Global strategy on human resources for health: Workforce 2030

In May 2014, the Sixty-seventh World Health Assembly adopted resolution WHA67.24 on Follow-up of the Recife Political Declaration on Human Resources for Health: renewed commitments towards universal health coverage. In paragraph 4(2) of that resolution, Member States requested the Director-General of the World Health Organization (WHO) to develop and submit a new global strategy for human resources for health (HRH) for consideration by the Sixty-ninth World Health Assembly.

Development of the draft Global Strategy was informed by a process launched in late 2013 by Member States and constituencies represented on the Board of the Global Health Workforce Alliance, a hosted partnership within WHO. Over 200 experts from all WHO regions contributed to consolidating the evidence around a comprehensive health labour market framework for universal health coverage (UHC). A synthesis paper was published in February 2015(1) and informed the initial version of the draft Global Strategy.

An extensive consultation process on the draft version was launched in March 2015. This resulted in inputs from Member States and relevant constituencies such as civil society and health care professional associations. The process also benefited from discussions in the WHO regional committees, technical consultations, online forums and a briefing session to Member States’ permanent missions to the United Nations (UN) in Geneva. Feedback and guidance from the consultation process are reflected in the draft Global Strategy, which was also aligned with, and informed by the draft framework on integrated peoplecentred health services.(2)

The Global Strategy on Human Resources for Health: Workforce 2030 is primarily aimed at planners and policy-makers of WHO Member States, but its contents are of value to all relevant stakeholders in the health workforce area, including public and private sector employers, professional associations, education and training institutions, labour unions, bilateral and multilateral development partners, international organizations, and civil society.

Throughout this document, it is recognized that the concept of universal health coverage may have different connotations in countries and regions of the world. In particular, in the WHO Regional Office for the Americas, universal health coverage is part of the broader concept of universal access to health care. …more


Lack of private GP buy-in is the Achilles heel of NHI

AFTER three years of laying the groundwork for the introduction of National Health Insurance (NHI), Health Minister Aaron Motsoaledi has run into a major stumbling block: the private-sector general practitioners (GPs), whose services will be essential to scale up the provision of health services at public facilities, simply do not want to work in his clinics. Fewer than 200 of the 8,000 GPs working in private practice have agreed to work in public clinics since the NHI pilot programme was launched in 11 of SA’s 53 health districts in April 2012, despite a national roadshow by Motsoaledi to talk up the benefits of the project. While more GPs have shown a willingness to work for the state in their own consulting rooms, the Department of Health has balked at the prospect, fearing it will not be able to exercise proper oversight…..more

Nursing Educom – meeting the Health information need of Nurses and Midwives working in Low and Middle income Countries

The link below is a project I have entered for the Connecting-nurses care-challenge innovation platform. This project aims to help improve the Health information need of nurses and midwives working in both rural and urban areas. I hope you take time to read and react to this project either by liking it and commenting on it through the link below. I also hope to work with HIFA in developing this project if it gets selected at any stage. Below is a brief of the project:

Goal: Nursing Educom is a web/mobile based platform which will provide care information to nurses

Problem: Nurses and midwives working in low and middle income countries especially in the communities have limited knowledge on how to save life and perform some life saving procedures in simple emergency situation. This causes unnecessary deaths and complications in the line of duty. The lack of quick and guaranteed care information lab or information database where nurses and midwives can easily access information in line of duty as well as update their knowledge in the current practices tends to be very low. 3 in 5 nurses working in communities and rural setting in Nigeria do not have the basic life saving know, do not have money for continuous continuing education, cannot afford seminars and conference fees and hence cannot upgrade their care knowledge. This is a major contributor to the outcome of patients care as well as patients experiences while receiving nursing care. The information need for nurses and midwives in Nigeria and Africa is at a very low rate, hence the need to provide them with access to health information. 80% of nurses working in Low and Middle income Countries find it difficult to pass information to the patient during and after treatment and do not engage their patient during treatment because of lack of knowledge, they do not know what to inform the patient even if the patient requests for the information, this creates a gap in the care and reduce the nurse-patient relationship to near zero. There is no dedicated platform for nurses to freely access research information, nursing practical demonstrations, new treatment guidelines and reference information when the need arises.

Nursing Educom… at:


Ralueke Ekezie

SciDev.Net: Dispel rumours to fix immunisation’s image problems

Below are extracts from a news article on SciDev.Net

Dispel rumours to fix immunisation’s image problems

Inga Vesper

Vaccine programmes can trigger fears of conspiracies and oppression. It’s time they got more collaborative…

“Each individual case of vaccine reluctance needs its own individual response — be it an explanatory website or a conjoined international diplomatic effort.”

“Some people think it’s sterilisation, or that we are infecting people with HIV/AIDs,” an MSF nurse working in the camp told SciDev.Net. “They say it’s the government’s way of controlling the refugees.”…

Fear of vaccination is one example of difficulties that arise when modern healthcare meets customs, beliefs, experiences and traditions — and it is not limited to the developing world, as the case of the MMR vaccine and fear of autism has shown…

In the 1990s, scientists recruited Zimbabweans for HIV/AIDS research without properly informing them of the risks, and many participants became infected with HIV/AIDS. Up until the 1980s, forced sexual reassignment surgery was conducted on homosexual black people in South Africa as part of medical experiments.

So, it is no wonder that modern vaccination programmes are regarded with suspicion in many parts of the world. But the health implications of such misperception are evident.

In Nigeria, a polio vaccine was widely boycotted in 2003 because local officials so mistrusted the government they believed rumours that the vaccine spread cancer.

What this suggests is that international health organisations and national health authorities are struggling to adapt their vaccine campaigns to address lingering concerns and meet cultural expectations. The problem of immunisation reluctance is widely known, yet few health authorities are making concerted efforts about it.

This is because the issue goes beyond merely providing better information. According to Unicef, people resist vaccines for many reasons. Culture and belief play a part, as does history. And sometimes it’s about how the vaccine is delivered. During polio vaccinations in India, for example, people from Uttar Pradesh did not want doctors from New Delhi to do the vaccinations for fear there would be no one to turn to in case of complications…

Modern media and communication technologies can play a part in dispelling myths about vaccines. Health providers need to team up with local opinion-shapers, such as religious and community leaders, education authorities and even celebrities, to dispel rumours and encourage people to get vaccinated.

One success story is the tetanus vaccine programme in Kenya. Shortly after its launch in 1994, the programme attracted misleading news reports stating that the vaccine’s ingredients were sterilising women. In this case, the World Health Organization teamed up with the Vatican to reassure local faith leaders and spread the message on the vaccine’s benefits.

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Using Twitter to drive research impact: A discussion of strategies, opportunities and challenges

Below are the citation and abstract of a new paper on the use of Twitter to drive research impact.

You can follow the HIFA Twitter feed here: @hifa_org (and the HIFA Facebook page here: )

With thanks to HIFA Twitter coordinator Jules Storr (and HIFA Facebook coordinator Tara Ballav Adhikari)

CITATION: International Journal of Nursing Studies

Volume 59, July 2016, Pages 15–26

Using Twitter to drive research impact: A discussion of strategies, opportunities and challenges

Katy Schnitzler, Nigel Davies, Fiona Ross, Ruth Harris



Researchers have always recognised the importance of disseminating the findings of their work, however, recently the need to proactively plan and drive the impact of those findings on the wider society has become a necessity. Firstly, this is because funders require evidence of return from investment and secondly and crucially because national research assessments are becoming powerful determinants of future funding. In research studies associated with nursing, impact needs to be demonstrated by showing the effect on a range of stakeholders including service users, patients, carers, the nursing workforce and commissioners. Engaging these groups is a well-known challenge influenced by lack of access to academic journals, lack of time to read long complex research papers and lack of opportunities to interact directly with the researchers. This needs to be addressed urgently to enable nursing research to increase the impact that it has on health delivery and the work of clinical practitioners. Social media is potentially a novel way of enabling research teams to both communicate about research as studies progress and to disseminate findings and research funders are increasingly using it to publicise information about research programmes and studies they fund. A search of the healthcare literature reveals that advice and guidance on the use of social media for research studies is not well understood or exploited by the research community. This paper, therefore, explores how using social networking platforms, notably Twitter offers potential new ways for communicating research findings, accessing diverse and traditionally hard-to-reach audiences, knowledge exchange at an exponential rate, and enabling new means of capturing and demonstrating research impact. The paper discusses approaches to initiate the setup of social networking platforms in research projects and considers the practical challenges of using Twitter in nursing and healthcare research. The discussion is illuminated with examples from our current research. In summary, we suggest that the use of social media micro-blogging platforms is a contemporary, fast, easy and cost effective way to augment existing ways of disseminating research which helps drive impact.

What is already known about the topic?

– Demonstrating impact of research is an increasing requirement of universities, funding bodies and governments in higher income countries, a trend which almost certainly will spread internationally.

– The use of social networking sites is expanding communication and networking in business and increasingly used in health and nursing communities.

– The use of social networking/micro-blogging platforms such as Twitter™ and Facebook™ by researchers as part of strategies to engage wider audiences are not well developed.

What this paper adds

– Comprehensive review and discussion of how micro-blogging platforms can be used to support dissemination and potentially increase the spread and impact of research.

– A scholarly discussion of how social networking sites can contribute to proactively engaging with multiple audiences to facilitate research impact.

– A detailed practical guide for researchers to enable them to consider how social networking platforms can support their research and its ongoing impact.

Best wishes, Neil

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New free e-learning course on Personalised Medicine

This course has been developed by ecancer in conjunction with the ‘Personalised Medicine’ project, co-funded under the European Community’s 7th Framework Programme, aimed at developing new tools, IT infrastructure and VPH models to accelerate personalised medicine for the benefit of the patient.

The course consists of 12 separate modules which contain explanations of a number of topics including molecular profiling, molecular imaging, personalised treatments, tailored surgery, cognitive psychology and pharmacogenomics, and is aimed at Healthcare professionals and researchers wanting to expand their knowledge of Personalised Medicine.

The modules are all free to take and can be accessed here

HIFA profile: Katie Foxall is Head of Publishing at eCancer, Bristol, UK. katie AT

Exploring the role of communication in community health in Sierra Leone

Below are extracts from an important new report from BBC Media Action, by Annabelle Wittels…

The full report [1.5 Mb] is available here:

BBC Media Action, the BBC’s international development charity, uses the power of media and communication to support people to shape their own lives. Working with broadcasters, governments, other organisations and donors, we provide information and stimulate positive change in the areas of governance, health, resilience and humanitarian response.

Giving communities access to reliable and actionable health information is particularly valuable in countries where there are exceptionally few health professionals, for example Sierra Leone…

As part of the efforts to rebuild and strengthen health systems in Sierra Leone, BBC Media Action conducted two studies in late 2015 to explore the role that media and communication can play in improving health outcomes across communities. This report presents the insights gained about people’s access to health information, decision-making processes and communication networks. Previous BBC Media Action research has revealed that the most effective health communication is two-way, involving audience feedback, discussion and use of information. BBC Media Action therefore extended the research focus to explore the health-seeking and information-seeking behaviour of participants.

This report draws on two studies: first, a nationally representative quantitative survey, and, second, a qualitative study across three locations in Sierra Leone. Data for the nationally representative quantitative survey was collected between October and mid-November 2015 across the country’s 14 districts. In total, 2,500 Sierra Leoneans were interviewed for the quantitative survey. The qualitative study had a strong focus on rural communities as these tend to have worse access to health centres and to be less wealthy and less educated than urban populations – factors that are associated with more negative health outcomes. Focus group discussions (FGDs) and in-depth interviews (IDIs) were conducted in rural Port Loko, rural Kenema, Western Area Rural and Western Area Urban.

The main research findings are:

Radio and mobile phones are the media platforms that can reach the most people…

People are accessing health information. Ninety-five per cent of research participants reported accessing health information in the previous three months – 93% receiving information about Ebola and 43% receiving information about pneumonia.

There is a strong interest in health information in Sierra Leone. Eighty-six per cent of Sierra Leoneans want to receive more information on health for themselves and their families.

People are interested in receiving information on a range of health issues…

The qualitative research revealed a number of factors that explain why people do not seek formal health providers or health information. These are:

– Seriousness of health issue. If there is a perception that a health issue is not acutely life-threatening, people are less likely to seek information about it…

– Previous experience. If the individual or their family has personal experiences of informal healthcare that are better than their experiences of formal healthcare, they prefer to rely on informal services before consulting formal healthcare providers.

– Prioritise the health of their children. Parents are more inclined to seek healthcare information when their children are ill. However, Sierra Leoneans are less likely to seek information for illnesses perceived as non-urgent.

– Preference for traditional healers for some illnesses. When illnesses are believed to have a spiritual source, people initially seek help from traditional healers…

– Costs of healthcare…

– Distance to the trusted healthcare provider. With only 900 qualified health professional in the country since the Ebola crisis, formal healthcare services are not available in every community…

Nonetheless, there are opportunities to encourage Sierra Leoneans to seek and engage more with health information:

– Face-to-face communication is most trusted. People prefer face-to-face communication, which gives them time to ask questions and allows communicators to reassure themselves that information has not been misunderstood.

– Community health workers (CHWs) have the potential to reach people with face-to-face information.

– Mobile phones are used by the majority of the population… only 25% of Sierra Leoneans indicated that they would pay for health information delivered via mobile phones.

Communicators of health information such as international or national non-governmental organisations (INGOs or NGOs), health practitioners and the Sierra Leonean government can draw on these insights to guide their future interventions in the following ways:

– CHWs are well placed to provide face-to-face communication. This study and other research5 show that Sierra Leoneans prefer face-to-face and interpersonal communication, but CHWs often rely on simple one-way models of communication. They could profit from support through training and tools. Such efforts should first help CHWs to fashion their communication in a way that encourages greater dialogue and exchange. Second, the training could address the demand for more in-depth information. Training and tools for CHWs should build confidence in providing information with greater depth and breadth.

– High levels of trust for nurses and doctors could be built on to maximise the credibility of health communication…

– Radio and mobile phones, the two media with the highest access and ownership figures across Sierra Leone, appear best positioned to provide health information. Other research suggests that if mobility is compromised, as it was during the Ebola crisis, people prefer to receive information by radio.

– When using mobile phones, information that can be delivered via basic phones and is voice-based, not requiring reading skills, is more likely to reach across different strata of Sierra Leonean society.

– Although two-way communication might be easier to achieve when face-to-face, mass media in Sierra Leone should build on experiences of communication during the Ebola crisis, which illustrated that bottom-up communication facilitates positive behaviour change.

Communication efforts should equip communities with actionable information. The findings from this study suggest that communities are more likely to implement health information if it is easy, cheap and quick to implement. This is especially important in the context of preventative care, within which community members show less proactive behaviours. Providing actionable information could help communities to overcome barriers to engage and act upon health knowledge.

Best wishes, Neil

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Lancet: Diabetes – 100s of millions lack access to medicines or information

‘Hundreds of millions of people live with diabetes today. Many of them do not know it, and many of those who do lack access to the necessary medicines or information’, says a Comment in this week’s Lancet [1].

The comment refers to a major study published in the same issue on Worldwide trends in diabetes since 1980 [2], which concludes: ‘Since 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide.’

The authors also note:

‘Diabetes and its macrovascular and microvascular complications account for more than 2 million deaths every year, and are the seventh leading cause of disability worldwide.’

‘Low-income and middle-income countries, including Indonesia, Pakistan, Mexico, and Egypt, replaced European countries, including Germany, Ukraine, Italy, and the UK, on the list of the top ten countries with most adults with diabetes’

An accompanying editorial says: ‘Immediate action is needed to avert this escalating health disaster.’ The full text of all articles is freely accessible.

1. Trends in diabetes: sounding the alarm

Krug, Etienne G

The Lancet , Volume 387 , Issue 10027 , 1485 – 1486

2. Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4·4 million participants

The Lancet , Volume 387, Issue 10027 , 1513 – 1530

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WHO, UK and German governments launch global patient safety movement

‘At the Patient Safety Global Action Summit last month, the global health community, led by the Dr Margaret Chan – the Director General of the World Health Organization, Jeremy Hunt MP – the UK Secretary of State for Health, Professor the Lord Ara Darzi – Director of the NIHR Imperial Patient Safety Translational Research Centre (PSTRC) and seven health ministers and ministerial delegates from 12 other health systems gathered in London to kick-off a global movement for patient safety, which aimed to jump-start coordinated global action to reduce avoidable harm caused to patients by the health services….’

Many of the above themes were captured in the report Patient Safety 2030

Below are extracts from the executive summary:


“First do no harm.” This principle remains central to the provision of high-quality healthcare. The mission to make care safer unites professionals and patients alike, and safety is a key component of any quality initiative. Yet there are still too many avoidable errors…

The increased complexity of care creates new risks of error and harm to patients…

In recent years, healthcare budgets have tightened across OECD countries, a necessity to ensure sustainability while facing reduced economic growth. However, this limits expenditure on resources that are crucial for patient safety, such as staffing levels and investment in appropriate facilities and equipment.

Appropriate deployment of governance and regulation, improved use of data and information, stronger leadership, and enhanced education and training all promote safer care. Moreover, emerging approaches – including behavioural insights and digital health – will add new options to the patient safety toolkit…

1. A systems approach. The approach to reduce harm must be integrated and implemented at the system level.

2. Culture counts. Health systems and organisations must truly prioritise quality and safety through an inspiring vision and positive reinforcement, not through blame and punishment.

3. Patients as true partners. Healthcare organisations must involve patients and staff in safety as part of the solution, not simply as victims or culprits.

4. Bias towards action. Interventions should be based on robust evidence. However, when evidence is lacking or still emerging, providers should proceed with cautious, reasoned decision-making rather than inaction.

For safety to triumph, we must make a global commitment to improve the safety of the care we provide. Patient safety is a shared goal of health systems all over the world. However, there is significant untapped potential in this global movement. To capture this potential, three ingredients are necessary:

1. Global: the movement should be truly global and include low- and middle-income countries that have so far been at its margins.

2. Focused: while safety is a common goal across countries, some issues are more dependent on the local context and require tailored solutions. International collaboration should focus on identifying high-level trends and raising awareness of common issues, including measurement of a core set of high-level indicators.

3. Coordinated: to maximise their impact and avoid duplication of efforts, the patient safety movement should be coordinated across all stakeholders…

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Yellow fever outbreak in Angola

Why a yellow fever outbreak in Angola is a “potential threat for the entire world”

‘Yellow fever, a much-feared mosquito-borne virus, has sickened thousands of people and killed hundreds in Angola over the past five months. A cluster of cases first appeared in Angola’s capital, Luanda, in December, and the virus has now sickened people in 16 of the country’s 18 provinces. People infected in Angola have already taken the virus to China, Kenya, Mauritania, and the Democratic Republic of the Congo (where at least 21 people have died), a pattern that has the World Health Organization very worried. “This outbreak,” the agency said this week, “constitutes a potential threat for the entire world.” A leading researcher of mosquito-borne diseases, Duane Gubler at Duke-NUS Medical School, is gravely concerned about the outbreak too. “We’re sitting on a time bomb waiting for it to blow,” he said, “and we’re really not doing anything about it.” As scientists try to get a grip on the outbreak in Angola, one fact is already clear: Many other countries are at risk because they’re not adequately prepared. Yellow fever is part of an uptick in mosquito-borne diseases all over the world that are suddenly threatening global heath in new and scary ways.’

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An Ageing World: 2015

Please find here a new report on global aging:

An Aging World: 2015

‘The world population continues to grow older rapidly as fertility rates have fallen to very low levels in most world regions and people tend to live longer. When the global population reached 7 billion in 2012, 562 million (or 8.0 percent) were aged 65 and over. In 2015, 3 years later, the older population rose by 55 million and the proportion of the older population reached 8.5 percent of the total population…’

This ageing population will place increasing demands on health systems and health professionals. Old age brings a much higher burden of disease with co-existence of multiple morbidity, including cardiovascular disease, diabetes, cancer and dementia. Health professionals will need more than ever to have the skills, information, medicines and resources to deal with increasingly complex cases.

Best wishes, Neil

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Micro-workouts mean no more excuses not to exercise

stretchingexercisexxxNEW YORK — Mark Ewell was at the St Louis airport waiting for a flight and lamenting that he had not had time to work out that day. So he paid a shoeshine guy $10 to watch his bag, laced up his running shoes and spent 15 minutes running through the concourse. Mr Ewell, a realtor in Colorado Springs, often does a boot camp-style exercise video or runs for an hour or more. But when he is short on time, he will do 50 push-ups or run up the stairs 10 times in the model home where he works. The short bursts allow him to complete a bit of physical activity every day. “What it’s about is eliminating excuses,” he says…..more