The double burden of human resource and HIV crises: a case study of Malawi
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BioMed Central
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The double burden of human resource and HIV crises: a case study of Malawi David McCoy*1, Barbara McPake2 and Victor Mwapasa3 Address: 1Centre for International Health and Development, University College London, 30 Guilford Street, London, WC1N 1EH, UK, 2Institute for International Health and Development, Queen Margaret University, Edinburgh, EH12 8TS, UK and 3Division of Community Health, College of Medicine, University of Malawi, Blantyre, Malawi Email: David McCoy* - [email protected]; Barbara McPake - [email protected]; Victor Mwapasa - [email protected] * Corresponding author
Published: 12 August 2008 Human Resources for Health 2008, 6:16
doi:10.1186/1478-4491-6-16
Received: 20 September 2007 Accepted: 12 August 2008
This article is available from: http://www.human-resources-health.com/content/6/1/16 © 2008 McCoy et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Two crises dominate the health sectors of sub-Saharan African countries: those of human resources and of HIV. Nevertheless, there is considerable variation in the extent to which these two phenomena affect sub-Saharan countries, with a few facing extreme levels of both: Lesotho, Zimbabwe, Zambia, Mozambique, the Central African Republic and Malawi. This paper reviews the continent-wide situation with respect to this double burden before considering the case of Malawi in more detail. In Malawi, there has been significant concurrent investment in both an Emergency Human Resource Programme and an antiretroviral therapy programme which was treating 60,000 people by the end of 2006. Both areas of synergy and conflict have arisen, as the two programmes have been implemented. These highlight important issues for programme planners and managers to address and emphasize that planning for the scale-up of antiretroviral therapy while simultaneously strengthening health systems and the human resource situation requires prioritization among compelling cases for support, and time (not just resources).
Background Two crises dominate the health sectors of sub-Saharan countries: those of human resources and of HIV. In principle, both these crises magnify each other. HIV places a significant additional load on the health workforce and contributes to attrition from it through illness, caring for family members who have developed AIDS and death. And the impact of the HIV crisis is accentuated because health workers are unavailable to implement anti-HIV interventions. A particular source of recent concern has been the impact on workforce distribution of increased levels of support for HIV/AIDS programmes and especially treatment. This
paper seeks to explore this interaction in more detail. It reviews the continent-wide distribution of the two phenomena and initial e
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