Modelling the Wage Bill and Budget Space for Health Workforce in Ghana: Implications for Sustainable Health Professions Education Policy.

IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES
Health Services Insights Pub Date : 2024-08-18 eCollection Date: 2024-01-01 DOI:10.1177/11786329241271568
Hamza Ismaila, Juliet Nabyonga-Orem, Yolande Heymans, Christmal Dela Christmals
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Abstract

Global discussions on health systems strengthening have lately tilted towards increasing investments in human resources for health to address health workforce challenges, especially shortages and employment. Countries have, as a result, increased investments in the health workforce by expanding the production and recruitment of the needed health workforce, with the resultant effects of increasing health workforce budget space and the unending clamour by health policy actors for further increases. Despite these calls, there has been no wage bill affordability and budget space analysis to rationalise the sustainable production of and demand for health workers, which is the thrust of Ghana's current health workforce policy and strategy. Using an adapted approach (the Asamani approach), the study modelled the supply of some essential health workers and their associated cost of employment, compared it with the modelled budget space for health workforce employment and then drew conclusions on the wage bill sustainability for policy consideration. Of the seven cadres considered in the study (doctors, professional nurses, midwives, enrolled nurses, community health nurses, pharmacists and biomedical scientists), who constitute about 97% of the wage bill, the study found the baseline stock to be 129 378 in 2022, which was estimated to increase to 199 715 by 2027 and 254 466 by 2032 with corresponding wage bills of US$869.4 million and US$ 1.1 billion, respectively, holding routine salary increases constant. The budget space for health was, meanwhile, projected to be US$899.3 million and US$1.1 billion in 2022 and 2032 respectively, out of a projected overall government fiscal space of US$7 billion per year. This study concludes that, given current levels and mix of production, Ghana was estimated to expend an average of 88% of its health budget space as wage bill cost. This was 54.4% over the global median and 95.6% over the African Region's median, making the current regime unsustainable.

加纳卫生劳动力的工资法案和预算空间建模:对可持续卫生专业教育政策的影响》(Modelling the Wage Bill and Budget Space for Health Workforce in Ghana: Implications for Sustainable Health Professions Education Policy)。
最近,全球关于加强卫生系统的讨论倾向于增加对卫生人力资源的投资,以 应对卫生工作人员的挑战,特别是短缺和就业问题。因此,各国增加了对卫生人员队伍的投资,扩大了所需卫生人员队伍的生产和招聘,其结果是增加了卫生人员队伍的预算空间,卫生政策参与者也不断呼吁进一步增加预算。尽管有这些呼声,但一直没有对工资总额的承受能力和预算空间进行分析,以合理确定卫生工作人员的可持续生产和需求,而这正是加纳当前卫生工作人员政策和战略的主旨。这项研究采用了一种经过调整的方法(阿萨马尼方法),对一些基本卫生工作者的供应及其相关就业成本进行建模,将其与建模的卫生工作者就业预算空间进行比较,然后得出关于工资总额可持续性的结论,供政策考虑。在研究中考虑的七种干部(医生、专业护士、助产士、注册护士、社区保健护士、药剂师和生物医 学科学家)中,他们约占工资总额的 97%,研究发现 2022 年的基线存量为 129378 人,估计到 2027 年将增加到 199715 人,到 2032 年将增加到 254 466 人,在常规工资增长不变的情况下,相应的工资总额分别为 8.694 亿美元和 11 亿美元。与此同时,在政府每年预计 70 亿美元的总体财政空间中,预计 2022 年和 2032 年的卫生预算空间分别为 8.993 亿美元和 11 亿美元。本研究的结论是,考虑到目前的生产水平和生产组合,估计加纳平均 88% 的卫生预算空间将用于支付工资支出。这比全球的中位数高出 54.4%,比非洲地区的中位数高出 95.6%,使现行制度难以为继。
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
Health Services Insights
Health Services Insights HEALTH CARE SCIENCES & SERVICES-
CiteScore
3.60
自引率
0.00%
发文量
47
审稿时长
8 weeks
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