Tim Martineau | Liverpool School of Tropical Medicine (original) (raw)
Papers by Tim Martineau
SSRN Electronic Journal, 2019
Bulletin of The World Health Organization, 2004
Pour acquerir des competences en matiere de recherche sanitaire, les personnels des pays en devel... more Pour acquerir des competences en matiere de recherche sanitaire, les personnels des pays en developpement doivent souvent se former a l'etranger. Pour les organismes de financement de la recherche qui parrainent ce type de formation, un des buts majeurs est d'assurer que les chercheurs qui beneficient d'une bourse de formation retourneront dans leur pays d'origine. Pour atteindre cet objectif, il faut faire appel a des strategies qui prennent ce probleme en compte des le depart. Les strategies decrites dans le present article ont ete elaborees dans le cadre du programme AITRP (programme international de formation et de recherche sur le SIDA (syndrome d'immunodeficience acquise)) destine aux etudiants et chercheurs etrangers et finance par le Fogarty International Center (FIC) aux National Institutes of Health (Etats-Unis d'Amerique). Ce programme soutient les universites des Etats-Unis qui proposent une formation a la recherche a des etudiants et chercheurs d...
Background Decentralisation is one of the popular strategies used for reforming the health sector... more Background Decentralisation is one of the popular strategies used for reforming the health sector in the developing countries. South Africa, like many other countries such as Ghana, Zambia, the Philippines etc has embarked on decentralisation of health services as an integral part of health sector reforms. While decentralisation is seen as an opportunity for taking management decision making responsibilities closer to frontline providers, there is little evidence of how decentralisation affect human resource management within the health sector. The research examined how decentralisation of health services has provided opportunities to improve management of human resources and staff performance in the sector. Method The study used quantitative and qualitative method to collect data. Data collection methods used self-administered questionnaires, review of personnel data, in-depth interviews and review of published and gray literature on HR and decentralisation. Quantitative data was a...
project 2 to identify the current knowledge about human resources for health (HRH) in postconflic... more project 2 to identify the current knowledge about human resources for health (HRH) in postconflict settings. The first section presents features commonly found in the period immediately after the end of a conflict and describes them according to the impact they have on public sector generally and more specifically on health. The second section describes how the health workforce may be affected in the post-conflict settings in terms of numbers of and distribution of health workers, their capacity and their performance. The third section on HR strategies and interventions is guided by the human resources for health action framework using illustrative examples from the post-conflict literature [2]. Methods. A range of bibliographic databases were searched via EBSCO Discovery to identify academic resources on post-conflict settings. Online resources for international organizations were searched for grey literature and relevant references in sourced literature were checked. The initial s...
The International Journal of Health Planning and Management
BACKGROUND Decentralisation has been adopted by many governments to strengthen national systems, ... more BACKGROUND Decentralisation has been adopted by many governments to strengthen national systems, including the health system. Decision space is used to describe the decision-making power devolved to local government. Human resource Management (HRM) is a challenging area that District Health Management Teams (DHMT) need some control over its functions to develop innovative ways of improving health services. The study aims to examine the use of DHMTs' reported decision space for HRM functions in Uganda. METHODS Mixed methods approach was used to examine the DHMTs' reported decision space for HRM functions in three districts in Uganda, which included self-assessment questionnaires and focus group discussions (FGDs). RESULTS The decision space available for the DHMTs varied across districts, with Bunyangabu and Ntoroko DHMTs reporting having more control than Kabarole. All DHMTs reported full control over the functions of performance management, monitoring policy implementation, forecasting staffing needs, staff deployment, and identifying capacity needs. However, they reported narrow decision space for developing job descriptions, resources mobilisation, and organising training; and no control over modifying staffing norms, setting salaries and developing an HR information system (HRIS). Nevertheless, DHMTs tried to overcome their limitations by adjusting HR policies locally, better utilising available resources and adapting the HRIS to local needs. CONCLUSIONS Decentralisation provides a critical opportunity to strengthen HRM in low-and-middle-income countries. Examining decision space for HRM functions can help identify areas where district health managers can change or improve their actions. In Uganda, decentralisation helped the DHMTs be more responsive to the local workforce needs and analysing decision space helped identify areas for improvement in HRM. There are some limitations and more power over HRM functions and strong management competencies would help them become more resourceful.
Human Resources for Health
Human Resources for Health
Background Most low- and middle-income countries are experiencing challenges in maternal health i... more Background Most low- and middle-income countries are experiencing challenges in maternal health in relation to accessing skilled birth attendants (SBA). The first step in addressing this problem is understanding the current situation. We aimed to understand SBA’s availability and distribution in Ituri Province, North Eastern Democratic Republic of the Congo (DRC) from 2013 to 2017. Methods We used available data on SBAs (doctors, nurses and midwives) from the Ituri Provincial Human Resource for Health Management Unit’s database from 2013 to 2017. The current distribution across and within three categories of district (rural, peri-urban and urban) and characteristics of SBAs as well as 5-year trends and vacancy trends were identified. Data on training outputs for SBA cadres was collected from training schools in the province. Descriptive analysis, disaggregating by district, cadre and gender where possible, was conducted using Excel. Results The national ratio of SBAs per 1000 popula...
Background Community Health Workers (CHWs) are critical players in fragile settings, where staff ... more Background Community Health Workers (CHWs) are critical players in fragile settings, where staff shortages are particularly acute, health indicators are poor and progress towards Universal Health Coverage is slow. Like other health workers, CHWs need support to contribute effectively to health programmes and promote health equity. Yet the evidence base of what kind of support works best is weak. We present evidence from three fragile settings - Sierra Leone, Liberia and Democratic Republic of Congo on managing CHWs, and synthesise recommendations for best approaches to support this critical cadre.Methods We used a qualitative study design to explore how CHWs are managed, the challenges they face and potential solutions. We conducted interviews with decision makers and managers (n = 37), life history interviews with CHWs (n = 15) and reviewed policy documents.Results Fragility disrupts education of community members so that they may not have the literacy levels required for the CHW r...
Health Research Policy and Systems
International Journal for Equity in Health
Health Policy and Planning
Human Resources for Health
BMJ global health, 2018
To achieve Universal Health Coverage (UHC), more health workers are needed; also critical is supp... more To achieve Universal Health Coverage (UHC), more health workers are needed; also critical is supporting optimal performance of existing staff. Integrated human resource management (HRM) strategies, complemented by other health systems strategies, are needed to improve health workforce performance, which is possible at district level in decentralised contexts. To strengthen the capacity of district management teams to develop and implement workplans containing integrated strategies for workforce performance improvement, we introduced an action-research-based management strengthening intervention (MSI). This consisted of two workshops, follow-up by facilitators and meetings between participating districts. Although often used in the health sector, there is little evaluation of this approach in middle-income and low-income country contexts. The MSI was tested in three districts in Ghana, Tanzania and Uganda. This paper reports on the appropriateness of the MSI to the contexts and its e...
Human Resources for Health
SSRN Electronic Journal, 2019
Bulletin of The World Health Organization, 2004
Pour acquerir des competences en matiere de recherche sanitaire, les personnels des pays en devel... more Pour acquerir des competences en matiere de recherche sanitaire, les personnels des pays en developpement doivent souvent se former a l'etranger. Pour les organismes de financement de la recherche qui parrainent ce type de formation, un des buts majeurs est d'assurer que les chercheurs qui beneficient d'une bourse de formation retourneront dans leur pays d'origine. Pour atteindre cet objectif, il faut faire appel a des strategies qui prennent ce probleme en compte des le depart. Les strategies decrites dans le present article ont ete elaborees dans le cadre du programme AITRP (programme international de formation et de recherche sur le SIDA (syndrome d'immunodeficience acquise)) destine aux etudiants et chercheurs etrangers et finance par le Fogarty International Center (FIC) aux National Institutes of Health (Etats-Unis d'Amerique). Ce programme soutient les universites des Etats-Unis qui proposent une formation a la recherche a des etudiants et chercheurs d...
Background Decentralisation is one of the popular strategies used for reforming the health sector... more Background Decentralisation is one of the popular strategies used for reforming the health sector in the developing countries. South Africa, like many other countries such as Ghana, Zambia, the Philippines etc has embarked on decentralisation of health services as an integral part of health sector reforms. While decentralisation is seen as an opportunity for taking management decision making responsibilities closer to frontline providers, there is little evidence of how decentralisation affect human resource management within the health sector. The research examined how decentralisation of health services has provided opportunities to improve management of human resources and staff performance in the sector. Method The study used quantitative and qualitative method to collect data. Data collection methods used self-administered questionnaires, review of personnel data, in-depth interviews and review of published and gray literature on HR and decentralisation. Quantitative data was a...
project 2 to identify the current knowledge about human resources for health (HRH) in postconflic... more project 2 to identify the current knowledge about human resources for health (HRH) in postconflict settings. The first section presents features commonly found in the period immediately after the end of a conflict and describes them according to the impact they have on public sector generally and more specifically on health. The second section describes how the health workforce may be affected in the post-conflict settings in terms of numbers of and distribution of health workers, their capacity and their performance. The third section on HR strategies and interventions is guided by the human resources for health action framework using illustrative examples from the post-conflict literature [2]. Methods. A range of bibliographic databases were searched via EBSCO Discovery to identify academic resources on post-conflict settings. Online resources for international organizations were searched for grey literature and relevant references in sourced literature were checked. The initial s...
The International Journal of Health Planning and Management
BACKGROUND Decentralisation has been adopted by many governments to strengthen national systems, ... more BACKGROUND Decentralisation has been adopted by many governments to strengthen national systems, including the health system. Decision space is used to describe the decision-making power devolved to local government. Human resource Management (HRM) is a challenging area that District Health Management Teams (DHMT) need some control over its functions to develop innovative ways of improving health services. The study aims to examine the use of DHMTs' reported decision space for HRM functions in Uganda. METHODS Mixed methods approach was used to examine the DHMTs' reported decision space for HRM functions in three districts in Uganda, which included self-assessment questionnaires and focus group discussions (FGDs). RESULTS The decision space available for the DHMTs varied across districts, with Bunyangabu and Ntoroko DHMTs reporting having more control than Kabarole. All DHMTs reported full control over the functions of performance management, monitoring policy implementation, forecasting staffing needs, staff deployment, and identifying capacity needs. However, they reported narrow decision space for developing job descriptions, resources mobilisation, and organising training; and no control over modifying staffing norms, setting salaries and developing an HR information system (HRIS). Nevertheless, DHMTs tried to overcome their limitations by adjusting HR policies locally, better utilising available resources and adapting the HRIS to local needs. CONCLUSIONS Decentralisation provides a critical opportunity to strengthen HRM in low-and-middle-income countries. Examining decision space for HRM functions can help identify areas where district health managers can change or improve their actions. In Uganda, decentralisation helped the DHMTs be more responsive to the local workforce needs and analysing decision space helped identify areas for improvement in HRM. There are some limitations and more power over HRM functions and strong management competencies would help them become more resourceful.
Human Resources for Health
Human Resources for Health
Background Most low- and middle-income countries are experiencing challenges in maternal health i... more Background Most low- and middle-income countries are experiencing challenges in maternal health in relation to accessing skilled birth attendants (SBA). The first step in addressing this problem is understanding the current situation. We aimed to understand SBA’s availability and distribution in Ituri Province, North Eastern Democratic Republic of the Congo (DRC) from 2013 to 2017. Methods We used available data on SBAs (doctors, nurses and midwives) from the Ituri Provincial Human Resource for Health Management Unit’s database from 2013 to 2017. The current distribution across and within three categories of district (rural, peri-urban and urban) and characteristics of SBAs as well as 5-year trends and vacancy trends were identified. Data on training outputs for SBA cadres was collected from training schools in the province. Descriptive analysis, disaggregating by district, cadre and gender where possible, was conducted using Excel. Results The national ratio of SBAs per 1000 popula...
Background Community Health Workers (CHWs) are critical players in fragile settings, where staff ... more Background Community Health Workers (CHWs) are critical players in fragile settings, where staff shortages are particularly acute, health indicators are poor and progress towards Universal Health Coverage is slow. Like other health workers, CHWs need support to contribute effectively to health programmes and promote health equity. Yet the evidence base of what kind of support works best is weak. We present evidence from three fragile settings - Sierra Leone, Liberia and Democratic Republic of Congo on managing CHWs, and synthesise recommendations for best approaches to support this critical cadre.Methods We used a qualitative study design to explore how CHWs are managed, the challenges they face and potential solutions. We conducted interviews with decision makers and managers (n = 37), life history interviews with CHWs (n = 15) and reviewed policy documents.Results Fragility disrupts education of community members so that they may not have the literacy levels required for the CHW r...
Health Research Policy and Systems
International Journal for Equity in Health
Health Policy and Planning
Human Resources for Health
BMJ global health, 2018
To achieve Universal Health Coverage (UHC), more health workers are needed; also critical is supp... more To achieve Universal Health Coverage (UHC), more health workers are needed; also critical is supporting optimal performance of existing staff. Integrated human resource management (HRM) strategies, complemented by other health systems strategies, are needed to improve health workforce performance, which is possible at district level in decentralised contexts. To strengthen the capacity of district management teams to develop and implement workplans containing integrated strategies for workforce performance improvement, we introduced an action-research-based management strengthening intervention (MSI). This consisted of two workshops, follow-up by facilitators and meetings between participating districts. Although often used in the health sector, there is little evaluation of this approach in middle-income and low-income country contexts. The MSI was tested in three districts in Ghana, Tanzania and Uganda. This paper reports on the appropriateness of the MSI to the contexts and its e...
Human Resources for Health