Highlighting health workers’ concerns through focused research: supporting studies in Malawi, Cambodia, Uganda and Sierra Leone
Author: VSO International
Country: Malawi, Cambodia, Seirra Leone Uganda
Challenges
The global shortage of 4.3 million health workers severely affects health and development indicators. However, there is a great shortage of research on the living conditions, attitudes and concerns of healthcare workers in many developing countries. A better understanding of these could potentially inform policy reforms and improvements in access to and quality of health care.
Policy description
VSO International has supported research projects on health workers in three countries: Malawi, Cambodia, and Uganda, and aims to start similar research in Sierra Leone The research aims to understand what affects the attitudes, behaviours and practices of health workers (which in turn limit users’ access to health care), and to bridge the gap between the reality of health workers’ lives and the expectations of policymakers and health users. Researchers use focus group discussions and interviews with front-line health workers as well as interviews with facility managers, district-level health officials, Ministry of Health and other providers, health advocacy organisations, unions, donors and INGOs.
In Uganda, VSO supports research enquires into the attitudes, behaviours and practices of health workers. The research attempts to understand what it is like being a health worker. Better understanding should lead to more harmony between users and health workers, and thus improve access to health care.
In Cambodia the research team asks health workers themselves what motivates them and how do they cope in challenging circumstances. The research aims to un-pack issues and come to a better understanding of problems. Hopefully this greater understanding can then help to generate practical and meaningful solutions.
In Malawi, research has focused on the generally neglected lot of Health Surveillance Assistants (HSAs), to understand their conditions and problems, and to potentially identify ways of redressing some of these.
Sierra Leone was recently affected by a decrease in the health workforce due to a prolonged strike, among other factors. As well as focus groups and interviews, the research team in Sierra Leone plans to do an online survey of health workers who have left Sierra Leone to find out why they left and what would tempt them back.
Outcomes
In Malawi, the research is showing that Health Surveillance Assistants (HSAs) are a critical part of health systems, a fact which has not been sufficiently acknowledged. It has also highlighted the needs for training, supervision and support of these Community Health Workers.
In all the countries, upon the completion of the research, meetings and workshops will be held with Parliamentarians, policymakers from Ministries of Health and international development partners to enable civil society organisations to debate the key issues emerging from the research with key health sector stakeholders. Where appropriate, other means of raising awareness such as the media and other advocacy approaches may also be used to ensure that the challenges facing health workers are publicly debated. This will hopefully enable a consensus for necessary action.
Conclusions
Civil society organisations can play a useful role, carrying out focused research on issues concerning health workforce in many countries. When shared with governments and discussed with civil society the information can contribute to improved understanding of the causes of health worker attrition and retention. .