Health Services Insights最新文献

{"title":"Understanding Unmet Healthcare Needs in Nigeria: Implications for Universal Health Coverage.","authors":"Paul Eze, Chioma Lynda Aniebo, Stanley Ilechukwu, Lucky Osaheni Lawani","doi":"10.1177/11786329251330032","DOIUrl":"10.1177/11786329251330032","url":null,"abstract":"<p><strong>Background: </strong>Many individuals in low- and middle-income countries with healthcare needs do not access the necessary, often lifesaving healthcare services. Existing universal health coverage (UHC) indicators do not account for a portion of the population with unmet healthcare needs.</p><p><strong>Objective: </strong>To estimate the prevalence, wealth-related inequality, and determinants of unmet healthcare needs in Nigeria using data from the nationally-representative Nigeria Living Standards Survey, 2018-2019.</p><p><strong>Methods: </strong>We analyzed data from a cross-sectional sample of 116 320 Nigerians from 22 110 households selected using multi-stage probability sampling. The outcome variable was self-reported unmet healthcare needs. We conducted concentration index (CIX) analyzes to assess wealth-related inequalities and performed multilevel logistic regression analysis to identify the determinants of unmet healthcare needs at the individual, household, and community levels.</p><p><strong>Results: </strong>The prevalence of unmet healthcare needs was 5.2% (95% CI: 5.0-5.5), representing about 11 million Nigerians (95% CI: 10.5-11.5 million). The most common reasons were high costs (unaffordability) and the perception that the illness or injury was not serious. Wagstaff-normalized CIX for unmet healthcare needs was pro-poor: -0.09730 for the general population and -0.10878 for those with chronic illnesses. Significant determinants of unmet healthcare needs include age (AOR: 0.99, 95% CI: 0.99-1.00), chronic illness (AOR: 8.73, 95% CI: 7.99-9.55), single-person households (AOR: 1.55, 95% CI: 1.20-2.02), poorest quintile households (AOR: 1.45, 95% CI: 1.19-1.78), and mildly (AOR: 1.17, 95% CI: 1.01-1.36) or moderately food-insecure households (AOR: 1.30, 95% CI: 1.11-1.51).</p><p><strong>Conclusion: </strong>A significant proportion of Nigerians, particularly the very poor, chronically ill, those living alone, or food insecure, have unmet healthcare needs. This highlights the necessity for targeted interventions to ensure vulnerable populations can access essential healthcare services. To progress toward UHC, the Nigerian health system must address critical issues related to healthcare accessibility.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251330032"},"PeriodicalIF":2.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing the Performance of Patient Appointment Scheduling: Outcomes of an Automated Waitlist Process to Improve Patient Wait Times for Appointments.","authors":"Frederick North, Rebecca J Buss, Elissa M Nelson, Matthew C Thompson, Jennifer Pecina, Nathaniel E Miller, Brian A Crum","doi":"10.1177/11786329251326461","DOIUrl":"10.1177/11786329251326461","url":null,"abstract":"<p><strong>Introduction: </strong>Online self-scheduling of medical appointments is increasingly common. An automated waitlist can be used for patients who desire an earlier appointment time if one becomes available after they are scheduled. Our study examines outcomes of an automated waitlist and self-rescheduling process.</p><p><strong>Methods: </strong>We studied outcomes of an automated waitlist self-rescheduling process in which patients with existing appointments elected to be placed on an automated waitlist for an earlier appointment offer. When software found earlier dates for the same visit type, patients were then notified through an automated process and could self-reschedule. We reviewed appointments for which patients were sent new offers when earlier appointment slots were found. We compared the accepted appointment offers with the original scheduled appointments and determined the number of days that the appointment had been moved up.</p><p><strong>Results: </strong>Spanning the calendar year 2023 there were 1 019 698 appointment offers generated by an automated waitlist process for 229 998 appointments and sent to 164 248 patients. The waitlist process automatically found open appointments as they became available and sent the first new appointment offer within 2 days after being placed on the waitlist for 74 736 (32.5%) of the 229 998 waitlisted appointments. Patients sent back at least 1 response for 104 554 (45.4%) of the waitlisted appointments. Of the responses, 56 636 accepted one of the sent offers for an accept rate of 24.6% (56 636/229 998). For accepted, moved-up visits, appointments were self-rescheduled earlier by a mean of 22.6 days (95%CI; 22.2, 22.9, <i>P</i> < .0001).</p><p><strong>Conclusion: </strong>New appointments can be successfully self-rescheduled using an automated waitlist process that allows patients to accept or decline new appointment offers. This process can increase the efficiency of scheduling and decrease appointment wait time for patients desiring more timely access to healthcare. In addition, this process can be successfully applied across several different appointment type categories.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251326461"},"PeriodicalIF":2.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, Patterns, and Determinants of Workplace Violence Among Healthcare Providers in Ethiopia: A Systematic Review and Meta-Analysis.","authors":"Bikila Balis, Usmael Jibro, Nesredin Ahmed, Efrem Lelisa, Dawit Firdisa, Magarsa Lami","doi":"10.1177/11786329251325405","DOIUrl":"10.1177/11786329251325405","url":null,"abstract":"<p><strong>Background: </strong>Workplace violence remains a persistent health and occupational issue, but stakeholders often lack sufficient evidence to guide effective mitigation strategies. This review aims to ascertain the prevalence and determinants of workplace violence among healthcare providers in Ethiopia, where the issue is under-researched.</p><p><strong>Methods: </strong>The search included studies conducted in Ethiopia, regardless of publication year, that reported workplace violence among healthcare providers using PubMed, SCOPUS, Web of Sciences, EMBASE, CINHAL, Google Scholar, university repositories, and reference. After each author independently evaluated a study for inclusion, data was extracted, and disagreements were discussed and settled. A random-effects meta-analysis approach was used to evaluate the pooled prevalence, patterns, and determinants of workplace violence at 95% confidence intervals. Additionally, the <i>I</i> ² and <i>P</i>-value were used to evaluate the heterogeneity. Meta-regression and subgroup analysis were used to assess the difference by study-level characteristics. Additionally, to evaluate the stability of pooled values to outliers and publication bias, sensitivity analysis and funnel plots were performed.</p><p><strong>Results: </strong>A total of 6986 participants from 17 eligible studies were included in this study. Of the participants, 56% (95% CI: 48%-63%) reported having experienced any form of workplace violence. Verbal abuse accounted for 57% (95% CI: 49-65%), sexual harassment for 56% (95% CI: 48-65%), physical violence for 55% (95% CI: 46-63%), and bullying/mobbing for 51% (95% CI: 40-62%), according to the participants' reports of workplace violence. Working night hours (AOR: 1.57; 95% CI: 1.20-1.93), being female (AOR: 2.24; 95% CI: 1.07-3.41), being single (AOR: 4.58; 95% CI: 2.44-6.73), working in an emergency department (AOR: 3.87; 95% CI: 2.33-5.41), and consuming alcohol (AOR: 2.69; 95% CI: 1.10-4.28) were all associated with a higher risk of workplace violence. Egger's test and the funnel plot revealed no publication bias, and sensitivity analysis demonstrated that the pooled odds ratios were stable.</p><p><strong>Conclusion: </strong>Given the comparatively high prevalence of workplace violence and its various types among healthcare providers, a multilevel intervention strategy was necessary to address and lessen its effects. In order to make the workplace safer and avoid negative consequences for health care providers as well as the larger healthcare system, this strategy should incorporate both individual-level strategies and targeted policies.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251325405"},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redefining Antibiotic Use in Palliative Care: Insights From End-of-Life Prescribing Patterns.","authors":"Helan Rajan, S Johnson, Bhagyashree Sharma","doi":"10.1177/11786329251324842","DOIUrl":"10.1177/11786329251324842","url":null,"abstract":"","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251324842"},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Follow-up for Survivors of Childhood Cancer in Saudi Arabia: A Multicenter Cross-Sectional Study.","authors":"Fahad Alabbas, Ibrahim Alharbi, Naveed Ahmad, Walid Ballourah, Khalid Alnajashi, Ghaleb Elyamany, Nawaf Alkhayat, Yaser Borai, Omar Alsharif, Hasna Hamzi, Amal Bin Hasan, Waleed Ibrahim, Luluah Albahlal, Sara Alnasser, Sulaiman Alajlan, Abdelrahman A Aboush, Reem Al-Sudairy, Abdulrahman Alsultan","doi":"10.1177/11786329241299317","DOIUrl":"https://doi.org/10.1177/11786329241299317","url":null,"abstract":"<p><strong>Background: </strong>With the advancement of childhood cancer therapy, long-term survivors are on the rise. Reports on childhood cancer survivors in Saudi Arabia are scarce. This study aims to assess the spectrum and burden of long-term complications among survivors of childhood cancer in Saudi Arabia.</p><p><strong>Methods: </strong>This cross-sectional study, conducted at multiple cancer centers in Saudi Arabia, enrolled survivors who had been diagnosed with cancer before the age of 14 and had completed at least 5 years after completion of cancer therapy. The primary outcome was to estimate the prevalence of chronic health conditions (CHC) among these survivors. The secondary outcome was to assess the impact of primary cancer diagnosis and cancer therapies on the occurrence of CHC.</p><p><strong>Results: </strong>A total of 305 survivors met the inclusion criteria as of July 2022. Females were 165 participants. The median follow-up and age at evaluation were 8.5 and 14 years, respectively. Leukemia was the most common cancer type (49.3%), followed by lymphoma (16.7%) and solid tumors (15.7%). Chemotherapy was administered to 287 survivors. Radiotherapy and surgery were used in 29.2% and 22.3% of cases, respectively. Seventy-eight percent of participants experienced at least 1 CHC, with 31.1% and 14.2% having 2 and 3 CHC, respectively. A multivariate logistic regression identified significant association between CHC and solid tumors compared to hematological malignancies (OR 2.2; 95% CI: 1.1-4.3; <i>P</i> = .023). Growth impairment was the most common CHC, followed by endocrinopathy. Radiotherapy was significantly associated with short stature (95% CI: 1.2-3.6; <i>P</i> = .008). The majority of CHC, 77.3%, were mild in severity, while 19.3% were moderate, 2.9% were severe, and .5% were life-threatening.</p><p><strong>Conclusion: </strong>The long-term complications of childhood cancer have revealed a prevalent concern. To optimize health outcomes, it is essential to implement well-structured and long-term follow-up tailored to risk profiles, utilize cost-effective screening methods, and promote prospective clinical research and establishment of a registry.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329241299317"},"PeriodicalIF":2.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Change Fatigue Among Clinical Nurses and Related Factors: A Cross-sectional Study in Public Hospitals.","authors":"Meng Lv, Jing Zhai, Li Zhang, Hong Wang, Ben-Hua Li, Ting Zhang, Paulo Moreira","doi":"10.1177/11786329251318586","DOIUrl":"10.1177/11786329251318586","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the levels of change fatigue among clinical nurses in public hospitals and identify the potential contributing factors.</p><p><strong>Design: </strong>A cross-sectional, multi-stage sampling study was conducted in accordance with the STROBE guideline.</p><p><strong>Methods: </strong>This study surveyed 2,228 nurses in China from October to December 2023 using Wen Juan Xing (www.wjx.cn) and employed stepwise multiple linear regression analysis to assess factors associated with change fatigue.</p><p><strong>Results: </strong>The average change fatigue score of nurses was found to be at a medium to high level. Factors such as female, professional title, average overtime hours, workflow changes, workload increase, work-content changes, work pressure increases, new technology implementation and the change frequency were all identified as exacerbating nurses' experience of fatigue related to change. Contrary to this, the support of change resources, communication and transmission of change information, distributed leadership, inclusive climate, readiness for change, change efficacy and workforce agility were found to alleviate the change fatigue to some extent.</p><p><strong>Conclusions: </strong>It is urgent and challenging for nursing managers to manage change fatigue. All of these identified predictors in study significantly contribute to the understanding of change fatigue among nurses and can provide valuable insights for health policies aimed at improving the effectiveness of nursing changes. Furthermore, they also offer a theoretical foundation for managers to develop targeted intervention programs for preventing and mitigating the negative impact of change fatigue on nurses and organizational outcomes.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251318586"},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A National Mobile Medical Unit (MMU) Program to Address the Healthcare Needs of Veterans Experiencing Homelessness: An Evaluation Protocol.","authors":"Jillian J Weber, Rebecca L Kinney, Jill S Roncarati, Kenneth Bruemmer, Monica Diaz, Jill Albanese","doi":"10.1177/11786329251320200","DOIUrl":"10.1177/11786329251320200","url":null,"abstract":"<p><strong>Background: </strong>Homelessness remains a public health concern in the United States (U.S.) and ending veteran homelessness has been a significant priority for the U.S. Department of Veterans Affairs (VA) for over a decade. However, veterans experiencing homelessness (VEH) have unmet healthcare needs and face numerous barriers to accessing and engaging in healthcare.</p><p><strong>Objectives: </strong>The Veterans Health Administration's (VHA) Homeless Programs Office (HPO) implemented mobile medical units (MMUs) within the tailored primary care model established in 2011 called the Homeless Patient Aligned Care Team (HPACT) program to expand access to care for hard-to-reach VEH. This article outlines the evaluation protocol for the HPACT MMU program to examine the impact of MMUs on engaging and retaining homeless veterans in VA primary care and other supportive services.</p><p><strong>Design: </strong>Using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, we will assess how mobile services engage VEH in VA primary care and preventive care. This 4-year program evaluation includes a plan to collect individual and organizational level quantitative and qualitative data.</p><p><strong>Discussion: </strong>The first stages of program adoption and implementation have been completed resulting in 25 MMUs being deployed across the U.S. that are fully operational and ready to serve VEH. Early outcomes demonstrate the significant impact of the ability MMUs in reducing barriers such as transportation for VEH, while increasing positive veteran health outcomes.</p><p><strong>Conclusion: </strong>This evaluation will provide insight on the innovative ways in which mobile medical units (MMUs) may expand the boundaries of the VA and external health care systems in efforts to improve health equity and access among our most vulnerable populations. Preliminary outcomes show significant engagement with VEH in the community and interest in the model of care. The program has the potential to play an essential role in achieving VA's goal of ending veteran homelessness.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251320200"},"PeriodicalIF":2.4,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Privacy Matters: Experiences of Rural and Remote Emergency Department Patients - A Mixed-Methods Research Conducted in Newfoundland and Labrador, Canada.","authors":"Aswathy Geetha Manukumar, Matthew Miller, Christopher Patey, Hensley H Mariathas, Nahid Rahimipour Anaraki, Anna Walsh, Oliver Hurley, Dorothy Senior, Holly Etchegary, Paul Norman, Peter Wang, Shabnam Asghari","doi":"10.1177/11786329251320431","DOIUrl":"10.1177/11786329251320431","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to investigate patients' privacy experience when receiving care in emergency departments (EDs) in Newfoundland and Labrador, Canada. We aim to assess the level of satisfaction with privacy and to assess for factors that improve or worsen the privacy experience, not limited to patient demographics, length of stay, and hospital location.</p><p><strong>Methods: </strong>This study used a mixed-methods design, gathering quantitative and qualitative data using a telephone survey and semi-structured interviews. Our primary outcome measure was patients' privacy experience in the ED. The independent variables in our study were age, gender, ED location, patient-reported wait times, reason for ED visit, and healthcare provider involved in care.</p><p><strong>Results: </strong>Among the 821 patients who participated in the interviews, 1 in 4 patients (24%) did not have satisfactory ED privacy experiences. Multinominal logistic regression showed patients who waited 4+ hours before being examined by a provider [aOR = 0.34, 95% CI: 0.17-0.69] and those who visited the urban EDs [aOR = 0.17, 95% CI: 0.09-0.35] reported low levels of privacy. Furthermore, those whose overall length of stay was 4 to 8 hours [aOR = 0.44, 95% CI: 0.23-0.84] and 8+ hours [aOR = 0.36, 95% CI: 0.17-0.78] also reported dissatisfaction with ED privacy experience. Our qualitative analysis found privacy concerns in waiting rooms, triage areas, and curtain rooms, with females voicing more concerns than males.</p><p><strong>Conclusion: </strong>Patients with longer wait times and who have been seen in urban EDs experience less privacy. Our qualitative data shows that women also raised more privacy concerns than men and that waiting rooms and triage areas are the locations with the most reported privacy concerns. Patient experience and outcomes would benefit from improving patient privacy when receiving care in EDs.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251320431"},"PeriodicalIF":2.4,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Maternal Waiting Homes in Pregnancy-Related Complications: A Case-Control Study in Sipepa Ward 5, Tsholotsho District Zimbabwe.","authors":"Sincerity Ncube, Mqhele Wilfred Mpofu, Perez Livias Moyo","doi":"10.1177/11786329251321643","DOIUrl":"10.1177/11786329251321643","url":null,"abstract":"<p><p>Maternal waiting homes (MWHs) are structures built near the healthcare facility, which aim to reduce the distance to accessing maternal health services and bring pregnant women closer to the health facility, near the time of delivery. This reduces the risk of pregnancy complications which can cause maternal and neonatal deaths, or low birth weight. Tsholotsho district adopted the use of Maternal waiting homes as there was an increase in pregnancy-related complications and incidents of maternal death. The study aimed to evaluate the effectiveness of maternity waiting homes in reducing pregnancy-related complications in Ward 5, Tsholotsho District. A 1:1 case-control study was used for the study, which recruited 248 women who attended Sipepa clinic. Data was collected using structured questionnaires and analysis for frequencies, means, proportions and odds ratios at 95% CI was done using SPSS version 29. The study established that Maternal waiting home use was a significant factor for reducing pregnancy complications (AOR = 0.16, 95% CI 0.09-0.28). Number of antenatal care visits less than 4 was found to be the significant independent risk factor for pregnancy complications (AOR = 2.9, 95% CI 1.3-6.2). The odds of adequate knowledge of the benefits of maternal waiting homes was 6.9 times higher among women who used MWHs than those who did not (OR = 6.9, 95% CI: 3.9-12.2). The study provides evidence that MWHs can significantly reduce pregnancy-related complications and improve maternal health outcomes in Sipepa, Tsholotsho. However, barriers to non-use of MWHs, such as lack of privacy, no food variety, and no cooking utensils, must be addressed to maximize the effectiveness of this intervention. There is a need for policymakers and healthcare providers to prioritize the implementation and expansion of MWHs in rural areas of Zimbabwe, where they can have the greatest impact on reducing maternal mortality and morbidity.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251321643"},"PeriodicalIF":2.4,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ballpark Estimates of Budget Space for Health Workforce Investments in the 47 Countries of the WHO African Region: A Modelling Study.","authors":"James Avoka Asamani, San Boris Kouadjo Bediakon, Hamza Ismaila, Sunny Okoroafor, Regina Titi-Ofei, Adam Ahmat, Juliet Nabyonga-Orem, Ogochukwu Chukwujekwu, Kasonde Mwinga","doi":"10.1177/11786329251320429","DOIUrl":"10.1177/11786329251320429","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The needs-based requirement for health workers in the 47 countries of the World Health Organization's African Region is estimated to be 11.8 million by 2030, and the supply will fail to meet the need, leaving an anticipated shortage of 6.1 million by 2030. However, several countries are also having a situation whereby trained health workers cannot be employed due to budget space constraints. This paper sought to explore the level of prioritisation of health and health workforce in government spending, estimate the budget space potential for investing in the employment of health workers using scenario analysis and estimate the budget space gap if all the trained health workers were to be employed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;Building on previous work using publicly available data, the study modelled 3 scenarios of health workforce investment (expenditure): (1) business as usual scenario in which it was assumed the level of prioritisation for health from the overall envelope for government spending on consumption, and the prioritisation of HWF from the health sector allocation/budget will be constant. Thus, expansion in the budget space will be a function of economic growth, (2) HWF prioritisation scenario, in which it was assumed that all parameters were held constant, but countries will prioritise at least 43% of their health budget for HWF employment - in line with the regional average and (3) health prioritisation scenario in which it is assumed that countries will prioritise at least 15% of public sector consumption (general government spending) for health - in line with the Abuja target - but maintain prevailing levels of HWF prioritisation from the health budget. A 3-step model was developed first to estimate the annual general government consumption expenditure envelope, from which the public expenditure envelope for health was estimated and then the potential expenditure envelope for the health workforce.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;On health workforce budget space, the 'business as usual' scenario, showed an estimated expenditure envelope for HWF from all sources could increase from $20.85 billion in 2022 to $31.81 billion by 2030, driven by macroeconomic factors like GDP growth. However, this could be affected by uncertainty in overseas development assistance. In 'HWF prioritisation' scenario, prioritising at least 43% of the health budget for health workforce (HWF) employment increased the HWF envelope by 28%. In the 'health prioritisation' scenario, prioritising at least 15% of public sector consumption expenditure for health (but maintaining the prevailing levels of prioritisation for HWF) could yield $55.32 billion for health workforce employment by 2030. In 2022, there was a 43% deficit in the current spending level to employ and pay the remuneration of all trained health workers in the Region, taking into account government and private sector spending as well as overseas development assistan","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251320429"},"PeriodicalIF":2.4,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}