Human resource challenges in health systems: evidence from 10 African countries.

Sub-Saharan Africa has fewer medical workers per capita than any region of the world, and that shortage has been highlighted consistently as a critical constraint to improving health outcomes in the region. This paper draws on newly available, systematic, comparable data from 10 countries in the region to explore the dimensions of this shortage. We find wide variation in human resources performance metrics, both within and across countries.

How to recruit teachers for hard-to-staff schools: A systematic review of evidence from low- and middle-income countries.

Education systems struggle to staff schools in rural areas or in areas with high concentrations of poverty. Potential policy solutions include financial incentives, mandatory rotations, and local recruitment drives, among others. First, this systematic review provides evidence on challenges with teacher staffing in certain types of schools.

Live tutoring calls did not improve learning during the COVID-19 pandemic in Sierra Leone.

Education systems regularly face unexpected school closures, whether due to disease outbreaks, natural disasters, or other adverse shocks. In low-income countries where internet access is scarce, distance learning - the most common educational solution - is often passive, via TV or radio, with little opportunity for teacher-student interaction. In this paper we evaluate the effectiveness of live tutoring calls from teachers, designed to supplement radio instruction during the 2020 school closures prompted by the COVID-19 pandemic.

Teacher pay in Africa: Evidence from 15 countries.

Pay levels for public sector workers-and especially teachers-are a constant source of controversy. In many countries in Sub-Saharan Africa, protests and strikes suggest that pay is low, while comparisons to average national income per capita suggest that it is high. This study presents data on teacher earnings from 15 African countries.

Analysis of clinical knowledge, absenteeism and availability of resources for maternal and child health: a cross-sectional quality of care study in 10 African countries.

Objective: Assess the quality of healthcare across African countries based on health providers' clinical knowledge, their clinic attendance and drug availability, with a focus on seven conditions accounting for a large share of child and maternal mortality in sub-Saharan Africa: malaria, tuberculosis, diarrhoea, pneumonia, diabetes, neonatal asphyxia and postpartum haemorrhage.

Methods: With nationally representative, cross-sectional data from ten countries in sub-Saharan Africa, collected using clinical vignettes (to assess provider knowledge), unannounced visits (to assess provider absenteeism) and visual inspections of facilities (to assess availability of drugs and equipment), we assess whether health providers are available and have sufficient knowledge and means to diagnose and treat patients suffering from common conditions amenable to primary healthcare. We draw on data from 8061 primary and secondary care facilities in Kenya, Madagascar, Mozambique, Nigeria, Niger, Senegal, Sierra Leone, Tanzania, Togo and Uganda, and 22 746 health workers including doctors, clinical officers, nurses and community health workers.

Practical lessons for phone-based assessments of learning.

School closures affecting more than 1.5 billion children are designed to prevent the spread of current public health risks from the COVID-19 pandemic, but they simultaneously introduce new short-term and long-term health risks through lost education. Measuring these effects in real time is critical to inform effective public health responses, and remote phone-based approaches are one of the only viable options with extreme social distancing in place.

Bias in patient satisfaction surveys: a threat to measuring healthcare quality.

Patient satisfaction surveys are an increasingly common element of efforts to evaluate the quality of healthcare. Many patient satisfaction surveys in low/middle-income countries frame statements positively and invite patients to agree or disagree, so that positive responses may reflect either true satisfaction or bias induced by the positive framing. In an experiment with more than 2200 patients in Nigeria, we distinguish between actual satisfaction and survey biases.

Health-care quality and information failure: Evidence from Nigeria.

Low-quality health services are a problem across low- and middle-income countries. Information failure may contribute, as patients may have insufficient knowledge to discern the quality of health services. That decreases the likelihood that patients will sort into higher quality facilities, increasing demand for better health services.

A randomized trial of supplemental parenteral nutrition in underweight and overweight critically ill patients: the TOP-UP pilot trial.

Background: Nutrition guidelines recommendations differ on the use of parenteral nutrition (PN), and existing clinical trial data are inconclusive. Our recent observational data show that amounts of energy/protein received early in the intensive care unit (ICU) affect patient mortality, particularly for inadequate nutrition intake in patients with body mass indices (BMIs) of <25 or >35. Thus, we hypothesized increased nutrition delivery via supplemental PN (SPN) + enteral nutrition (EN) to underweight and obese ICU patients would improve 60-day survival and quality of life (QoL) versus usual care (EN alone).

Orphans and schooling in Africa: a longitudinal analysis.

AIDS deaths could have a major impact on economic development by affecting the human capital accumulation of the next generation. We estimate the impact of parent death on primary school participation using an unusual five-year panel data set of over 20,000 Kenyan children. There is a substantial decrease in school participation following a parent death and a smaller drop before the death (presumably due to pre-death morbidity).