State of the health workforce in the WHO African Region: decade review of progress and opportunities for policy reforms and investments.

Introduction: An adequate health workforce is one of the cornerstones of a healthy nation. Over the last two decades, Africa has gained momentum in mitigating critical health workforce gaps, but urgent actions are still needed to accelerate progress towards universal health coverage and ensuring health security. This analysis provides an overview of the health workforce in the WHO African Region for the last decade.

Projected health workforce requirements and shortage for addressing the disease burden in the WHO Africa Region, 2022-2030: a needs-based modelling study.

Introduction: An adequate health workforce (HWF) is essential to achieving the targets of the Sustainable Development Goals (SDG), including universal health coverage. However, weak HWF planning and constrained fiscal space for health, among other factors in the WHO Africa Region, has consistently resulted in underinvestment in HWF development, shortages of the HWF at the frontlines of service delivery and unemployment of qualified and trained health workers. This is further compounded by the ever-evolving disease burden and reduced access to essential health services along the continuum of health promotion, disease prevention, diagnostics, curative care, rehabilitation and palliative care.

Modelling the Wage Bill and Budget Space for Health Workforce in Ghana: Implications for Sustainable Health Professions Education Policy.

Global discussions on health systems strengthening have lately tilted towards increasing investments in human resources for health to address health workforce challenges, especially shortages and employment. Countries have, as a result, increased investments in the health workforce by expanding the production and recruitment of the needed health workforce, with the resultant effects of increasing health workforce budget space and the unending clamour by health policy actors for further increases. Despite these calls, there has been no wage bill affordability and budget space analysis to rationalise the sustainable production of and demand for health workers, which is the thrust of Ghana's current health workforce policy and strategy.

The nature and contribution of innovative health financing mechanisms in the World Health Organization African region: A scoping review.

Background: Achieving financial risk protection for the whole population requires significant financing for health. Health systems in low- and middle-income countries (LMIC) are plagued with persistent underfunding, and recent reductions in official development assistance have been registered. To create fiscal space for health, the pursuit of efficiency gains and exploring innovative health financing for health seem attractive.

The state and significant drivers of health systems efficiency in Africa: A systematic review and meta-analysis.

Background: Low-and-middle-income countries, especially in Africa, lack the capacity to adequately invest in health systems to attain universal health coverage (UHC). As such, countries must improve efficiency and provide more services within the available resources. This systematic review synthesised evidence on the efficiency of health systems in the African region and its drivers.

Optimizing the roles of health workers to improve access to health services in Africa: an implementation framework for task shifting and sharing for policy and practice.

Background: Globally, countries are taking actions to ensure that their population have improved access to people-centred and integrated health services. Attaining this requires improved access to health workers at all levels of health service delivery and equitably distributed by geographical location. Due to the persistent health worker shortages, countries have resorted to implementing task shifting and task sharing in various settings to optimally utilize existing health workers to improve access to health services.

Task Shifting and Task Sharing Implementation in Africa: A Scoping Review on Rationale and Scope.

Numerous studies have reported task shifting and task sharing due to various reasons and with varied scopes of health services, either task-shifted or -shared. However, very few studies have mapped the evidence on task shifting and task sharing. We conducted a scoping review to synthesize evidence on the rationale and scope of task shifting and task sharing in Africa.

Developing an interprofessional education programme for a health science faculty in South Africa: A multi-method study.

Objective: Work-ready graduates need to be equipped with expertise and therefore, critical changes are required in the curricula for health professions. Here, we aimed to review the design of an interprofessional education programme (IPE) with regards to appropriateness and implementation for the Faculty of Health Sciences at North-West University, South Africa.

Methods: This study employed a sequential multi-method design to develop an IPE programme for a health science faculty in South Africa.

Conceptualisation, development and implementation of Interprofessional Education programmes: A qualitative document analysis.

Interprofessional Education (IPE) occurs when two or more health professionals learn with, from and about each other to improve collaboration within a healthcare team and represents a key step towards the realisation of Interprofessional Collaborative Practice (IPCP) which, in turn, enhances the healthcare outcomes of patients. Many health professions education institutions are taking on the challenge of developing IPE programmes and it is essential to provide evidence-based information to guide these institutions in their journey. We analysed the IPE programmes of six health professions education institutions from High-Income Countries and Low- and Middle-Income Countries according to the 12 steps of IPE programme introduction for health professions.

A Simulation-Based Clinical Nursing Education Framework for a Low-Resource Setting: A Multimethod Study.

Simulation-based clinical education is a useful strategy for teaching, learning, and assessing clinical competence in health professions education. However, the use of simulation-based clinical nursing education (SBCNE) in low-resource settings such as Ghana has been hampered by the lack of a context-specific framework to guide its design, implementation, and evaluation. This study sought to develop a context-specific framework to guide the design, implementation, and evaluation of SBCNE in a low-resource setting.

Exploring the availability of specialist health workforce education in East and Southern Africa: a document analysis.

Background: Specialist health professionals improve health outcomes. Most low-income and middle-income countries do not have the capacity to educate and retain all types of specialists across various health professions. This study sought to explore and describe the opportunities available for specialist health professions education and the pathways to becoming a specialist health professional in East and Southern Africa (ESA).

Investing in the health workforce: fiscal space analysis of 20 countries in East and Southern Africa, 2021-2026.

Background And Objectives: The health workforce (HWF) is at the core of ensuring an efficient, effective and functional health system, but it faces chronic underinvestment. This paper presents a fiscal space analysis of 20 countries in East and Southern Africa to generate sustained evidence-based advocacy for significant and smarter investment in the HWF.

Methods: We adapted an established empirical framework for fiscal space analysis and applied it to the HWF.

The process of developing health workforce strategic plans in Africa: a document analysis.

Background: Many countries are faced with a multitude of health workforce-related challenges partly attributed to defective health workforce planning. Earlier efforts to guide the process and harmonise approaches to national health workforce policies and planning in the Africa Region included, among others, the development of the WHO Africa Regional Office (WHO/AFRO) Policies and Plans for Human Resources for Health Guidelines for Countries in the WHO African Region in 2006. Although this guideline has led to uniformity and rigour in developing human resources for health (HRH) policies and strategies in Africa, it has become imperative to synthesise the emerging evidence and best practices in the development of health workforce strategies.

Frameworks for the design, implementation, and evaluation of simulation-based nursing education: A scoping review.

This scoping review was conducted to identify and describe constructs of frameworks and theories used to guide the design, implementation, and evaluation of simulation in nursing education globally, with a focus on their applicability in low-resource settings. Six electronic databases, three of which were on EBSCO Host (CINAHL, MEDLINE, ERIC), PubMed, Scopus, and ProQuest, as well as Google Scholar, were searched to retrieve studies published in the English language between 2012 and February 2022. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) checklist, and was guided by Arksey and O'Malley's five-step scoping review methodological framework.

Cost analysis of health workforce investments for COVID-19 response in Ghana.

The COVID-19 pandemic had multiple adverse impacts on the health workforce that constrained their capacity to contain and combat the disease. To mitigate the impact of the pandemic on the Ghanaian health workforce, the government implemented a strategy to recruit qualified but unemployed health workers to fill staffing gaps and incentivise all public sector health workers. This paper estimated the cost of the new recruitments and incentives given to health workers and presented lessons for health workforce planning in future health emergencies towards health systems resilience.

Teaching and Learning of Clinical Competence in Ghana: Experiences of Students and Post-Registration Nurses.

Despite the growing demand for competent nurses to fill the shortage gap, nursing education institutions have not always been able to equip students with the requisite clinical competence needed in the practice setting. Several studies have described the experiences of undergraduate nursing students in the clinical learning environment. No study was found on the experiences of diploma nursing students and post-registration nurses regarding the teaching and learning of clinical competence in Ghana.

Perceptions of the functioning and effectiveness of nursing regulators in Ghana and South Africa: a cross-sectional study.

Objective: Nursing regulators are important governance structures for nurses who are critical to the achievement of universal health coverage (UHC). This study examined the perspectives of the heads of nursing education institutions (NEIs) in Ghana and South Africa on the functioning and effectiveness of the respective nursing regulators.

Design: This was a cross-sectional survey.

Modelling the supply and need for health professionals for primary health care in Ghana: Implications for health professions education and employment planning.

Background: The health workforce (HWF) is critical in developing responsive health systems to address population health needs and respond to health emergencies, but defective planning have arguably resulted in underinvestment in health professions education and decent employment. Primary Health Care (PHC) has been the anchor of Ghana's health system. As Ghana's population increases and the disease burden doubles, it is imperative to estimate the potential supply and need for health professionals; and the level of investment in health professions education and employment that will be necessary to avert any mismatches.

Health Service Activity Standards and Standard Workloads for Primary Healthcare in Ghana: A Cross-Sectional Survey of Health Professionals.

The attainment of health system goals is largely hinged on the health workforce availability and performance; hence, health workforce planning is central to the health policy agenda. This study sought to estimate health service activity standards and standard workloads at the primary health care level in Ghana and explore any differences across health facility types. A nationally representative cross-sectional survey was conducted among 503 health professionals across eight health professions who provided estimates of health service activity standards in Ghana's Primary Health Care (PHC) settings.

Advancing the Population Needs-Based Health Workforce Planning Methodology: A Simulation Tool for Country Application.

Although the conceptual underpinnings of needs-based health workforce planning have developed over the last two decades, lingering gaps in empirical models and lack of open access tools have partly constrained its uptake in health workforce planning processes in countries. This paper presents an advanced empirical framework for the need-based approach to health workforce planning with an open-access simulation tool in Microsoft Excel to facilitate real-life health workforce planning in countries. Two fundamental mathematical models are used to quantify the supply of, and need for, health professionals, respectively.

The needs-based health workforce planning method: a systematic scoping review of analytical applications.

Although the theoretical underpinnings and analytical framework for needs-based health workforce planning are well developed and tested, its uptake in national planning processes is still limited. Towards the development of open-access needs-based planning model for national workforce planning, we conducted a systematic scoping review of analytical applications of needs-based health workforce models. Guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses-extension for Scoping Reviews (PRISMA-ScR) checklist, a systematic scoping review was conducted.

Implementation of the National Health Insurance Scheme (NHIS) in Ghana: Lessons for South Africa and Low- and Middle-Income Countries.

Background: South Africa is having difficulties in rolling out the National Health Insurance(NHI) policy. There are ongoing arguments on whether the NHI will provide access to quality and equitable healthcare it is intended to and whether South Africa is ready to implement the policy. Many stakeholders believe the country needs more preparation if the policy will be successful.

Curriculum framework for advanced practice nursing in sub-Saharan Africa: a multimethod study.

Objectives: The implementation of advanced practice nursing (APN) programmes in sub-Saharan Africa (SSA) has been difficult due to lack of SSA-specific curriculum frameworks or benchmarks to guide institutions in developing and implementing APN programmes. A few APN programmes in SSA were benchmarked on western philosophy and materials, making local ownership and sustainability challenging. This paper presents an SSA-specific concept-based APN (Child Health Nurse Practitioner, CHNP) curriculum framework developed to guide institutions in developing relevant and responsive APN curricula in order to qualify CHNP and contribute to a decreased incidence of preventable deaths of children in the SSA region.

The essence, opportunities and threats to Advanced Practice Nursing in Sub-Saharan Africa: A scoping review.

Background: The conditions that stimulated the implementation of Advanced Practice Nursing programmes all over the world have long been ignored in sub-Saharan Africa.

Objective: This study sought to explore the essence, opportunities and threats to the implementation of an Advanced Practice Nursing (Child Health Nurse Practitioner) programmes in sub-Saharan Africa.

Methods: A scoping review was conducted and findings reviewed by a multinational multidisciplinary health experts' team through a Delphi study.

The State of Nursing Research in Ghana: An Integrative Literature Review.

Introduction: For nursing practice to be responsive to the needs of patients, it must be driven by contextual research evidence. To guide institutional and national nursing research policy, there is need to determine the quantity and quality of nursing research in Ghana.

Purpose: The purpose of this integrative literature review was to quantify, critically evaluate, and describe nursing research publication in Ghana from January 2007 to December 2016 with regard to the country's research capacity to sustain evidence-based practice.