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Post-Disaster Recovery: A Case Study of Human Resource Deployment in the Health Sector in Post-Conflict Kosovo

Published online by Cambridge University Press:  25 March 2011

Katherine P. O'Hanlon*
Affiliation:
Assistant Professor, Department of Emergency Medicine, University of Rochester Medical Center, Rochester, New York USA
Boris Budosan
Affiliation:
Health/Mental Health Advisor for INGO Cordaid, Den Hague, Netherlands
*
Correspondence: Katherine P. O'Hanlon, MD, MPH Assistant Professor Department of Emergency MedicineUniversity of Rochester Medical CenterRochester, New York 14642 USA. E-mail: katherine_ohanlon@urmc.rochester.edu

Abstract

Introduction: A professional understanding of disasters, paired with the need for health service development, can provide opportunities for the recovery and improvement of the health sector. Investment in training capacity ranks among the top priorities of a recovering health sector. The recovery and development of primary healthcare delivery systems has been implemented by various international and local health players in the aftermath of conflicts around the world. However, human resource development in the post-conflict environment has not been evaluated and/or published appropriately in the medical literature.

Objective: In this retrospective, descriptive study, the authors describe the strategy and evaluate the effectiveness of a field-based training program for primary healthcare doctors implemented by the US-based international non-governmental organization, the International Medical Corps, after the conflict in Kosovo in 1999.

Methods: A six-month, comprehensive education and training program on primary healthcare issues was delivered to 134 Kosovar primary healthcare physicians in 10 Kosovo municipalities in 1999 and 2000. Qualitative and quantitative data were collected. The qualitative methods included open-ended, semi-structured, key informant interviews, structured focus groups, and unstructured participant observations. The quantitative method was multiple-choice knowledge tests.

Results: The education and training program proved to be culturally appropriate and well-accepted by local communities. The program met its overall objective to refresh the knowledge of primary care doctors on various primary healthcare issues and set the stage for further strengthening and development of primary health services and their required human resources in Kosovo.

Conclusions: The comprehensive education and training of primary healthcare doctors in Kosovo was a feasible, much appreciated, and effective intervention implemented in a difficult post-conflict environment. This training was one of the early steps in the modernization of primary healthcare services in Kosovo. Later, primary health care was strengthened by the introduction of a Department of Family Medicine at the university, which includes a residency program. The intervention described in this study has the potential to be reproduced in other post-disaster environments, especially in resource-poor settings with long-time troubled health sectors in developing countries.

Type
Original Research
Copyright
Copyright O'Hanlon © World Association for Disaster and Emergency Medicine 2011

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References

Nelson, BD, Simic, S, Beste, L, et al: Multimodal assessment of the primary healthcare system of Serbia: A model for evaluating post-conflict health systems. Prehosp Disaster Med 2003;18(1):613.CrossRefGoogle Scholar
Ssengooba, F, Rahman, AS, Hongor, C, et al: Health sector reforms and human resources for health in Uganda and Bangladesh: Mechanisms of effects. Human Resources for Health 5:3. Available at http://www.human-resources-health.com/content/5/1/3. Accessed on 07 December 2009.CrossRefGoogle Scholar
Macrae, J: Rebuilding health systems: An overview of the dilemmas. WHO Health in Emergencies 2002;13:12.Google Scholar
Stephenson, RS, DuFrane, C: Disasters and development: Part 2: Understanding and exploiting disaster-development linkages. Prehosp Disaster Med 2005;20(1):6164.CrossRefGoogle ScholarPubMed
Gardemann, J: Primary health care in complex humanitarian emergencies: Rwanda and Kosovo. Experiences and their implications for public health training. Croat Med J 2002;43(2):148155.Google ScholarPubMed
Pavignani, E: Analyzing human resources for health. Module 10 in a modular manual analyzing disrupted health sectors. Available at http://www.who.int/hac/techguidance/tools/disrupted_sectors/module_10/en/index.html. Accessed 02 December 2009.Google Scholar
The University of New South Wales: The challenge of human resource management in conflict-prone Situations. Available at http://www.sphcm.med.unsw.edu.au/SPHCMWeb.nsf/resources/AUSCAN_Background_II.pdf/$file/AUSCAN_Background_II.pdf. Accessed 01 December 2009.Google Scholar
World Health Organization: Health in Emergencies. Newsletter of the Department of Health Action in Crises, Issue No.18. Available at http://www.who.int/hac/about/12010.pdf. Accessed 03 December 2009.Google Scholar
World Health Organization: WHO Operations in Kosovo. Action Plan for 2000. Copenhagen: World Health Organization, Regional Office for Europe.Google Scholar
World Health Organization: The World Health Report 2008: Primary Health Care-Now, More than Ever. Geneva: World Health Organization.Google Scholar
World Health Organization: Analysis of Selected Demographic Indicators for Kosovo, 1975–1995. Prishtina: WHO Humanitarian Assistance Office.Google Scholar
Spiegel, P, Salama, P: War and mortality in Kosovo, 1998–1999: An epidemiological study. Lancet 2000;355:22042209.CrossRefGoogle Scholar
The Sphere Project: Humanitarian Charter and Minimum Standards in Disaster Response. Available at: http://www.sphereproject.org/. Accessed 04 December 2009.Google Scholar
Albreht, T, Delnoij, MJD, Klazinga, N: Changes in primary health care centers over the transition period in Slovenia. Eur J Public Health 2006;16(3):237242.CrossRefGoogle ScholarPubMed
World Health Organization: Kosovo Health Sector Situation. Prishtina: WHO, Humanitarian Assistance Office, 1999.Google Scholar
Morikawa, JM: Primary care training in Kosovo. Family Medicine Journal 2003;35(6):440444.Google ScholarPubMed
Cami, A: Kosova health system. Prishtina: Ministry of Health Publication, Ministry of Health, 2004.Google Scholar
Organization of Security and Cooperation in Europe: OSCE mission in Kosovo: Municipal profiles. Available at http://www.osce.org/kosovo/13982.html. Accessed 25 November 2009.Google Scholar
Buowa, D, Vuori, H: Rebuilding a health care system: War, reconstruction and health care reforms in Kosovo. Eur J Public Health 2006;17(2):226230.CrossRefGoogle Scholar
Kirkpatrick, DL: Evaluating Training Programs: The Four Levels. San Francisco: Berrett-Koehler Publications, 1998.Google Scholar
Doctors without Borders: International Activity Report from Angola. Available at http://doctorswithoutborders.org/publications/ar/report.cfm?id=1212. Accessed 16 January 2010.Google Scholar
Povey, G, Mercer, MA: East Timor in Transition: Health and Health Care. Report from East Timor. Available at http://www.healthallianceinternational.org/files/papers/health_healthcare_2002_TL_1.pdf. Accessed 18 January 2010.Google Scholar
USAID-Iraq: Top strategic accomplishments in Iraq. Available at http://www.usaid.gov/iraq/accomplishments/iraq_accomplishments_oct07.pdf. Accessed 19 January 2010.Google Scholar
Islamic Republic of Afghanistan: Health Sector Strategy for the Afghanistan National Development Strategy. Kabul: Ministry of Public Health.Google Scholar
RTI International: Building the capacity of health care providers in Iraq. Available at http://www.rti.org/page.cfm?nav=366&objectid=46B5BE66-19D7-4A48-9647D3426B8E1FE2. Accessed 19 January 2010.Google Scholar
Pavignani, E, Colombo, A: Providing health services in countries disrupted by civil wars: A comparative analysis of Mozambique and Angola 1975–2000. WHO publication. Available at http://www.who.int/hac/techguidance/hbp/Providing_services_main/en/index.html. Accessed 20 November 2009.Google Scholar
Driessche, KV, Sabue, M, Dufour, W, et al: Training health care workers to promote HIV services for patients with tuberculosis in the Democratic Republic of Congo. Human Resources for Health, 7:23. Available at http://www.human-resources-health.com/content/7/1/23. Accessed 08 December 2009.CrossRefGoogle Scholar
Dormael Van, M, Dugas, S, Kone, Y, et al: Appropriate training and retention of community doctors in rural areas: A case study from Mali. Human Resources for Health, 6:25. Available at http://www.human-resources-health.com/content/6/1/25. Accessed on 08 December 2009.CrossRefGoogle Scholar
Abdel-Naser, AA, Muzelil, HA, Aladin, HA, et al: Evaluation study of the training programs for health personnel in Al-Qassim, Saudi Arabia. East Mediterr Health J 1998;4(1):8693.Google Scholar
Seif El Din, AG, Faten, AK, Randa, MY, Hoda, YA: Evaluation of an educational training program for the development of trainers in child mental health in Alexandria. East Mediterr Health J 1996;2(3):482493.CrossRefGoogle Scholar
Omar, M, Gerein, N, Tarin, E, et al: Training evaluation: a case study of training Iranian health managers. Human resources for Health, 7:20. Available at http://www.human-resources-health.com/content/7/1/20. Accessed 08 December 2009.CrossRefGoogle Scholar
Walshe, K, Freeman, T: Effectiveness of quality improvement: Learning from evaluations. Qual Saf Health Care 2002;11:8587.CrossRefGoogle ScholarPubMed
Pérez-Cuevas, R, Reyes, H, Guiscafre, H, et al: The primary care clinic as a setting for continuing medical education: Program description. CMAJ 2000;163(10):12951299.Google ScholarPubMed
Ridde, V, Fournier, P, Banza, B, et al: Program evaluation training for health professionals in francophone Africa: process, competence, acquisitions and use. Human Resources for Health, 7:3. Available at http://www.human-resources-health.com/content/7/1/3. Accessed 07 December 2009.CrossRefGoogle Scholar
Hedley, NR, Maxuni, B: Development of family medicine in Kosovo. BMJ 2005;331:201203.CrossRefGoogle ScholarPubMed
Personal correspondence with Dr. Burhan Hadri, program assistant for this study. Correspondence by electronic mail on 21 May 2010.Google Scholar
LaFond, A, Brown, L: A Guide to Monitoring and Evaluation of Capacity-Building Interventions in the Health Sector in Developing Countries. MEASURE Evaluation Manual Series, No. 7. Available at http://www.cpc.unc.edu/measure/publications/pdf/ms-03-07.pdf. Accessed 08 December 2009.Google Scholar
Cueto, M: The origins of primary health care and selective primary health care. American Journal of Public Health 2004;94(11):18641874.CrossRefGoogle ScholarPubMed