HRH: The effect of human resource management on performance in hospitals in Sub-Saharan Africa: a systematic literature review (2)

6 May, 2019

Human resource management in health that excludes the factors and relevance of context will suffer the perils of inadequate coverage of the varied circumstances in developing and developed economies. In establishing Clinical Governance in Nigeria in 2004, the fact was obvious after the initial comprehensive situation analysis of the health system hence the number of pillars was increased from the conventional seven to twelve pillars: 'Whole system change of failing health systems'. file:///C:/Users/Joseph%20Ana/Desktop/HP%20laptop%20documents/Documents/12-Pillar%20Clinical%20Governance%20-%20in%20mPowering%20website%20%20-.pdf [*see note below]

Subsequently in 2017, in response to the finding of human resource poor performance including very low diagnostic and treatment accuracy rates in a World Bank sponsored service delivery indicator study in primary health care in Nigeria, we piloted Practical Approach to Care Kit ( PACK) Nigeria (Adult) programme, taking the context of practice into consideration. The outcome on performance was remarkable, increasing clinical performance of the 354 primary health care clinicians in 51 facilities spread over three states over several indicators: ‘Using a mentorship model to localise the Practical Approach to Care Kit (PACK): from South Africa to Nigeria. BMJ Global Health Oct 2018, 3 (Suppl 5) e001079; DOI: 10.1136/bmjgh-2018-001079’.

The context is everything when considering human resource management in health.

Joseph Ana.


@Health Resources International (HRI) WA.

National Implementing Organisation: 12-Pillar Clinical Governance

National Implementing Organisation: PACK Nigeria Programme for PHC

Publisher: Medical and Health Journals; Books and Periodicals.

Nigeria: 8 Amaku Street, State Housing & 20 Eta Agbor Road, Calabar.

Tel: +234 (0) 8063600642

Website: email: ;

[*Note from HIFA moderator (Neil PW): The above URL points to a local file that is not accessible. An excellent introduction on 'The 12-Pillar Clinical Governance Approach: Strengthening health systems in Nigeria'is provided here: See also ]