbabwe is infected with HIV. Furthermore, the flaws in the design of the country's Economic Structural Adjustment Program contributed to the strains on the health sector, particularly with regard to civil service reform and health sector staffing. In response to this problem, the World Bank can increase its effectiveness in the sector by fitting program design to accommodate institutional and political constraints and to take advantage of existing capacities. Furthermore, the government must give priority to reducing the budget deficit and restructuring debt service to prevent further deterioration in the public health sector. Lastly, the government must also take immediate steps to give priority to AIDS prevention--particularly to substantially increase resources devoted to behavior change-- and mount an effective intersectoral response to the epidemic.