Human resources for health strategies adopted by providers in resource-limited settings to sustain long-term delivery of ART: a mixed-methods study from UgandaReportar como inadecuado




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Human Resources for Health

, 14:63

First Online: 19 October 2016Received: 22 December 2015Accepted: 01 October 2016

Abstract

BackgroundHuman resources for health HRH constraints are a major barrier to the sustainability of antiretroviral therapy ART scale-up programs in Sub-Saharan Africa. Many prior approaches to HRH constraints have taken a top-down trend of generalized global strategies and policy guidelines. The objective of the study was to examine the human resources for health strategies adopted by front-line providers in Uganda to sustain ART delivery beyond the initial ART scale-up phase between 2004 and 2009.

MethodsA two-phase mixed-methods approach was adopted. In the first phase, a survey of a nationally representative sample of health facilities n = 195 across Uganda was conducted. The second phase involved in-depth interviews n = 36 with ART clinic managers and staff of 6 of the 195 health facilities purposively selected from the first study phase. Quantitative data was analysed based on descriptive statistics, and qualitative data was analysed by coding and thematic analysis.

ResultsThe identified strategies were categorized into five themes: 1 providing monetary and non-monetary incentives to health workers on busy ART clinic days; 2 workload reduction through spacing ART clinic appointments; 3 adopting training workshops in ART management as a motivation strategy for health workers; 4 adopting non-physician-centred staffing models; and 5 devising ART program leadership styles that enhanced health worker commitment.

ConclusionsFacility-level strategies for responding to HRH constraints are feasible and can contribute to efforts to increase country ownership of HIV programs in resource-limited settings. Consideration of the human resources for health strategies identified in the study by ART program planners and managers could enhance the long-term sustainment of ART programs by providers in resource-limited settings.

KeywordsHIV Health systems Sustainability Implementation science Human resources for health  Download fulltext PDF



Autor: Henry Zakumumpa - Modupe Oladunni Taiwo - Alex Muganzi - Freddie Ssengooba

Fuente: https://link.springer.com/







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