Table of contents

Table of contents

Overview of the impact of HIV/AIDS on the health workforce .....................................................................

............... 1

Definition and importance of the health workforce..............................................................................

........................ 1

The magnitude of the health workforce crisis ...................................................................................

.......................... 1

Why the concern? ...............................................................................................................

................................. 3

Loss rates by cadre ............................................................................................................

.................................. 4

Why are health workers absent? .................................................................................................

........................ 4

Unfilled posts in the health sector ............................................................................................

............................ 4

The gender dimension...........................................................................................................

............................... 5

Health system effects of HIV/AIDS ..............................................................................................

........................ 5

HIV/AIDS-related morbidity and mortality among health workers ..................................................................

............ 8

HIV/AIDS-related morbidity .....................................................................................................

............................. 8

HIV/AIDS-related mortality .....................................................................................................

.............................. 8

Policy implications of morbidity and mortality .................................................................................

..................... 9

Impact of HIV/AIDS on workforce motivation, performance and migration ..........................................................

.... 10

Motivation and performance.....................................................................................................

.......................... 10

Migration ......................................................................................................................

....................................... 11

Attrition of health workers in Africa ..........................................................................................

.......................... 11

Policy options for the future ..................................................................................................

..................................... 12

Policy goal ....................................................................................................................

...................................... 13

Current policy gaps and obstacles.................................

.............................................................

....................... 13

Recommendations for future policy ..............................................................................................

..................... 19

Conclusion .....................................................................................................................

............................................ 21

Annex 1. Summary of lessons learnt .............................................................................................

........................... 22

Background to the consultancy ..................................................................................................

........................ 22

Methodology ....................................................................................................................

................................... 22

Initial findings...............................................................................................................

....................................... 22

Recommendations ................................................................................................................

............................. 23

List of figures

Figure 1. 250-fold variation in supply of doctors among countries, ratio of doctors per 100 000 population ........... 2

Figure 2. 400-fold variation in supply of nurses among countries, ratio of nurses per 100 000 population ............. 2

Figure 3. Projection of health workers with AIDS, Botswana .....................................................................

............... 3

Figure 4. Reported TB patients in Swaziland, 1991–2004 .........................................................................

............... 6

Figure 5. Caseload in Kenyan facilities, 1996, 1999 and 2002 ...................................................................

.............. 6

Figure 6. Expansion of ART services ............................................................................................

............................. 7

Figure 7. Health worker attrition due to death, Mozambique Ministry of Health..................................................

...... 9

Figure 8. International migration of nurses to the United Kingdom from selected African countries, 1998–2003.. 11

Figure 9. Attrition of health workforce staff, Kenya, 1996–2001................................................................

.............. 12

Figure 10. Causes of attrition among health workers in six selected districts, Malawi, 1996–2002 (n=527) ......... 12

Figure 11. Improvements in staff satisfaction, Uganda, 2004 ....................................................................

............. 18

Figure 12. Improvements in staff performance, Uganda, 2004 .....................................................................

.......... 18

Use of

Reviewed

Antiretroviral Agents in HIV-1-Infected Adults and Adolescents

available at

http://aidsinfo.nih.gov/guidelines

HIV and Its Treatment – Seeing an HIV Health Care Provider

For more information:

Contact an AIDS

info

health information specialist at 1-800­

448-0440 or visit

http://aidsinfo.nih.gov

. See your health

care provider for medical advice.

This information is based on the U.S. Department of Health and Human Services’

Guidelines for the Use of

Reviewed

Antiretroviral Agents in HIV-1-Infected Adults and Adolescents

available at

http://aidsinfo.nih.gov/guidelines

HIV and Its Treatment – When to Start Anti-HIV Medications

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