{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T18:30:17Z","timestamp":1794076217529,"version":"4.8.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2005,8,10]],"date-time":"2005-08-10T00:00:00Z","timestamp":1123632000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"},{"start":{"date-parts":[[2005,8,10]],"date-time":"2005-08-10T00:00:00Z","timestamp":1123632000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Hum Resour Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sub-Saharan Africa faces a human resources crisis in the health sector. Over the past two decades its population has increased substantially, with a significant rise in the disease burden due to HIV\/AIDS and recurrent communicable diseases and an increased incidence of noncommunicable diseases. This increased demand for health services is met with a rather low supply of health workers, but this notwithstanding, sub-Saharan African countries also experience significant wastage of their human resources stock.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This paper is a desk review to illustrate suggestions that the way human resources for health (HRH) are trained and deployed in Africa does not enhance productivity and that countries are unable to realize the full potential expected from the working life of their health workers. The paper suggests data types for use in measuring various forms of \"wastage\".<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\"Direct\" wastage \u2013 or avoidable increases in loss of staff through factors such as emigration and death \u2013 is on the rise, perhaps as a result of the HIV\/AIDS epidemic. \"Indirect\" wastage \u2013 which is the result of losses in output and productivity from health professionals' misapplied skills, absenteeism, poor support and lack of supervision \u2013 is also common.<\/jats:p>\n                    <jats:p>HIV\/AIDS represents a special cause of wastage in Africa. Deaths of health workers, fear of infection, burnout, absenteeism, heavy workloads and stress affect productivity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The paper reviews strategies that have been proposed and\/or implemented. It suggests areas needing further attention, including: developing and using indicators for monitoring and managing wastage; enhancing motivation and morale of health workers; protecting and valuing the health worker with enhanced occupational safety and welfare systems; and establishing the moral leadership to effectively tackle HIV\/AIDS and the brain drain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/1478-4491-3-6","type":"journal-article","created":{"date-parts":[[2005,8,11]],"date-time":"2005-08-11T02:23:54Z","timestamp":1123727034000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":94,"title":["Wastage in the health workforce: some perspectives from African countries"],"prefix":"10.1186","volume":"3","author":[{"given":"Delanyo","family":"Dovlo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2005,8,10]]},"reference":[{"issue":"1","key":"35_CR1","first-page":"45","volume":"3","author":"D Dovlo","year":"1999","unstructured":"Dovlo D, Nyonator F: Migration of graduates of the University of Ghana Medical School: a preliminary rapid appraisal. 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