PEPFAR's Strategic Investments in Human Resources for Health

March 17, 2014

PEPFAR’s investments in Human Resources for Health (HRH) have helped enable partner countries to dramatically expand access to lifesaving HIV prevention, treatment, and care services while strengthening their overall health systems.


Core elements of PEPFAR’s investments in HRH (and illustrative example of program impact) include:


1) Pre-service education for health workers

PEPFAR provides a comprehensive array of resources to support students, faculty and institutions, including: student tuition/faculty salaries; student recruitment and placement; faculty retention; faculty and curriculum development and infrastructure.


2) In-service education

Since 2010, PEPFAR has supported over 1 million in-service training encounters for health professionals, focusing on a broad range of HIV competencies, as well as encompassing other diseases including tuberculosis (TB), in addition to the delivery of health services at large.


3) National HRH planning and management

PEPFAR’s support for the development of national HRH Strategic Plans and Human Resources Information Systems in 17 countries across Africa has enabled governments to more effectively plan and manage their scarce health personnel to address HIV and other related health conditions.


4) New models of service delivery


PEPFAR’s support includes facilitating task-shifting/sharing (e.g., Nurse Initiated and Managed ART) and the development of new health cadres into the HIV/AIDS response. In South Africa, PEPFAR has supported the South African government in introducing Clinical Associates – a new cadre of mid-level health workers to provide HIV and AIDS prevention, care and treatment, as well as other public health services, particularly in rural areas.



5) Recruitment and retention strategies

PEPFAR supports the application of innovative recruitment and retention strategies, especially in rural and underserved areas. In Mozambique, PEPFAR has supported “gap year funding” to address delays in remuneration and ensure that health professionals are expediently deployed to provide services.


6) Health regulation and policy


PEPFAR support to the African Health Profession Regulatory Collaborative (ARC) has strengthened both regulations/standards and nursing/midwifery leadership councils in 17 countries in sub-Saharan Africa, while fostering country ownership of HRH activities. In Lesotho, ARC activities contributed to implementation of a national nurses/midwives continuing professional development program, and in Mozambique ARC efforts supported drafting of legislation to create a Nurses and Midwives Act.


 7) Implementation science


Through its support for implementation science, PEPFAR has strengthened the evidence base surrounding HRH. For example, PEPFAR investigated the key drivers of retention in HIV care through a study analyzing preferences for working in rural clinics among trainee health professionals in Uganda.


 8) Strengthening capacity to respond to communicable diseases

PEPFAR support to the Field Epidemiology and Laboratory Field Program (FELTP) has improved the ability of national health systems to address HIV and other communicable diseases. FELTP’s two-year advanced degree programs enable practicing health professionals to gain the necessary public health disease surveillance skills to more effectively and efficiently monitor HIV and other communicable diseases within a country. FELTP graduates have been instrumental in stemming disease outbreaks such as aflatoxin in Kenya (2004), Rift Valley Fever in Kenya and Tanzania (2007), and cholera in Zimbabwe (2009).


9) Policy guidance on HRH

PEPFAR has supported the World Health Organization’s development of global HRH guidance, including “Global Recommendations and Guidelines on Task Shifting” (2007) and guidelines on Transforming and Scaling up Health Professionals' Education and Training (2014).

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