Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 24
Filtrar
1.
Malays J Med Sci ; 31(3): 1-17, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38984245

RESUMO

Mapping the distribution of medical specialists in the Ministry of Health (MOH) Malaysia facilities is expected to be more complex as the demand for specialty and subspecialty services increases in the future. A more robust and definitive gap analysis is needed to facilitate planning and resource allocation. The Medical Development Division developed a master list of framework of specialties, subspecialties and areas of interest, and Specialist Database Module in the Medical Programme Information System (MPIS) as tools to facilitate mapping of services. Relational database of specialists' location, facilities, workload, population profile and other relevant parameters were developed to provide data visualisation in specific dashboard. Needs versus supply ratio is proposed as one of parameters to visualise specialised medical services distribution by geographical localities.

2.
Int J Qual Stud Health Well-being ; 19(1): 2356928, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38773959

RESUMO

PURPOSE: Informal caregivers (ICs) in Africa perform a long list of tasks to support hospitalization care. However, available studies are weak in accounting for the experiences of everyday role-routines of hospital-based informal caregiving (HIC) in under-resourced settings. This article explored the experiences of role-routines among informal caregivers in a Nigerian tertiary health facility. METHODS: The ethnographic exploratory study relied on primary data collected from 75 participants, including 21 ICs, 15 inpatients, 36 hospital staff, and 3 ad-hoc/paid carers in a tertiary health facility in Southwestern Nigeria. RESULTS: ICs perform several essential roles for hospitalized relatives, with each role characterized by a range of tasks. An integrative narrative of everyday routines of HIC as experienced by ICs showed critical complexities and complications involved in seemingly simple tasks of assisting hospitalized relatives with hygiene maintenance, medical investigations, blood donation, resource mobilization, errand-running, patient- and self-care and others. The role-routines are burdensome and ICs' experiences of them revealed the undercurrents of how health systems dysfunctions condition family members to support hospitalization care in Nigeria. CONCLUSION: The intensity and repetitive nature of role-routines is suggestive of "routinization of suffering". We recommend the closing of gaps driving hospital-based informal caregiving in Africa's under-resourced settings.


Assuntos
Cuidadores , Humanos , Nigéria , Cuidadores/psicologia , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Família , Hospitalização , Idoso , Doadores de Sangue/psicologia , Antropologia Cultural , Pesquisa Qualitativa , Adulto Jovem
3.
West Afr J Med ; 40(12 Suppl 1): S44, 2023 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-38071571

RESUMO

Background: Physician emigration is increasing exponentially in developing countries. In Nigeria, with the last decade's unprecedented brain drain, it has gained the popular moniker 'japa syndrome'. Aim: This study aimed to determine push and pull factors affecting physician migration in Nigeria, to provide evidence-backed recommendations for physician retention policies. Materials/Methods: A cross-sectional study was conducted among attendees at the 2022 Abuja Cardiovascular Symposium hosted by Limi Multispecialty Hospital and the Nigerian Cardiac Society. Convenience and snowball sampling were used, and 295/400 responded to comprehensive self-administered questionnaires (73.7% response rate). Data was analysed using SPSS v.26. Results: Most participants (79.4%) were aged 20-39 years (Mean 35 years SD ±10.17); female (58.6%); married (58.4%) and had family size below six (73.6%). About 85.8% were employed, and 55.9% worked in private establishments. Solely basic medical degrees were possessed by 64.4%, and 63.7% earned N300,000-N399,999 (USD 396.82-USD 527.78) monthly. Top destinations were UK (50.5%), Canada (43.3%), and USA (37.9%), with low remuneration (71.2%), insecurity (62.7%), and difficult working environments (55.9%) most frequent push factors. Postgraduate-training frustrations (38.6%), and limited educational opportunities for oneself (37.6%), children (26.4%), or spouse (19.7%) were the least. High earning potential (76.6%), career growth opportunities (70.8%), and high-level equipment/technology (54.9%) were frequent pull factors. Conclusion: Physician emigration threatens Nigeria's health system and should be addressed multi-sectorally to boost physician remuneration and improve work environments and societal security. Additionally, innovative education and digital technology would encourage health workforce retention.


Assuntos
Médicos , Criança , Humanos , Feminino , Nigéria , Estudos Transversais , Emigração e Imigração , Mão de Obra em Saúde
4.
Health Res Policy Syst ; 21(1): 41, 2023 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-37264403

RESUMO

BACKGROUND: Evidence-informed policymaking on human resources for health (HRH) has been directly linked with health system productivity, accessibility, equity, quality, and efficiency. The lack of reliable HRH data has made the task of planning the HRH more difficult in all settings. AIM: This study aimed to develop a conceptual model to integrate HRH data and evidence. METHODS: The current study is a mixed-method study conducted in three phases: a rapid literature review, a qualitative phase, and an expert panel. Firstly, the electronic databases were searched up to 2018. Then, in the qualitative phase, semi-structured interviews with 50 experts were conducted. Data analysis was performed using the content analysis approach. After several expert panels, the draft of the model was validated with 15 key informants via two Delphi rounds. RESULTS: Our proposed model embraces all dominant elements on the demand and supply side of the HRH in Iran. The conceptual model consists of several components, including input (regulatory system, structure, functions), educational system (pre-service and in-service education), health labor market structure, process (technical infrastructure), and output (productions, policymaking process). We considered networking toward sustainable interaction among stakeholders, and also the existence of capacity to integrate HRH information and produce evidence for actions. CONCLUSION: The proposed model can be considered a platform for developing a harmonized system based on the HRH data flow to evidence-informed decision-making via networking. We proposed a step-by-step approach for the sustainability of establishing a national human resources for health observatory (HRHO). The proposed HRHO model can be replicable and flexible enough to be used in different context domains.


Assuntos
Modelos Teóricos , Humanos , Irã (Geográfico) , Recursos Humanos
5.
Malays J Med Sci ; 30(2): 1-7, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37102057

RESUMO

Estimating number of doctors including medical specialists needed in the public sector is fundamental to guide human resource planning and implementation of specialist training in Malaysia. Crude population-based and individual basic specialities population-based ratios were used to estimate number of doctors including specialists needed in the public sector by 2025 and 2030. These estimates were then compared with existing number of specialists, current production rates and other parameters to determine level of deficit of the various medical specialities in the future. Medical specialist production versus deficit index was introduced as a tool to present the expected outcome of the existing specialist training. The index can be used as a guide to strategise policies and implementation plans related to training and human resource.

6.
Community Dent Oral Epidemiol ; 51(3): 462-468, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36546537

RESUMO

INTRODUCTION: Dental therapists are mid-level oral healthcare providers introduced in 1977 to the South African health system to improve access to oral health services. There has, however, been anecdotal evidence of their unusually high rate of attrition that is cause for concern. AIM AND OBJECTIVES: This study aimed to determine the demographic profile and attrition rate among members of the South African Dental Therapy profession. METHODS: A retrospective time series review of records of all dental therapists who were previously registered and who are still registered with the Health Professions Council of South Africa (HPCSA) between 1977 and 2019 was conducted. RESULTS: A total of 1232 dental therapists were registered from 1977 to 2019. The majority (64%) were Africans. Most practicing dental therapists were based in KwaZulu-Natal (44%) and Gauteng (27%), which are the provinces where dental therapists are trained. The overall attrition rate between 1977 and 2019 was 40%, with a figure of 9% for the last 10 years of the study (2010 to 2019). CONCLUSION: This study has provided the first evidence of the high attrition rate of dental therapists in South Africa. The high attrition warrants further investigation to address the loss of valuable human resources from an already overburdened and under-resourced public oral health sector.


Assuntos
Saúde Bucal , Humanos , África do Sul/epidemiologia , Estudos Retrospectivos
7.
Med J Islam Repub Iran ; 36: 127, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36447541

RESUMO

Background: Many countries face critical challenges due to shortage and maldistribution of human resources for health (HRH). An HRH observatory can be used as a mechanism to monitor HRH issues and facilitate evidence-based decision-making. This study aims to identify the essential elements of an HRH observatory for Iran. Methods: This qualitative study was conducted through semi-structured interviews with 30 key informants over two months since May 2019. Purposeful and snowball sampling methods were used. Each interview lasted a minimum of 60 min. Data analysis was performed using the content analysis approach. Results: The essential elements for integrating HRH information were categorized into the following themes: organizational structure, partnership, prerequisites for implementing HRH observatory, data management, and evidence-informed policymaking. Our results propose a national HRH observatory for Iran consisting of steering, technical and research boards, and also stakeholders' and research networks under the governance of the ministry of health and medical education (MOHME). It is required to make a comprehensive plan in several steps and arrangements based on the country's situation. The stakeholder's network was identified based on their role in HRH development and production of information and evidence. The main aim of the HRH observatory considers monitoring trends in patterns of the HRH for evidence-based decision-making and policy development. Our results propose an evidence development network consisting of a national HRH Research Center (HRHRC) and a cooperative network formed by several medical universities. Conclusion: We provide a comprehensive approach to establishing a national HRH observatory. We consider the HRH observatory as a cooperative initiative among key stakeholders to produce knowledge in order to improve human resource policymaking. The proposed HRH observatory model emphasizes networking and stakeholder involvement.

8.
Hum Resour Health ; 19(Suppl 1): 124, 2022 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-35090478

RESUMO

BACKGROUND: Vietnam has encountered difficulties in ensuring an adequate and equitable distribution of health workforce. The traditional staffing norms stated in the Circular 08/TT-BYT issued in 2007 based solely on population or institutional size and do not adequately take into consideration the variations of need such as population density, mortality and morbidity patterns. To address this problem, more rigorous approaches are needed to determine the number of personnel in health facilities. One such approach is Workload Indicators of Staffing Need (WISN) developed by the World Health Organization (WHO), a facility-based workforce planning method that assists managers in defining the responsibilities of different workforce categories and improving the appropriateness and efficiency of a staff mix. METHODS: This study applied the WISN approach and was employed in 22 clinical departments at four hospitals in Vietnam between 2015 and 2018. 22 targeted group discussions involving nurses were conducted. Hospital personnel records have been retrieved. The data were analyzed according to WISN instructions. RESULTS: Of the 22 departments, there was a shortage of 1 to 2 nurses in 10 departments, with WISN ratios ranging between 0.88 and 0.95. Only 01 clinical colleges at Can Tho Hospital lacked 05 nurses, facing a high workload with a WISN ratio of 0.78. Administrative time represented 20-40% of the total work time of a nurse. In comparison, nurses at Can Tho Hospital spent time on administration from 24 onwards. 5-41.7% of their working time while nurses at Thanh Hoa Hospital spent 21-33%. CONCLUSIONS: The application of the WISN enabled health managers to analyze the workload of nurses, calculate staffing needs, and thus effectively contribute to the workforce planning process. It is expected that the results of this research will encourage the use of the WISN tool in other hospitals and health facilities across the health system. At provincial and national levels, this study provides important evidence to help policy makers develop guidelines for personnel norms for health facilities in the context of limited resources, while the existing regulation is no longer appropriate.


Assuntos
Recursos Humanos de Enfermagem Hospitalar , Carga de Trabalho , Mão de Obra em Saúde , Hospitais , Humanos , Admissão e Escalonamento de Pessoal , Vietnã , Recursos Humanos
9.
J Int Migr Integr ; 23(3): 1377-1396, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34539258

RESUMO

The emigration of doctors from Nigeria has been on the increase in recent years, with no obvious efforts to manage or mitigate the negative impacts of this growing trend on the already weak health system. This study assessed the emigration intentions of doctors undergoing residency training at the premier tertiary healthcare center in Nigeria and the factors that influence these intentions. This mixed-method study was cross-sectional in design. A semi-structured questionnaire was used to identify the factors that influence the emigration intentions of resident doctors at the University College Hospital, Ibadan, Southwest Nigeria. In-depth interviews (IDIs) were also conducted to further explore the push and pull factors identified from the survey and their migration preferences. A total of 244 resident doctors completed the questionnaires and 10 participated in the IDIs. Overall, 57.4% of the respondents had emigration intentions and 34.8% had made various attempts at emigrating. Major factors that encouraged resident doctors to emigrate to developed countries included better working and living conditions, good salary and the opportunity for career advancement in destination countries. Family ties was the single most important factor that deterred resident doctors from emigrating. The UK was found to be the top preferred destination. Strategic approaches and multisectoral collaborations will be required to address doctors' emigration from Nigeria. These efforts should be targeted at not just the health sector but should also include the social and economic aspects of the lives of resident doctors, to improve their living conditions.

10.
Hum Resour Health ; 19(1): 39, 2021 03 22.
Artigo em Inglês | MEDLINE | ID: mdl-33752675

RESUMO

BACKGROUND: Investment in human resources for health not only strengthens the health system, but also generates employment and contributes to economic growth. India can gain from enhanced investment in health workforce in multiple ways. This study in addition to presenting updated estimates on size and composition of health workforce, identifies areas of investment in health workforce in India. METHODS: We analyzed two sources of data: (i) National Health Workforce Account (NHWA) 2018 and (ii) Periodic Labour Force Survey 2017-2018 of the National Sample Survey Office (NSSO). Using the two sources, we collated comparable estimates of different categories of health workers in India, density of health workforce and skill-mix at the all India and state levels. RESULTS: The study estimated (from NHWA 2018) a total stock of 5.76 million health workers which included allopathic doctors (1.16 million), nurses/midwives (2.34 million), pharmacist (1.20 million), dentists (0.27 million), and traditional medical practitioner (AYUSH 0.79 million). However, the active health workforce size estimated (NSSO 2017-2018) is much lower (3.12 million) with allopathic doctors and nurses/midwives estimated as 0.80 million and 1.40 million, respectively. Stock density of doctor and nurses/midwives are 8.8 and 17.7, respectively, per 10,000 persons as per NHWA. However, active health workers' density (estimated from NSSO) of doctor and nurses/midwives are estimated to be 6.1 and 10.6, respectively. The numbers further drop to 5.0 and 6.0, respectively, after accounting for the adequate qualifications. All these estimates are well below the WHO threshold of 44.5 doctor, nurses and midwives per 10,000 population. The results reflected highly skewed distribution of health workforce across states, rural-urban and public-private sectors. A substantial proportion of active health worker were found not adequately qualified on the one hand and on the other more than 20% of qualified health professionals are not active in labor markets. CONCLUSION: India needs to invest in HRH for increasing the number of active health workers and also improve the skill-mix which requires investment in professional colleges and technical education. India also needs encouraging qualified health professionals to join the labor markets and additional trainings and skill building for already working but inadequately qualified health workers.


Assuntos
Mão de Obra em Saúde , Médicos , Pessoal de Saúde , Humanos , Índia , Recursos Humanos
11.
Hum Resour Health ; 19(1): 31, 2021 03 10.
Artigo em Inglês | MEDLINE | ID: mdl-33691723

RESUMO

BACKGROUND: System dynamics (SD) modelling can inform policy decisions under Thailand's Universal Health Coverage. We report on this thinking approach to Thailand's strategic health workforce planning for the next 20 years (2018-2037). METHODS: A series of group model building (GMB) sessions involving 110 participants from multi-sectors of Thailand's health systems was conducted in 2017 and 2018. We facilitated policymakers, administrators, practitioners and other stakeholders to co-create a causal loop diagram (CLD) representing a shared understanding of why the health workforce's demands and supplies in Thailand were mismatched. A stock and flow diagram (SFD) was also co-created for testing the consequences of policy options by simulation modelling. RESULTS: The simulation modelling found hospital utilisation created a vicious cycle of constantly increasing demands for hospital care and a constant shortage of healthcare providers. Moreover, hospital care was not designed for effectively dealing with the future demands of ageing populations and prevalent chronic illness. Hence, shifting emphasis to professions that can provide primary care, intermediate care, long-term care, palliative care, and end-of-life care can be more effective. CONCLUSIONS: Our SD modelling confirmed that shifting the care models to address the changing health demands can be a high-leverage policy of health workforce planning, although very difficult to implement in the short term. of health workforce planning, although very difficult to implement in the short term.


Assuntos
Mão de Obra em Saúde , Cobertura Universal do Seguro de Saúde , Programas Governamentais , Planejamento em Saúde , Humanos , Tailândia
12.
Niger Med J ; 61(2): 90-95, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32675901

RESUMO

CONTEXT: Primary health care (PHC) is the cornerstone of the Nigerian National Health Policy. The national policy on PHC under one roof is undergoing implementation nationwide as a means of strengthening the PHC system. Akwa Ibom State (AKS) is set to commence full implementation of the policy. AIMS: The aim of the study was to assess the existing human resource and infrastructure in PHC facilities in AKS. SETTINGS AND DESIGN: A descriptive cross-sectional study was carried out in 18 facilities selected from the three senatorial zones of AKS, Nigeria. SUBJECTS AND METHODS: A rapid assessment of selected PHC facilities based on a checklist adapted from the minimum standards for PHC as provided by the National PHC Development Agency. The results were analyzed using Excel and presented in tables. RESULTS: A total of 18 health facilities were included in the study. Human resources available were 276 full time core health workers, of which 48 (17.4%) were volunteer workers. There was inequitable distribution in district and facility type as 122(44.2%) work in Ikot Ekpene Senatorial district and 242 (87.7%) of them work in the Operational Base. Basic lifesaving equipment such as resuscitation sets was unavailable in more than 50% of the health facilities. CONCLUSIONS: There are absolute deficit and inequitable distribution of available human resources in AKS PHCs. Basic-lifesaving equipment is grossly inadequate. There is an urgent need for more health workers to be employed and provision of basic equipment for the PHCs.

13.
Gates Open Res ; 4: 159, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33615144

RESUMO

The COVID-19 pandemic has disrupted the already low resourced, fragmented and largely unregulated health systems in countries like India. It has only further exacerbated the stress on human resources for health (HRH) in many unanticipated ways. We explored the effect of COVID-19 pandemic on the health workforce in India, and analytically extrapolated the learnings to draw critical components to be addressed in the HRH policies, which can further be used to develop a detailed 'health workforce resilience' policy. We examined the existing literature and media reports published during the pandemic period, covering the gaps and challenges that impeded the performance of the health workers. Recommendations were designed by studying the learnings from various measures taken within India and in some other countries. We identified seven key areas that could be leveraged and improved for strengthening resilience among the health workforce. The system-level factors (at macro level) include developing a health workforce resilience policy, planning and funding for emergency preparedness, stakeholder engagement and incentivization mechanisms; the organization-level factors (meso level) include identifying HRH bench strength, mobilizing the health workforce, psycho-social support, protection from disease; and the individual-level factors (micro level) include measures around self-care by health workers. In keeping with the interdisciplinary nature of the associated factors, we emphasize on developing a future-ready health workforce using a multi-sectoral approach for building its strength and resilience.

14.
J Educ Health Promot ; 8: 97, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31143814

RESUMO

BACKGROUND: The main issue for advancing any health system is human resources for health (HRH); although efforts to address HRH shortage and performance have accelerated over recent years, HRH is still a problem for delivering quality services. Addressing key governance issues is essential for developing capable health workforce, and good governance should be an integral part of planning and implementation of HRH. MATERIALS AND METHODS: This is a qualitative study, undertaken in 2017. Data processing included 14 in-depth interviews with the experts of human resource management in medical universities and the Ministry of Health and Medical Education. The sampling was carried out using purposeful sampling method and continued until reaching data saturation. Data analysis was performed using subject analysis method. RESULTS: This study assessment of the human resource governance in ten principles includes strategic vision, participation and consensus orientation, rule of law, transparency, responsiveness, equity and inclusiveness, effectiveness and efficiency, accountability, intelligence and information, and ethics. The result showed that although MOHME tries to reduce insufficient and unbalance's human resources and expand the capacity building in human resource planning, there are not enough practical knowledge and skills among policy-makers. CONCLUSIONS: Strengthening human resource governance should have been among the priorities identified in the health national strategy and government should have a long-term perspective, and all key factors in government, civil society, academia, and other stakeholders should participate in human resource policy-making and their participations should be accepted as a culture.

16.
Glob Health Action ; 11(1): 1489603, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30103658

RESUMO

Recently, China has played a more and more important role in global health, mainly by improving health outcomes of its own population nationwide and participating international health activities. In addition, China has participated in a dozen of international organizations, which all contained health domains, particularly the Belt and Road Initiative with an ambitious goal to improve health of the people in the countries alongside closely partnered with the World Health Organization. All these highlight the need of human resource for global health at the national level. The National Health and Family Planning Commission translated this political will into action - that a talent pool candidate for global health will be established in China. The establishment of the talent pool would be of great significance for China's engagement in global health activities. However, much work, such as training, collaboration, and innovation, etc., remains to be done in the future. Based on the successful practice, China can share lessons learned to other countries.


Assuntos
Saúde Global , Política , Desenvolvimento de Pessoal , China , Planejamento em Saúde , Humanos , Organização Mundial da Saúde
17.
Int J Health Policy Manag ; 7(11): 1024-1039, 2018 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-30624876

RESUMO

BACKGROUND: The Rwanda Human Resources for Health Program (HRH Program) is a 7-year (2012-2019) health professional training initiative led by the Government of Rwanda with the goals of training a large, diverse, and competent health workforce and strengthening the capacity of academic institutions in Rwanda. METHODS: The data for this organizational case study was collected through official reports from the Rwanda Ministry of Health (MoH) and 22 participating US academic institutions, databases from the MoH and the College of Medicine and Health Sciences (CMHS) in Rwanda, and surveys completed by the co-authors. RESULTS: In the first 5 years of the HRH Program, a consortium of US academic institutions has deployed an average of 99 visiting faculty per year to support 22 training programs, which are on track to graduate almost 4600 students by 2019. The HRH Program has also built capacity within the CMHS by promoting the recruitment of Rwandan faculty and the establishment of additional partnerships and collaborations with the US academic institutions. CONCLUSION: The milestones achieved by the HRH Program have been substantial although some challenges persist. These challenges include adequately supporting the visiting faculty; pairing them with Rwandan faculty (twinning); ensuring strong communication and coordination among stakeholders; addressing mismatches in priorities between donors and implementers; the execution of a sustainability strategy; and the decision by one of the donors not to renew funding beyond March 2017. Over the next 2 academic years, it is critical for the sustainability of the 22 training programs supported by the HRH Program that the health-related Schools at the CMHS significantly scale up recruitment of new Rwandan faculty. The HRH Program can serve as a model for other training initiatives implemented in countries affected by a severe shortage of health professionals.


Assuntos
Fortalecimento Institucional , Programas Governamentais , Pessoal de Saúde/educação , Mão de Obra em Saúde , Cooperação Internacional , Organizações , Instituições Acadêmicas , Países em Desenvolvimento , Docentes , Administração Financeira , Humanos , Ruanda , Estudantes , Estados Unidos
18.
Acta Medica Philippina ; : 438-446, 2018.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-959665

RESUMO

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> This study aimed to assess the health workforce's service capacities within a health Service Delivery Network (SDN) of an urban poor and a rural poor setting.</p><p style="text-align: justify;"><b>METHODS:</b> This is a concurrent mixed-methods study implemented in Navotas and Masbate, an urban poor and a rural poor area, respectively. Health needs of the residents were assessed through records review, qualitative methods and a household survey. Health facilities in the identified SDN were assessed using the Service Availability and Readiness Assessment (SARA) tool. Training data of Human Resource for Health (HRH) were also obtained.</p><p style="text-align: justify;"><b>RESULTS:</b> SDN in the two areas are different in terms of formality where memoranda of agreement were prepared between Masbate facilities but not in Navotas. Health worker to population ratios were 12.1 per 10,000 in Navotas and 2.7 in Masbate, respectively. The primary care facilities in the two sites met the recommended level of trainings for health workers in obstetric care, immunization, childhood nutrition and tuberculosis. There was a lack of post-graduate training in non-communicable diseases in all facilities. Poverty and geography were significant factors affecting health service delivery.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> In terms of human resources, both sites have limited number of health workers and the ratios fall far below WHO guideline. Recommendations include: Primary health care staff complement should be increased in the two SDNs. HHRDB should conduct a study to settle the issue of continuing medical education requirements that are not congruent with WHO recommendations. The SDNs should include the access of medicines and commodities by poor patients in private facilities during times of stock outs. Also, during stock outs or unavailability of government health personnel, transportation should be made available via the SDN to transport poor patients to private or nongovernment facilities with the needed personnel. The DOH and HHRDB should investigate innovative strategies for telehealth services that do not require continuous electricity, nor telephone or cellphone signal.</p>


Assuntos
Humanos , Serviços de Saúde Comunitária , Acessibilidade aos Serviços de Saúde , Atenção à Saúde , Qualidade da Assistência à Saúde
19.
Hum Resour Health ; 15(1): 27, 2017 04 04.
Artigo em Inglês | MEDLINE | ID: mdl-28376823

RESUMO

BACKGROUND: The shortage of a skilled health workforce is a global crisis. International efforts to combat the crisis have shown few benefits; therefore, more country-specific efforts are required. Tanzania adopted health sector reforms in the 1990s to ensure, among other things, availability of an adequate skilled health workforce. Little is documented on how the post-reform training and deployment of medical doctors (MDs) have contributed to resolving Tanzania's shortage of doctors. The study aims to assess achievements in training and deployment of MDs in Tanzania about 20 years since the 1990s health sector reforms. METHODS: We developed a human resource for health (HRH) conceptual model to study achievements in the training and deployment of MDs by using the concepts of supply and demand. We analysed secondary data to document the number of MDs trained in Tanzania and abroad, and the number of MDs recommended for the health sector from 1992 to 2011. A cross-sectional survey conducted in all regions of the country established the number of MDs available by 2011. RESULTS: By 1992, Tanzania had 1265 MDs working in the country. From 1992 to 2010, 2622 MDs graduated both locally and abroad. This translates into 3887 MDs by 2011. Tanzania needs between 3326 and 5535 MDs. Our survey captured 1299 MDs working throughout the country. This number is less than 40% of all MDs trained in and needed for Tanzania by 2011. Maldistribution favouring big cities was evident; the eastern zone with less than 30% of the population hosts more than 50% of all MDs. No information was available on the more than 60% of MDs uncaptured by our survey. CONCLUSIONS: Two decades after the reforms, the number of MDs trained in Tanzania has increased sevenfold per year. Yet, the number and geographical distribution of MDs practicing in the country has remained the same as before the reforms. HRH planning should consider the three stages of health workforce development conceptualized under the demand and supply model. Auditing and improvement of the HRH database is highly recommended in dealing with Tanzania's MD crisis.


Assuntos
Logro , Educação Médica , Reforma dos Serviços de Saúde , Mão de Obra em Saúde/tendências , Médicos/provisão & distribuição , Estudos Transversais , Médicos Graduados Estrangeiros , Necessidades e Demandas de Serviços de Saúde , Humanos , Médicos/tendências , Área de Atuação Profissional , Inquéritos e Questionários , Tanzânia
20.
Journal of Preventive Medicine ; (12): 541-544,549, 2017.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-792623

RESUMO

Objective To learn the status and equity of human resource allocation for health so as to provide evidence for health administrative department. Methods Descriptive analysis and annual percent changes (APC) were used to analyze the numbers and trends of human resource allocation for health from 2011 to 2015, and Gini coefficients were used for equity evaluation. Results In 2015, Hangzhou had the largest number (12.62) of medical personnel per 1000 persons while Jiaxing had the least amount (7.43) . Hangzhou had the largest number (10.32) of medical technical personnel per 1000 persons while Wenzhou had the least amount (6.23) . Hangzhou had the largest number (3.86) of licensed (assistant) doctors per 1000 persons while Jiaxing had the least amount (2.15) . Hangzhou had the largest number (4.23) of registered nurses per 1000 persons while Wenzhou had the least amount (2.42) . Jiaxing had 8.06 medical personnel, 7.03 medical technical personnel, 2.33 licensed (assistant) doctors and 2.86 registered nurses per square kilometer which were all the largest number while Lishui had 1.21 medical personnel, 1.00 medical technical personnel, 0.39 licensed (assistant) doctors and 0.38 registered nurses per square kilometer which were all the least. The doctor-to-nurse ratio was only 1:1.01 in 2015. Both numbers of human resources for health per 1000 persons and per square kilometer increased year by year from 2011 to 2015, and Gini coefficients of each index expressed by per 1000 persons were all under 0.2, while it ranged from 0.2 to 0.3 when they were expressed by per square kilometer. Conclusion Numbers of human resource allocation for health had an increasing trend and the allocation was fair, but the equity evaluated by service population was better than by service areas, and the research about accessibility of regional human resource allocation for health needs to be concerned.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...