World Health & Population最新文献

{"title":"Improving Access to Care among Underserved Populations: The Role of Health Workforce Data in Health Workforce Policy, Planning and Practice","authors":"J. Wesson, P. Mcquide, C. Viadro, Maritza Titus, N. Forster, D. Trudeau, M. Corbett","doi":"10.12927/whp.2015.24314","DOIUrl":"https://doi.org/10.12927/whp.2015.24314","url":null,"abstract":"Universal health coverage (UHC) is central to the post-2015 development agenda. In Namibia, optimal organization of HIV and high-priority health services requires robust, policy-relevant health workforce evidence. This paper examines Namibia’s use of the Workload Indicators of Staffing Need (WISN) tool, which estimates staffing requirements based on health facility workload. Namibia’s public health sector applied WISN regionally and nationally. We analyzed four health workforce decisionmaking scenarios (staff redeployment, scarce skill allocation, staffing norms and task sharing) and used spatial analytic techniques to consider facility under/overstaffing in association with regional HIV prevalence, finding significant staff shortages in densely populated regions with high HIV burdens. Innovative use of WISN results by health systems managers and policymakers can help rationalize staff deployment, provide concrete information on staffing needs and model the impact of potential policy changes. These examples illustrate WISN’s value for policy and practice decisions that can further global commitments to achieve UHC. Background Globally, efforts are underway to define the post-2015 development agenda. For the health-related goals, the cornerstone is country movement toward universal health coverage (UHC), which aims to ensure that all people obtain the health services they need without suffering financial hardship. The global community has also reached a “defining moment” in its response to HIV, as ending the epidemic becomes an attainable goal (WHO 2014a). The relationship between UHC and HIV is closely interconnected, according to the WHO (2014a), which notes that the global response to HIV has been a trailblazer for UHC (WHO 2014a). In settings where UHC or conditions approximating universal coverage are lacking, the uneven distribution of health services and resources will typically result in inequities and underserved populations. The UHC agenda requires attention to country-level human resources for health (HRH) needs (WHO 2014b). Nearly a decade ago, the WHO (2006a) suggested that 2.28 health workers (physicians, nurses and midwives) per 1,000 of the population represents the HRH threshold necessary to achieve 80% population coverage to provide attended childbirths and immunizations, which are core Millennium Development Goal health indicators. According to some, however, this “minimalist” threshold vastly underestimates meeting population health needs and required HRH stock, masks regional/national disparities and ignores shortages of other cadres (O’Brien and Gostin 2011). Health worker shortages and imbalances represent a particular challenge in Africa, where three-fifths (63%) of the WHO-designated HRH crisis countries are located (Mdege et al. 2012; Moosa et al. 2014;","PeriodicalId":321758,"journal":{"name":"World Health & Population","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122905537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thai Health Promotion Foundation: Innovative Enabler for Health Promotion","authors":"Sakol Sopitarchasak, S. Adulyanon, Tananart Lorthong","doi":"10.12927/whp.2015.24316","DOIUrl":"https://doi.org/10.12927/whp.2015.24316","url":null,"abstract":"Thai Health Promotion Foundation (ThaiHealth), founded in 2001, is the first organization of its kind in Asia and serves as an innovative enabler to enhance health promotion and a healthy society and environment for all people in Thailand. This paper describes ThaiHealth’s structure, accomplishments and lessons learned to help inform other settings in their national health promotion efforts. Established under the Health Promotion Act, ThaiHealth’s budget is obtained from surcharge excise taxes on tobacco and alcohol, a financial mechanism that facilitates a sustainable funding source for ThaiHealth to continuously support health","PeriodicalId":321758,"journal":{"name":"World Health & Population","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129386383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Findings from a Survey of an Uncategorized Cadre of Clinicians in 46 Countries – Increasing Access to Medical Care with a Focus on Regional Needs Since the 17th Century","authors":"N. Cobb, M. Meckel, J. Nyoni, Karen E. Mulitalo, Hoonani M Cuadrado, Jeri Sumitani, G. Kayingo, D. Fahringer","doi":"10.12927/whp.2015.24296","DOIUrl":"https://doi.org/10.12927/whp.2015.24296","url":null,"abstract":"With the United Nations Development Programme (UNDP) Post-2015 Development Agenda upon us, it is increasingly important to address the worldwide deficit of human resources for health. Ironically, there is a unique subset of regionally trained healthcare providers that has existed for centuries, functioning often as an “invisible” workforce. These practitioners have been trained in an accelerated medical model and serve their communities in over 46 countries worldwide. For the purpose of this paper, “medical model” is defined as the evidence-based and scientific manner of training and practice that defines physicians globally. Inconsistent nomenclature, however, has resulted in these workers practicing as a virtually unidentified and disjointed cadre on the margins of health policy planning. We use the term Accelerated Medically Trained Clinician (AMTC) here as a categorical designation to encompass these professionals who have been referred to by various titles. We conducted an exploratory, systematic review for AMTCs in over 70 counties to asses if there is such a cadre, the name or title of their cadre, period of and curricula of training and existence of credentialing. This paper reports our findings and aims to serve as a springboard for future, in-depth studies on how we can better categorize and utilize these clinicians. Introduction The escalating global crisis of the health workforce shortage is alarming. The Global Health Workforce Alliance (GHWA) estimates that by 2035, the global shortage of healthcare providers will be well over 12.9 million (Global Health Workforce Alliance Strategy 2013-2016 2012). Current estimates indicate that over one billion people do not have access to healthcare providers today (Crisp and Chen 2014). The paucity of appropriately trained healthcare providers worldwide limits access to fitfor-purpose healthcare. Maldistribution and migration of skilled healthcare workers, as well as limited-skills training, also contribute to the current health workforce deficit. The International Labour Organization (2015) recently published Global Evidence on Inequities in Rural Health Protection: New Data on Rural Deficits in Health Coverage for 174 Countries, noting that the “fundamental rights to health and social protection remains largely unfulfilled for rural populations.” It goes on to note, “while 56% of the global rural population lacks health coverage, only 22% of urban populations are not covered.” They estimate that “23% of the worlds’ health workforce are sent to rural areas, while more than 50% of the population live there.” One of the most significant inferences of this paper is a worldwide call for additional fit-for-purpose health workers to meet this basic fundamental right (Scheil-Adlung 2015). The importance of a more harmonized system for data collection of human resources for health was also a key point.","PeriodicalId":321758,"journal":{"name":"World Health & Population","volume":"22 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126117577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Workforce Measurement: Seeking Global Governance and National Accountability","authors":"M. DeLuca, Sofia Castro Lopes","doi":"10.12927/whp.2015.24295","DOIUrl":"https://doi.org/10.12927/whp.2015.24295","url":null,"abstract":"","PeriodicalId":321758,"journal":{"name":"World Health & Population","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127084205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human Resources for Health: A Critical yet Challenging Pathway to Universal Health Coverage in Indonesia","authors":"Rosalia Sciortino and Roy Tjong","doi":"10.12927/whp.2015.24315","DOIUrl":"https://doi.org/10.12927/whp.2015.24315","url":null,"abstract":"","PeriodicalId":321758,"journal":{"name":"World Health & Population","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133033099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time for a Copernican Revolution in Health Labour Markets","authors":"A. Soucat","doi":"10.12927/whp.2015.24312","DOIUrl":"https://doi.org/10.12927/whp.2015.24312","url":null,"abstract":"he last decade has highlighted dramatic gaps in the quantity, skill-mix and geographic distribution of the health workforce which, in turn, has restrained progress against the health-related Millennium Development Goals (Campbell et al 2013; WHO 2006). The global community has now embarked on a journey towards even more ambitious health targets outlined in the Sustainable Development Goals – scheduled for adoption by the United Nations General Assembly in September 2015 – including reaching universal health coverage (UHC). The experiences described in this special issue of the Journal of World Health and Population – The Global Health Workforce: Striving for Equity Tackling Challenges on the Ground – highlight the depth, breadth and complexity of the health workforce issues that countries will need to solve before they can reach UHC. This issue highlights three main challenges faced by the global community: first, we do not train enough health workers to respond to the growing demand fueled by population and economic growth and transformation (particularly demand linked to aging and equity); second, we do not nurture the kind of health workers who will be able to respond meaningfully to this expanding demand, i.e. serving the poor and responding to changing needs; and third, we operate in a rapidly changing technological environments where medical practice and learning techniques are in a state of permanent transformation. The papers in this special issue provide a snapshot of the efforts at addressing these vexing issues in very different contexts, including low-income and fragile states. All countries operate in a globalized market where demand is increasing, and health workers can be mobile in response to the powerful attraction T 6","PeriodicalId":321758,"journal":{"name":"World Health & Population","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132150730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Health Service Partnership: First Year Findings","authors":"V. Kerry, Libby J. Cunningham, P. Daoust, S. Sayeed","doi":"10.12927/whp.2015.24313","DOIUrl":"https://doi.org/10.12927/whp.2015.24313","url":null,"abstract":"","PeriodicalId":321758,"journal":{"name":"World Health & Population","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122939230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delivering on Equity Depends on Us","authors":"M. DeLuca","doi":"10.12927/whp.2015.24311","DOIUrl":"https://doi.org/10.12927/whp.2015.24311","url":null,"abstract":"Wo r l d He a lt H & Po P u l at i o n • Vo l.16 no.1 am honoured to present this most prescient issue of World Health and Population. Focused on The Global Health Workforce: Striving for Equity Tackling Challenges on the Ground, my charge to our invited authors was: “present a closeup and candid account of obstacles that confound the effective practice of the health workers on the ground, share your experiences, and recommend workable solutions.” The resulting seven papers from more than 30 authors tell us of healthcare circumstances in more than 50 countries. They describe myriad issues germane and familiar to health workforce challenges: large shortages of health professionals, competency, scope of practice, lack of credentialing and licensure mechanisms for cadres of health workers; maldistribution of the health workforce; protection of health workers; perverse incentives engendered by health systems and their impact on professional practice, access and costs; and how the lack of health workforce measurement cripples health systems and thwarts population health. These manuscripts include: an evaluation of multi-sector collaboration in Thailand to promote public health and healthy behaviours (Sopitarchasak et al. 2015); protecting and retaining health workers in civil war-torn Syria (Abbara et al. 2015); the initial report of an innovative continuity based model for health professionals training health professionals in 11 countries (Kerry et al. 2015); a survey of 70 lowand middle-income countries to assess stock, training and credentials of medically trained clinicians, including physician assistants and medical officers (Cobb et al. 2015); one year in, an assessment of Indonesia’s national health insurance system and the contextual HRH challenges (Sciortino and Roy 2015); team-based HIV treatment services using a nurse-led practice model to expand access to services in Namibia I FROM THE GUEST EDITOR","PeriodicalId":321758,"journal":{"name":"World Health & Population","volume":"227 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115232985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of the Conflict on Syria’s Health System and Human Resources for Health","authors":"A. Abbara, K. Blanchet, Zaher Sahloul, F. Fouad, A. Coutts, W. Maziak","doi":"10.12927/WHP.2015.24318","DOIUrl":"https://doi.org/10.12927/WHP.2015.24318","url":null,"abstract":"Prior to the conflict, Syria’s health system was comparable with that of other middle-income countries; however, the prolonged conflict has led to significant destruction of the health infrastructure. The lack of security and the direct targeting of health workers and health facilities have led to an exodus of trained staff leaving junior health workers to work beyond their capabilities in increasingly difficult circumstances. This exodus together with the destruction of the health infrastructure has contributed to the increase in communicable and non-communicable diseases and the rising morbidity and mortality of the Syrian population. Strengthening the health system in the current and post-conflict phase requires the retention of the remaining health workers, incentives for health workers who have left to return as well as engagement with the expatriate Syrian and international medical communities.","PeriodicalId":321758,"journal":{"name":"World Health & Population","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127847024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No Global Health without Human Resources For Health (HRH): The Nursing Lens","authors":"J. Shamian, G. Murphy, A. E. Rose, L. Jeffs","doi":"10.12927/cjnl.2014.24317","DOIUrl":"https://doi.org/10.12927/cjnl.2014.24317","url":null,"abstract":"sustained economic and social development” (WHO 2010). This was recognized more than 30 years ago by the Alma-Ata Declaration signatories, who noted that Health for All would contribute to both a better quality of life, and global peace and security (WHO 1978). In continuing work to achieve this goal of Health for All, the contemporary global health agenda has focused on creating sustainable health systems that address universal health coverage (UHC) and the post-2015 sustainable development goals (SDGs), including non-communicable diseases, and health system financing. However, as noted in the Global Health Workforce Alliance (GHWA) report, A Universal Truth: No Health without a Workforce (2014), any aspiration to attain or sustain UHC will only be realized with a strong vibrant health workforce.","PeriodicalId":321758,"journal":{"name":"World Health & Population","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131794063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}