This paper is one of a series of papers commissioned by the Regional Network for Equity in Health in southern Africa (EQUINET) for a programme of work with Oxfam GB on 'Equity issues in HIV/AIDS, Health Sector Responses and Treatment Access in Southern Africa'. This paper discusses the implications for health personnel of the HIV epidemic, and health sector responses to it, in southern Africa, using Malawi as a case study. Published and grey literature has been consulted to assess the situation and its implications for equity.
The first part of the paper covers the context of health sector organisations in southern Africa. It discusses the global labour market for health workers; the impacts that the HIV epidemic is having on health organisations; and the impacts of the epidemic on individuals and their life expectations and career choices. It raises the areas requiring policy responses.
The second part of the paper explores these issues further in Malawi. A very brief introduction is given to the context of the HIV epidemic and the health sector in Malawi. Further information on Malawi is presented in a separate country paper in the same programme of work by Kemp et al (2003). The paper then reviews the HRH situation in Malawi in relation to the impacts of HIV/AIDS. It explores the difficulties in monitoring and managing the deployment of HRH, and the risks of infection to the users and workers in Malawi's health services. The paper discuss the equity implications of the situation in Malawi, the policy responses initiated and required and how these could best be supported. A concluding section summarises the issues and conclusions in relation to HIV/AIDS and HRH in equitable health sector responses for southern African countries.
Equinet discussion paper no. 12 edited by R. Loewenson and C. Thompson, 41 pp.