How can countries respond to the health and care workforce crisis? Insights from international evidence

IF 1.9 4区 医学 Q3 HEALTH POLICY & SERVICES
Barbara McPake, Prarthna Dayal, Julia Zimmermann, Gemma A. Williams
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Abstract

Future global health security requires a health and care workforce (HCWF) that can respond effectively to health crises as well as to changing health needs with ageing populations, a rise in chronic conditions and growing inequality. COVID-19 has drawn attention to an impending HCWF crisis with a large projected shortfall in numbers against need. Addressing this requires countries to move beyond a focus on numbers of doctors, nurses and midwives to consider what kinds of healthcare workers can deliver the services needed; are more likely to stay in country, in rural and remote areas, and in health sector jobs; and what support they need to deliver high-quality services. In this paper, which draws on a Policy Brief prepared for the World Health Organization (WHO) Fifth Global Forum on Human Resources for Health, we review the global evidence on best practices in organising, training, deploying, and managing the HCWF to highlight areas for strategic investments. These include (1). Increasing HCWF diversity to improve the skill-mix and provide culturally competent care; (2). Introducing multidisciplinary teams in primary care; (3). Transforming health professional education with greater interprofessional education; (4). Re-thinking employment and deployment systems to address HCWF shortages; (5). Improving HCWF retention by supporting healthcare workers and addressing migration through destination country policies that limit draining resources from countries with greatest need. These approaches are departures from current norms and hold substantial potential for building a sustainable and responsive HCWF.

各国如何应对医疗和护理人员危机?国际证据的启示。
未来的全球卫生安全需要一支能够有效应对卫生危机以及随着人口老龄化、慢性病增加和不平等加剧而不断变化的卫生需求的卫生与护理人员队伍(HCWF)。COVID-19 已提请人们注意即将出现的保健和护理人员队伍危机,即预计人数与需求之间存在巨大缺口。要解决这一问题,各国就不能只关注医生、护士和助产士的数量,而要考虑什么样的医护人员能够提供所需的服务;他们更有可能留在国内、农村和偏远地区,并在卫生部门工作;以及他们需要什么样的支持才能提供高质量的服务。本文借鉴了为世界卫生组织(WHO)第五届全球卫生人力资源论坛编写的《政策简报》,回顾了全球在组织、培训、部署和管理医护人员方面的最佳实践,以突出战略投资领域。这些领域包括:(1)增加高危工作团队的多样性,以改善技能组合并提供符合文化要求的护理;(2).在初级保健中引入多学科团队;(3).改革卫生专业教育,加强跨专业教育;(4).重新思考就业和调配制度,以解决高危工作场所人员短缺问题;(5).为医护人员提供支持,通过目的地国政策解决移民问题,限制从需求最大的国家流失资源,从而留住医护人员。这些方法偏离了当前的规范,对于建立一个可持续的、反应迅速的医护人员队伍具有巨大的潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.50
自引率
3.70%
发文量
197
期刊介绍: Policy making and implementation, planning and management are widely recognized as central to effective health systems and services and to better health. Globalization, and the economic circumstances facing groups of countries worldwide, meanwhile present a great challenge for health planning and management. The aim of this quarterly journal is to offer a forum for publications which direct attention to major issues in health policy, planning and management. The intention is to maintain a balance between theory and practice, from a variety of disciplines, fields and perspectives. The Journal is explicitly international and multidisciplinary in scope and appeal: articles about policy, planning and management in countries at various stages of political, social, cultural and economic development are welcomed, as are those directed at the different levels (national, regional, local) of the health sector. Manuscripts are invited from a spectrum of different disciplines e.g., (the social sciences, management and medicine) as long as they advance our knowledge and understanding of the health sector. The Journal is therefore global, and eclectic.
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