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Human Resources for Health

Smisha Agarwal, Karen Kirk, Pooja Sripad, Ben Bellows, Timothy Abuya, Charlotte Warren
BACKGROUND: Globally, there is renewed interest in and momentum for strengthening community health systems, as also emphasized by the recent Astana Declaration. Recent reviews have identified factors critical to successful community health worker (CHW) programs but pointed to significant evidence gaps. This review aims to propose a global research agenda to strengthen CHW programs. METHODS AND RESULTS: We conducted a search for extant systematic reviews on any intermediate factors affecting the effectiveness of CHW programs in February 2018...
March 21, 2019: Human Resources for Health
Siyuan Liang, James Macinko, Dahai Yue, Qingyue Meng
BACKGROUND: Previous studies have focused on the relationship between increases in the health care workforce and child health outcomes, but little is known about how this relationship differs in contexts where economic growth differs by initial level and pace. This study evaluates the association between increased health professionals and the under-five mortality rate (U5MR) in rural Chinese counties from 2008 to 2014 and examines whether this relationship differs among counties with different patterns of economic growth over this period...
March 18, 2019: Human Resources for Health
Marie-Annick Gagné, Carl-Ardy Dubois, Alexandre Prud'Homme, Roxane Borgès Da Silva
BACKGROUND: Nurses play a significant role in healthcare systems. Their workplace experience can have an impact not only on nurses themselves, but also on patients and organizations, particularly in terms of quality of care and performance. Despite the importance of this experience, it remains an ambiguous concept with varying interpretations. Current studies do not fully capture its complexity, as its multiple dimensions are often considered in isolation. As such, developing a portrait of nurses' workplace experience that integrates its multiple dimensions can provide decision-makers with better indications regarding what levers can be mobilized to generate positive results for nurses, patients, and organizations...
March 14, 2019: Human Resources for Health
Barbara McPake, Prarthna Dayal, Christopher H Herbst
BACKGROUND: The 2013-2014 West African Ebola outbreak highlighted how the world's weakest health systems threaten global health security and heralded huge support for their recovery. All three Ebola-affected countries had large shortfalls and maldistribution in their health workforce before the crisis, which were made worse by the epidemic. This paper analyzes the investment plans in Liberia, Sierra Leone, and Guinea to strengthen their health workforces and assesses their potential contribution to the re-establishment and strengthening of their health systems...
March 7, 2019: Human Resources for Health
Jacinta Nzinga, Jacob McKnight, Joyline Jepkosgei, Mike English
BACKGROUND: Nursing practice is a key driver of quality care and can influence newborn health outcomes where nurses are the primary care givers to this highly dependent group. However, in sub-Saharan Africa, nursing work environments are characterized by heavy workloads, insufficient staffing and regular medical emergencies, which compromise the ability of nurses to provide quality care. Task shifting has been promoted as one strategy for making efficient use of human resources and addressing these issues...
March 6, 2019: Human Resources for Health
Shuo J Huang, Omar Galárraga, Kelley A Smith, Saipale Fuimaono, Stephen T McGarvey
BACKGROUND: Type 2 diabetes mellitus (T2DM) is highly prevalent in American Samoa. Community health worker (CHW) interventions may improve T2DM care and be cost-effective. Current cost-effectiveness analyses (CEA) of CHW interventions have either overlooked important cost considerations or not been based on randomized clinical trials (RCTs). The Diabetes Care in American Samoa (DCAS) intervention which occurred in 2009-2010 was a cluster-randomized, culturally tailored, home-visiting CHW intervention and improved HbA1c levels...
March 5, 2019: Human Resources for Health
Ari Probandari, Hary Sanjoto, Melani Ratih Mahanani, Luthfi Azizatunnisa, Sampir Widayati
INTRODUCTION: Patient-centered care approach in multidrug-resistant tuberculosis care requires health worker safety that covers both being safe and feeling safe to conduct the services. Stigma has been argued as a barrier to patient-centered care. However, there has been relatively little research addressing the issues of safety and stigma among health staff. This paper explored the issue of being safe, feeling safe, and stigmatizing attitude among health staff working with multidrug-resistant tuberculosis cases in primary health care facilities in Indonesia...
March 4, 2019: Human Resources for Health
Salésio Macuácua, Raquel Catalão, Sumedha Sharma, Anifa Valá, Marianne Vidler, Eusébio Macete, Mohsin Sidat, Khátia Munguambe, Peter von Dadelszen, Esperança Sevene
BACKGROUND: Pre-eclampsia is one of the leading causes of maternal death in Mozambique. Limited access to health care facilities and a lack of skilled health professionals contribute to the high maternal morbidity and mortality rates in Mozambique and indicate a need for community-level interventions. The aim of this review was to identify and characterise health policies related to the role of CHWs in the management of pre-eclampsia and eclampsia in Mozambique. METHODS: The policy review was based on three methods: a desk review of relevant documents from the Mozambique Ministry of Health (n = 7), contact with 28 key informants in the field of health policy in Mozambique (n = 5) and literature review (n = 699)...
February 28, 2019: Human Resources for Health
Kristy Meng-Hsi Law, Vannarath Te, Peter S Hill
BACKGROUND: From 2006, the Association of South East Asian Nations (ASEAN) has been developing Mutual Recognition Arrangements (MRAs) across key professions, including medicine, dentistry and nursing, that would facilitate the development of an ASEAN Economic Community, with shared regional standards and easier mobility of the workforce. This paper examines the interface between those agreements and the registration, professional education and mobility of health personnel in Cambodia...
February 26, 2019: Human Resources for Health
Onyema Ajuebor, Giorgio Cometto, Mathieu Boniol, Elie A Akl
BACKGROUND: Community health workers (CHWs) are an important component of the health workforce in many countries. The World Health Organization (WHO) has developed a guideline to support the integration of CHWs into health systems. This study assesses stakeholders' valuation of outcomes of interest, acceptability and feasibility of policy options considered for the CHW guideline development. METHODS: A cross-sectional mixed methods (quantitative and qualitative) study targeting stakeholders involved directly or indirectly in country implementation of CHW programmes was conducted in 2017...
February 18, 2019: Human Resources for Health
Said Ahmad Maisam Najafizada, Ronald Labonté, Ivy Lynn Bourgeault
INTRODUCTION: There is ample evidence to indicate that community health workers (CHW) are valuable human resources for health in many countries across the globe, helping to fill the gap created by a chronic health workforce shortage. This shortage is not only in number but also in workforce distribution and skill mix. There remains a lack of evidence, however, concerning the size and distribution of CHWs and their relationship to the professionally regulated and recognized health workforce, such as physicians and nurses, and the unregulated and unrecognized health workforce, such as traditional birth attendants and traditional healers...
February 6, 2019: Human Resources for Health
Nathanael Sirili, Gasto Frumence, Angwara Kiwara, Mughwira Mwangu, Isabel Goicolea, Anna-Karin Hurtig
BACKGROUND: The World Health Organization advocates that health workforce development is a continuum of three stages of entry, available workforce and exit. However, many studies have focused on addressing the shortage of numbers and the retention of doctors in rural and remote areas. The latter has left the contribution of the entry stage in particularly the deployment process on the shortage of health workforce less understood. This study therefore explored the experiences of medical doctors (MDs) on the deployment process after the internship period in Tanzania's health sector...
February 1, 2019: Human Resources for Health
Shaun C Ewen, Tess Ryan, Chris Platania-Phung
BACKGROUND: This paper provides a narrative review that scopes and integrates the literature on the development and strengthening of the Australian Aboriginal and Torres Strait Islander health researcher workforce. The health researcher workforce is a critical, and oft overlooked, element in the health workforce, where the focus is usually on the clinical occupations and capabilities. Support and development of the Australian Aboriginal and Torres Strait Islander health researcher workforce is necessary to realise more effective health policies, a more robust wider health workforce, and evidence-led clinical care...
January 30, 2019: Human Resources for Health
Marília Silva Paulo, Tom Loney, Luís Velez Lapão
BACKGROUND: The United Arab Emirates (UAE) is a rapidly developing high-income country that was formed from the union of seven emirates in 1971. The UAE has experienced unprecedented population growth coupled with increased rates of chronic diseases over the past few decades. Healthcare workers are the core foundation of the health system, especially for chronic care conditions, and the UAE health workforce needs to be fully prepared for the increased rates of chronic diseases in the adult population...
January 24, 2019: Human Resources for Health
Belinda O'Sullivan, Deborah J Russell, Matthew R McGrail, Anthony Scott
BACKGROUND: The capacity for high-income countries to supply enough locally trained doctors to minimise their reliance on overseas-trained doctors (OTDs) is important for equitable global workforce distribution. However, the ability to achieve self-sufficiency of individual countries is poorly evaluated. This review draws on a decade of research evidence and applies additional stratified analyses from a unique longitudinal medical workforce research program (the Medicine in Australia: Balancing Employment and Life survey (MABEL)) to explore Australia's rural medical workforce self-sufficiency and inform rural workforce planning...
January 22, 2019: Human Resources for Health
M I Motala, J M Van Wyk
BACKGROUND: Foreign medical graduates (FMGs) have continued to render effective health care services to underserved communities in many high- and middle-income countries. In rural and disadvantaged areas of South Africa, FMGs have alleviated the critical shortage of doctors. FMGs experience challenges to adjust to new working environments as they have studied and obtained their medical qualifications in a country that differs from the one where they eventually choose to practise. OBJECTIVES: This scoping review synthesises literature about the experiences of FMGs upon entering a host country and the factors that facilitate their adjustment to the new context...
January 21, 2019: Human Resources for Health
Victor Were, Elizabeth Jere, Kevin Lanyo, George Mburu, Rose Kiriinya, Agnes Waudo, Bwalya Chiteba, Keith Waters, Prachi Mehta, Tom Oluoch, Martha Rodgers
BACKGROUND: Shortage of health workforce in most African countries is a major impediment to achieving health and development goals. Countries are encouraged to develop evidence-based strategies to scale up their health workforce in order to bridge the gap. South-South collaborations have gained popularity due to similarities in the challenges faced in the region. This strategy has been used in trade, education, and health sector among others. This paper is a road map of using a South-South collaboration to develop a Human Resources Information System (HRIS) to inform scale-up of the health workforce...
January 15, 2019: Human Resources for Health
Kristen Beek, Alison McFadden, Angela Dawson
BACKGROUND: Midwives have an essential role to play in preparing for and providing sexual and reproductive health (SRH) services in humanitarian settings due to their unique knowledge and skills, position as frontline providers and geographic and social proximity to the communities they serve. There are considerable gaps in the international guidance that defines the scope of practice of midwives in crises, particularly for the mitigation and preparedness, and recovery phases. We undertook a systematic review to provide further clarification of this scope of practice and insights to optimise midwifery performance...
January 14, 2019: Human Resources for Health
Nonglak Pagaiya, Pudtan Phanthunane, Adun Bamrung, Thinakorn Noree, Karnwarin Kongweerakul
BACKGROUND: For an effective health system, human resources for health (HRH) planning should be aligned with health system needs. To provide evidence-based information to support HRH plan and policy, we should develop strategies to quantify health workforce requirements and supply. The aim of this study is to project HRH requirements for the Thai health service system in 2026. HRH included in this study were doctors, dentists, nurses, pharmacists, medical technicians (MTs), physiotherapists (PTs), and Thai traditional medicine (TTM) practitioners...
January 8, 2019: Human Resources for Health
R Ved, K Scott, G Gupta, O Ummer, S Singh, A Srivastava, A S George
BACKGROUND: India's accredited social health activist (ASHA) programme consists of almost one million female community health workers (CHWs). Launched in 2005, there is now an ASHA in almost every village and across many urban centres who support health system linkages and provide basic health education and care. This paper examines how the programme is seeking to address gender inequalities facing ASHAs, from the programme's policy origins to recent adaptations. METHODS: We reviewed all publically available government documents (n = 96) as well as published academic literature (n = 122) on the ASHA programme...
January 8, 2019: Human Resources for Health
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