Saturday, February 2, 2008

Gathering Background on Malawi Nurses

Since my four-month field project later this year is going to focus on nurses in Malawi, one of the first steps is figuring out what kind of background material is already available. Since I'm a journalist--and we have notoriously short attention spans--this won't be as exhaustive as an academic literature search. But I hope to hit some of the highlights so that I at least sound prepared when I go to meet the true experts--the nurses themselves.

I'll admit I'm having a little trouble organizing what I know so far since it's coming at me in e-mail responses, web searches, advice from actual people in real-live conversations and books that have been given or sent to me, but here are three items that jump out so far:

"Human Resources for Health: Overcoming the Crisis," a Joint Learning Initiative led by Lincoln Chen of Harvard University, Jo Ivey Boufford at New York University and others. This book contains an overview of the health worker crisis around the world with plenty of statistics.

The HRH Global Resources Center. (HRH stands for Human Resources for Health, not His/Her Royal Highness.) This USAID-funded project pulls together a lot of web-based information that you can sort by country, topic and somewhat by language (English, French and Spanish). A little bit of searching found this series of academic papers about Malawi's efforts to retain nurses, doctors and other skilled health professionals.

International Programs. More specifically, in 2005 the United Kingdom and Malawi launched a program to help Malawi retain more of its nurses and other health care professionals. Part of this effort is the Human Resources Emergency Response Program (don't you just love all these long official names?), which has the radical idea of simply paying nurses more money. (Most international donor programs don't offer salaries to service providers because that is thought to be unsustainable. After all, what do you do once the 5-year program is over?)

Haven't learned a lot from the official memos but expect to learn more when I meet some of the people who helped set up the program, like Dr. Ann Phoya, who I am told was Director of Nursing for Malawi at the time the program was set up and now helps to run it.

A news search for Phoya's name turned up this piece from The Observer in which she talks about some of the limitations that have emerged. Indeed, a press release on the official website of the Malawian Ministry of Health suggests that at least some nurse midwives are contemplating going out on strike.

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