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The double burden of human resource and HIV crises: a case study of Malawi.

McCoy D, McPake B, Mwapasa V - Hum Resour Health (2008)

Bottom Line: Two crises dominate the health sectors of sub-Saharan African countries: those of human resources and of HIV.Nevertheless, there is considerable variation in the extent to which these two phenomena affect sub-Saharan countries, with a few facing extreme levels of both: Lesotho, Zimbabwe, Zambia, Mozambique, the Central African Republic and Malawi.Both areas of synergy and conflict have arisen, as the two programmes have been implemented.

View Article: PubMed Central - HTML - PubMed

Affiliation: Centre for International Health and Development, University College London, 30 Guilford Street, London, WC1N 1EH, UK. d.mccoy@ucl.ac.uk

ABSTRACT
Two crises dominate the health sectors of sub-Saharan African countries: those of human resources and of HIV. Nevertheless, there is considerable variation in the extent to which these two phenomena affect sub-Saharan countries, with a few facing extreme levels of both: Lesotho, Zimbabwe, Zambia, Mozambique, the Central African Republic and Malawi. This paper reviews the continent-wide situation with respect to this double burden before considering the case of Malawi in more detail. In Malawi, there has been significant concurrent investment in both an Emergency Human Resource Programme and an antiretroviral therapy programme which was treating 60,000 people by the end of 2006. Both areas of synergy and conflict have arisen, as the two programmes have been implemented. These highlight important issues for programme planners and managers to address and emphasize that planning for the scale-up of antiretroviral therapy while simultaneously strengthening health systems and the human resource situation requires prioritization among compelling cases for support, and time (not just resources).

No MeSH data available.


Related in: MedlinePlus

Total numbers of doctors, nurses and midwives against adult HIV prevalence across African countries for which both statistics are available. (Source: Authors' analysis based on HRH global atlas and UNAIDS data).
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Figure 2: Total numbers of doctors, nurses and midwives against adult HIV prevalence across African countries for which both statistics are available. (Source: Authors' analysis based on HRH global atlas and UNAIDS data).

Mentions: When countries with low HR levels are assessed in terms of HIV prevalence, all the non-African countries with a critical human resource shortage are found to have relatively low adult HIV prevalence rates. According to UNAIDS [4], adult HIV prevalence ranges from less than 0.1 to 1.6% in these countries except Haiti, where prevalence is 3.8%. The twin burden of HRH crisis and HIV/AIDS crisis is therefore an African phenomenon. Figure 2 plots total numbers of doctors, nurses and midwives against adult HIV prevalence across all African countries for which both statistics are available. It identifies 6 countries with an HRH crisis as defined by WHO and with adult HIV prevalence rates greater than 10%. These are Lesotho, Zimbabwe, Zambia, Mozambique, the Central African Republic and Malawi (see Figure 2).


The double burden of human resource and HIV crises: a case study of Malawi.

McCoy D, McPake B, Mwapasa V - Hum Resour Health (2008)

Total numbers of doctors, nurses and midwives against adult HIV prevalence across African countries for which both statistics are available. (Source: Authors' analysis based on HRH global atlas and UNAIDS data).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2533352&req=5

Figure 2: Total numbers of doctors, nurses and midwives against adult HIV prevalence across African countries for which both statistics are available. (Source: Authors' analysis based on HRH global atlas and UNAIDS data).
Mentions: When countries with low HR levels are assessed in terms of HIV prevalence, all the non-African countries with a critical human resource shortage are found to have relatively low adult HIV prevalence rates. According to UNAIDS [4], adult HIV prevalence ranges from less than 0.1 to 1.6% in these countries except Haiti, where prevalence is 3.8%. The twin burden of HRH crisis and HIV/AIDS crisis is therefore an African phenomenon. Figure 2 plots total numbers of doctors, nurses and midwives against adult HIV prevalence across all African countries for which both statistics are available. It identifies 6 countries with an HRH crisis as defined by WHO and with adult HIV prevalence rates greater than 10%. These are Lesotho, Zimbabwe, Zambia, Mozambique, the Central African Republic and Malawi (see Figure 2).

Bottom Line: Two crises dominate the health sectors of sub-Saharan African countries: those of human resources and of HIV.Nevertheless, there is considerable variation in the extent to which these two phenomena affect sub-Saharan countries, with a few facing extreme levels of both: Lesotho, Zimbabwe, Zambia, Mozambique, the Central African Republic and Malawi.Both areas of synergy and conflict have arisen, as the two programmes have been implemented.

View Article: PubMed Central - HTML - PubMed

Affiliation: Centre for International Health and Development, University College London, 30 Guilford Street, London, WC1N 1EH, UK. d.mccoy@ucl.ac.uk

ABSTRACT
Two crises dominate the health sectors of sub-Saharan African countries: those of human resources and of HIV. Nevertheless, there is considerable variation in the extent to which these two phenomena affect sub-Saharan countries, with a few facing extreme levels of both: Lesotho, Zimbabwe, Zambia, Mozambique, the Central African Republic and Malawi. This paper reviews the continent-wide situation with respect to this double burden before considering the case of Malawi in more detail. In Malawi, there has been significant concurrent investment in both an Emergency Human Resource Programme and an antiretroviral therapy programme which was treating 60,000 people by the end of 2006. Both areas of synergy and conflict have arisen, as the two programmes have been implemented. These highlight important issues for programme planners and managers to address and emphasize that planning for the scale-up of antiretroviral therapy while simultaneously strengthening health systems and the human resource situation requires prioritization among compelling cases for support, and time (not just resources).

No MeSH data available.


Related in: MedlinePlus