Monitoring and evaluation in global HIV/AIDS control - weighing incentives and disincentives for coordination among global and local actors

This paper discusses coordination efforts of both donors and recipient countries in the monitoring and evaluation (M&E) of health outcomes in the field of HIV/AIDS. The coordination of M&E is a much underdeveloped area in HIV/AIDS programming in which, however, important first steps towards better synchronisation have already been taken. In this paper, we review the concepts and meanings commonly applied to M&E, and approaches and strategies for better coordination of M&E in the field of HIV/AIDS. Most importantly, drawing on this analysis, we examine why the present structure of global health governance in this area is not creating strong enough incentives for effective coordination among global and local actors. Copyright © 2010 John Wiley & Sons, Ltd

Mental Health and Wellbeing in England: the Adult Psychiatric Morbidity Survey 2014

This report presents findings of a survey of mental illness and wellbeing among people aged 16 and over living in private households in England. The survey was commissioned by NHS Digital and funded by the Department of Health, and is the fourth in a series of surveys of adult mental health

Politics Matters: A Response to Recent Commentaries

McCoy and Singh rightly comment on how extraordinary it is to need to spell out the political nature, actions and motivations underlying global health policy (1), which articulates where they (and we) are coming from. Yet without such commentators, it would be easy for the global health community today to forget how political and macro-economic decisions in the 1980s and 90s gave oxygen to the social determinants that undermined the health of populations, especially in low-income countries. These fuelled the diseases that are the focus of today’s global health partnerships; and some of the same organisations played leading roles in setting the global health agenda then, as today

A Profile of Migrant Nurses in Ireland. Nurse Migration Project Policy Brief 4

Migrant nurses, mainly from outside of the EU, are now an essential component of the Irish nursing workforce. This is the result of almost a decade of active overseas nurse recruitment from countries such as India and the Philippines. Between 2000 and 2008, non-EU migrant nurses accounted for 40% of nurses newly registered with the Irish Nursing Board [2] (see Fig. 1). According to the INO, \u22It is a reality, not readily acknowledged by Irish health employers, that this country would now be forced to close literally thousands of beds”’ [3] without the presence of migrant nurses in the health system. Despite this reliance, there is little information available about Ireland’s migrant nurse workforce. Some quite basic questions remain unanswered including: How many migrant nurses currently work in Ireland? In what fields of nursing and at what grades do they work? How many are women and how many men? What ages are they? What skills and experience did they bring to Ireland and are these being well utilised? Do they have children, either in Ireland or in their home country? Are they satisfied working and living in Ireland? And – of crucial importance – do they intend to stay here? The RCSI nurse migration project is beginning to fill these information gaps, through qualitative and quantitative surveys of migrant nurses in Ireland. This policy brief is the third on emerging project findings

Relevance and Effectiveness of the WHO Global Code Practice on the International Recruitment of Health Personnel – Ethical and Systems Perspectives

The relevance and effectiveness of the World Health Organization’s (WHO’s) Global Code of Practice on the International Recruitment of Health Personnel is being reviewed in 2015. The Code, which is a set of ethical norms and principles adopted by the World Health Assembly (WHA) in 2010, urges members states to train and retain the health personnel they need, thereby limiting demand for international migration, especially from the under-staffed health systems in low- and middle-income countries. Most countries failed to submit a first report in 2012 on implementation of the Code, including those source countries whose health systems are most under threat from the recruitment of their doctors and nurses, often to work in 4 major destination countries: the United States , United Kingdom, Canada and Australia. Political commitment by source country Ministers of Health needs to have been achieved at the May 2015 WHA to ensure better reporting by these countries on Code implementation for it to be effective. This paper uses ethics and health systems perspectives to analyse some of the drivers of international recruitment. The balance of competing ethics principles, which are contained in the Code’s articles, reflects a tension that was evident during the drafting of the Code between 2007 and 2010. In 2007-2008, the right of health personnel to migrate was seen as a preeminent principle by US representatives on the Global Council which co-drafted the Code. Consensus on how to balance competing ethical principles – giving due recognition on the one hand to the obligations of health workers to the countries that trained them and the need for distributive justice given the global inequities of health workforce distribution in relation to need, and the right to migrate on the other hand – was only possible after President Obama took office in January 2009. It is in the interests of all countries to implement the Global Code and not just those that are losing their health personnel through international recruitment, given that it calls on all member states “to educate, retain and sustain a health workforce that is appropriate for their (need) ...” (Article 5.4), to ensure health systems’ sustainability. However, in some wealthy destination countries, this means tackling national inequities and poorly designed health workforce strategies that result in foreign-trained doctors being recruited to work among disadvantaged populations and in primary care settings, allowing domestically trained doctors work in more attractive hospital setting

Overseas nurse recruitment: Ireland as an illustration of the dynamic nature of nurse migration.

This paper presents an analysis of Ireland\u27s recent experience of overseas nurse recruitment. Ireland began actively recruiting nurses from overseas in 2000 and has recruited almost 10,000 nurses, primarily from India and the Philippines since that time. This paper takes a timely look at the Irish experience to date. It reviews the literature on the supply and demand factors that determine the need for, and the international migration of, nurses and presents working visa and nurse registration statistics. This enables the authors to quantify and discuss the trends and scale of recent nurse migration to Ireland from outside the European Union (EU). The paper discusses the data essential for national workforce planning and highlights the deficiencies in the Irish data currently available for that purpose. The paper concludes with a discussion of the implications of Ireland\u27s heavy reliance on overseas nurse recruitment