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

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dc.contributor.authorCailhol, Johann
dc.contributor.authorCraveiro, Isabel
dc.contributor.authorMathole, Thubelihle
dc.contributor.authorParsons, Ann Neo
dc.contributor.authorLehmann, Uta
dc.contributor.authorSanders, David
dc.contributor.authorMadede, Tavares
dc.contributor.authorMakoa, Elsie
dc.contributor.authorVan Leemput, Luc
dc.contributor.authorBiesma, Regien
dc.contributor.authorBrugha, Ruairi
dc.contributor.authorChilundo, Baltazar
dc.contributor.authorDussault, Gilles
dc.contributor.authorVan Damme, Wim
dc.date.accessioned2017-06-28T08:48:10Z
dc.date.available2017-06-28T08:48:10Z
dc.date.issued2013
dc.description.abstractBACKGROUND: 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.en_US
dc.description.accreditationDepartment of HE and Training approved list
dc.identifier.citationCailhol, J. et al. (2013). 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. Globalization and Health, 9 (52): 1-14en_US
dc.identifier.issn1744-8603
dc.identifier.urihttp://hdl.handle.net/10566/3004
dc.language.isoenen_US
dc.publisherBioMed Central -The Open Access Publisheren_US
dc.rightsCopyright Authors. This is an open access article under the terms of the Creative Commons Attribution-Non Commercial License.
dc.subjectHuman resources for healthen_US
dc.subjectSub-Saharan Africaen_US
dc.subjectHRH policiesen_US
dc.subjectGlobal health initiativesen_US
dc.subjectHIVen_US
dc.subjectGFATMen_US
dc.subjectPEPFARen_US
dc.subjectHealth system strengtheningen_US
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_US
dc.typeArticleen_US

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