Human Resources for Health最新文献

{"title":"Can financial retention incentives slow health worker migration? PPP-adjusted salary differentials in Zimbabwe's donor-dependent health system.","authors":"Gavin George","doi":"10.1186/s12960-026-01074-y","DOIUrl":"https://doi.org/10.1186/s12960-026-01074-y","url":null,"abstract":"<p><strong>Background: </strong>Large-scale migration of health workers from low-income countries continues to undermine health system capacity, particularly in contexts characterised by fiscal constraint and donor dependence. While retention incentives are widely used to mitigate attrition, their ability to offset international wage differentials remains contested. Zimbabwe provides a salient case, having implemented a long-standing Health Worker Retention Scheme (HWRS), largely financed by external partners, to stabilise critical cadres within the public health sector. This study aimed to quantify PPP-adjusted international salary differentials for selected Zimbabwean health worker cadres and to assess the extent to which donor-financed retention incentives narrow these gaps.</p><p><strong>Methods: </strong>This was a cross-country comparison of annual remuneration for three cadres: professional nurses, medical officers, and medical specialists, using a purchasing power parity (PPP) framework. Salaries in Zimbabwe, South Africa, the United Kingdom, and the United States were compiled from official public-sector pay schedules and adjusted using International Comparison Program (ICP) 2021 PPP conversion factors. Zimbabwean salaries were analysed under three scenarios: base salary; base salary plus USD-denominated Government of Zimbabwe (GOZ) allowances; and total remuneration including GOZ allowances and Global Fund-financed HWRS top-ups. PPP-adjusted salary gaps were calculated relative to Zimbabwean health workers' base salary.</p><p><strong>Results: </strong>Combined USD-denominated Government of Zimbabwe allowances and Global Fund-financed HWRS top-ups substantially increased PPP-adjusted salaries across all cadres, more than doubling remuneration for medical officers and specialists and nearly tripling earnings for nurses. Despite these increases, PPP-adjusted salaries in South Africa, the United Kingdom, and the United States remained several multiples higher than those in Zimbabwe.</p><p><strong>Conclusion: </strong>Combined domestic and donor-financed retention incentives meaningfully improve Zimbabwe's relative salary position but do not fundamentally alter the international remuneration gradient that underpins health worker migration. In donor-dependent health systems, such schemes function as stabilising mechanisms rather than long-term solutions. Sustainable retention will require complementary strategies addressing career progression, working conditions, and the global governance of health worker mobility.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From implementation to learning: a process-oriented framework to evaluate innovative global health capacity building in fragile and conflict-affected settings.","authors":"Shadi Saleh, Rim Alaeddine, Tracy Daou, Nisrine El-Hadi, Rania Mansour, Hady Naal","doi":"10.1186/s12960-026-01075-x","DOIUrl":"https://doi.org/10.1186/s12960-026-01075-x","url":null,"abstract":"<p><strong>Background: </strong>Global Health Capacity Building (GHCB) initiatives are central to strengthening health systems and workforce readiness in Fragile and Conflict-Affected Settings (FCAS). While many evaluation frameworks exist, most were developed for stable contexts and offer limited guidance on how to adapt evaluation processes to environments rife with political instability, limited infrastructure, population mobility, and rapidly shifting conditions. As innovative learning modalities, such as online and blended learning modalities expand in FCAS, there is a critical need for evaluation approaches that are context-responsive, process-oriented, and tailored to fragile settings.</p><p><strong>Method: </strong>This paper presents the Evaluation of Capacity Building (eCAP) framework, an evidence-informed framework for evaluating GHCB in FCAS. The eCAP framework was developed through a 5-year iterative process by the Global Health Institute at the American University of Beirut, as informed by 3 sequential phases: (1) 3 systematic reviews exploring evaluation methods for GHCB in low- and middle-income countries and in the MENA region; (2) evaluation of 5 case studies implemented in the region; and (3) a synthesis of outcomes and process-related results between 2019 and 2024.</p><p><strong>Results: </strong>The eCAP framework conceptualizes the evaluation lifecycle in FCAS as a dynamic and adaptive process across three interconnected phases: (1) understanding the program (modality, population, context, level of evaluation, and program logic); (2) implementation (logistics, recruitment, engagement, tool selection, and timing of data collection), and (3) analysis, feedback, and learning. Without prescribing standardized indicators, the framework emphasizes decision-making principles for evaluation that enable adaptation to contextual constraints and other field-based realities. The framework is useful for diverse FCAS, and it has demonstrated feasibility and utility in capturing short-to-medium term outcomes while preserving methodological rigor under challenging and unstable conditions.</p><p><strong>Conclusion: </strong>The eCAP framework addresses a key gap in the evaluation of GHCB initiatives in FCAS by offering a structured yet adaptable approach grounded in ample field-based evidence. The framework provides practical guidance for researchers, implementers, and funders seeking to design and evaluate capacity building initiatives in complex humanitarian environments. Ultimately, this framework has implications for strengthening evaluation practices, improving programmatic learnings, and guiding policy and funding decisions related to capacity building in FCAS.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing a transdisciplinary competency framework for interdisciplinary case management practice in long-term care: a participatory Delphi study.","authors":"Yuting Huang, Nan Xia, Vivian Weiqun Lou, Yin Zhong","doi":"10.1186/s12960-026-01070-2","DOIUrl":"https://doi.org/10.1186/s12960-026-01070-2","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization has identified the long-term care system as a critical area for enhancing the health and quality of life of older adults. Within this system, case management is a prevalent service delivery model implemented by interdisciplinary teams comprising professionals from various sectors. However, the absence of a comprehensive transdisciplinary competency framework applicable across different disciplines obstructs the development of relevant training programs and hinders workforce capacity building and professionalization. This study was conducted in the context of Hong Kong's long-term care system and aimed to establish a transdisciplinary competency framework through expert consensus to advance case management practices.</p><p><strong>Methods: </strong>This study employed an online five-stage participatory Delphi approach, with two rounds of questionnaire surveys and three roundtable discussions. The expert panel featured 40 health and social care professionals in the long-term care field. Their task was to develop a list of essential competencies for the long-term care workforce in case management. To determine the list of competencies, metrics such as the percentage of agreement, mean rating scores for each statement, and interquartile range were assessed using a 5-point Likert scale that measured clarity, relevance, and importance.</p><p><strong>Results: </strong>The panel reached consensus on a comprehensive transdisciplinary framework that includes 49 competencies organized into six key domains: overarching values; knowledge of long-term care and case management practices; assessment skills; analytical and intervention skills; communication skills and teamwork; and advocacy. Experts highlighted that this framework can significantly improve the capacity-building efforts of interdisciplinary teams involved in long-term care case management. The competencies are further organized into three progressive levels-basic, intermediate, and advanced-to support the growth of practitioners' professional skills.</p><p><strong>Conclusion: </strong>The proposed transdisciplinary competency framework provides a foundation for developing and implementing training curricula for frontline professionals in the long-term care sector. Governments can utilize this framework to create career progression pathways that attract more talent to the field and enhance the supervision and evaluation of practitioners' competencies. This approach will help ensure the quality of long-term care services.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Georgia's public health workforce: a study on demographics, engagement, and capacity building.","authors":"Smriti Ridhi, Binita Adhikari, Ekaterine Cherkezishvili, Elene Godziashvili, Tamar Gabunia, Tushar Singh, Sara Bennett","doi":"10.1186/s12960-026-01072-0","DOIUrl":"https://doi.org/10.1186/s12960-026-01072-0","url":null,"abstract":"<p><strong>Background: </strong>A well-functioning public health system relies on a robust workforce. Comprehensive data on the workforce, such as number, distribution, and key characteristics, are crucial for evidence-based workforce planning and development. However, few comprehensive public health workforce assessments exist, especially in low- and middle-income countries. Public health reforms over the years and needs identified during the COVID-19 pandemic prompted this assessment in Georgia.</p><p><strong>Methods: </strong>A survey of the core public health workforce, including employees at central and regional units of the National Center for Disease Control and Public Health (NCDC) and Municipal Public Health Centers (MPHC), was conducted online between June and September 2023. The survey collected data on workforce demographics, education, on-the-job training, and time spent across different program areas and job functions, along with questions on career progression, job satisfaction, and motivation.</p><p><strong>Results: </strong>The response rate was 81.3%. Findings showed that the median age was 48 for NCDC and 56 for MPHC employees. Over 80% of NCDC and 90% of MPHC employees are women. More than 50% of the workforce hold a master's degrees or higher, and over half of degree-holders specialized in public health or medicine. Mean years of service are 14.9 (NCDC) and 18.0 (MPHC), but career mobility is limited, only 33.3% of NCDC and 10.5% of MPHC staff have ever been promoted. NCDC employees spend most time on administration and surveillance/response, while MPHC staff focus on communicable disease management, administration, and immunization. Training participation is limited, with employees in key positions having better access. Despite limited advancement and relatively low pay, the workforce reported high job satisfaction and strong intrinsic motivation.</p><p><strong>Conclusions: </strong>These findings are pivotal in identifying workforce planning and development bottlenecks and developing targeted strategies. Key interventions include addressing an aging workforce through targeted recruitment and succession planning, providing competitive salaries to attract a younger workforce, and strengthening training offerings. This effort to profile the public health workforce could guide similar assessments in the future and in other countries to prevent, detect, and respond to public health threats.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community perspectives on health professionals' competence for quality primary health care in Amhara region, Ethiopia: a qualitative study.","authors":"Gebeyehu Tsega, Getu Degu, Gizachew Yismaw, Mirkuzie Woldie","doi":"10.1186/s12960-026-01068-w","DOIUrl":"https://doi.org/10.1186/s12960-026-01068-w","url":null,"abstract":"<p><strong>Background: </strong>Communities, as funders and users of the health system, have a vital role in ensuring the provision of integrated people-centered primary health care (PHC). However, there is a lack of information on community voices about the competence of health professionals in Ethiopia. Therefore, this study aimed to explore the community voices on the competence of health professionals for the provision of quality PHC services.</p><p><strong>Methods: </strong>A qualitative case study involving 10 key informant interviews and 6 FGDs was conducted from June 1 to July 30, 2023, in the Amhara Region among community representatives. The sample size was determined based on data saturation, and purposive heterogeneous sampling was employed. The high-quality health system framework and the Standards for Reporting Qualitative Research (SRQR) were used for analysis and report writing, respectively.</p><p><strong>Results: </strong>The key informants and discussants shared views regarding the competence of health professionals working in PHC facilities. These were categorized into three main themes and six subthemes. The main themes were quality impacts, process of care, and foundations. The subthemes were confidence in health professionals' competence, health outcomes of the care provided by health professionals, economic benefits of the care, users' experiences, competent care and system, and governance.</p><p><strong>Conclusions: </strong>The community had lost trust/confidence in the health professionals working at the PHC settings due to their negative experiences with them and forgone health care services. The community recommended that primary health care should have highly competent health professionals who receive adequate support, payment, working conditions, training, regulation, and who prioritize the people's needs and expectations in their practices. This implies that the region has not yet achieved effective implementation of UHC principles through PHC. Thus, the regional and sub-regional governments and health professionals should work to rebuild the confidence (trust) of the community by paying attention to their concerns and pain points.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Equity in the distribution of general practitioners and specialists in Iran: a health needs-adjusted analysis using the Robin Hood index (2006-2019).","authors":"Nader Jahanmehr, Soheila Damiri, Zahra Meshkani","doi":"10.1186/s12960-026-01057-z","DOIUrl":"https://doi.org/10.1186/s12960-026-01057-z","url":null,"abstract":"<p><strong>Backgrounds: </strong>Physicians are among the most vital healthcare resources. The equitable distribution of human resources could help policymakers to reach equity as the most important health care goal. In Iran, addressing the shortage of qualified healthcare personnel requires policymakers to consider the population's health needs. The present study evaluated the equity in the distribution of general practitioners (GPs) and specialists (SPs) in Iran, both before and after adjusting for health needs. Disability-adjusted life years (DALYs) and mortality were used as indicators of health needs.</p><p><strong>Method: </strong>This study is based on a retrospective cross-sectional design and looks at the distribution of GPs and SPs across Iranian provinces over 14 years (2006-2019) by the Robin Hood index. Data on the number of GPs and specialists, as well as provincial mortality, were obtained from the Statistical Center of Iran. DALYs were sourced from the Global Burden of Disease (GBD) study. Additionally, Lorenz curves were plotted to visualize the distribution by use of Excel 2016. The R.4.5.1 software (package EconGeo) was used to analysing the data.</p><p><strong>Results: </strong>During the study period, the Robin Hood index for GPs, based on population size, mortality, and DALYs, was 0.104, 0.127, and 0.111, respectively; for SPs, the corresponding values were 0.118, 0.133, and 0.124. The greatest equity in the distribution of GPs and SPs was observed in 2016 and 2019, respectively. Overall, less than 13% of the physicians should be redistributed to reach equity. Tehran exhibited both the lowest disparity in SP distribution and the highest disparity in GP distribution, relative to mortality and DALYs.</p><p><strong>Conclusion: </strong>Overall, the distribution of GPs and SPs in Iran was close to the equity line; however, SP distribution was closer to the equity line than that of GPs. The distribution appeared more equitable when evaluated using population size, DALYs, and mortality, respectively. Using population size alone as a planning tool can be misleading. Instead, health workforce policies should take a broader view-one that includes how people use services, how demographics are changing, and how local socioeconomic conditions shape health needs. Effective strategies-including financial incentives, career pathway development, implementation of post-graduation \"return-to-service\" programs, adoption of telemedicine, and integration of artificial intelligence-can support physician retention and, in turn, foster a more equitable distribution of medical professionals.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scoping review of research capability building: impact on health workforce attraction and retention in rural and remote Australia.","authors":"Tsegaye G Haile, Justin Manuel, Mohamed Estai","doi":"10.1186/s12960-026-01069-9","DOIUrl":"https://doi.org/10.1186/s12960-026-01069-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Research capacity building (RCB) aims to enhance skills, embed evidence-informed practice, and contribute to improving patient and workforce outcomes, particularly in rural and remote areas that are disproportionately affected by workforce shortages, limited resources, and geographic isolation. However, evidence on the impact of RCB on health workforce outcomes and the barriers and enablers influencing RCB implementation and its sustainability remains limited. Thus, we mapped the available evidence on the relationship between RCB and health workforce outcomes, including attraction and retention in rural and remote areas, identified key success factors and challenges, and highlighted strategies to inform future policy and practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A scoping review of published and publicly available grey literature from Australia (January 2000 to end of February 2025) was undertaken following the PRISMA-ScR 2020 statement and Joanna Briggs Institute methodology. CINAHL, MEDLINE, ProQuest Central, and Scopus online databases were searched, supplemented by Google, Google Scholar, and reference snowballing. The interconnectedness of the following domains was explored: (i) health professionals, (ii) research engagement and RCBs, (iii) workforce outcomes, such as attraction and retention, and (iv) rural/remote settings. Both qualitative and quantitative studies were included, with descriptive and thematic analyses conducted deductively and inductively following the socioecological model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Nineteen studies were included: nine qualitative, six quantitative, and four mixed methods. Three examined RCB implementations, three assessed the impact of RCB, one evaluated program effectiveness, and the remainder investigated multiple outcomes, including barriers and facilitators. Included studies reported that RCB initiatives were described as contributing to improved research skills, increased professional satisfaction, and perceived workforce retention, particularly when initiatives provided mentorship, protected time, and addressed locally relevant priorities. Common barriers identified limited organisational support, high workloads, and short-term funding, while strong leadership, embedded research facilitators, and alignment with community needs were key enablers. Longitudinal evidence directly linking RCB initiatives to measurable improvements in workforce attraction and retention was scarce.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our findings suggest a potential association between RCB and strengthened skills, increased professional satisfaction, and improved workforce stability in rural and remote areas. To sustain the impacts of RCB, the findings highlight the importance of locally relevant design, ensure adequate resourcing, and provide strong organisational leadership support. Finally, robust longitudinal evaluations of the impact of RCB on workforce attraction and retention wi","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rehabilitation in primary health care: workforce and pathways toward 2030.","authors":"Mariana Fagundes Cinti, Juliana Leme Gomes, Mário Lopes, Thiago Souza Silveira, Danielle Silva Viegas de Oliveira, Beatriz Priscila Costa, Debora Bernardo, Ana Carolina Basso Schmitt","doi":"10.1186/s12960-026-01067-x","DOIUrl":"https://doi.org/10.1186/s12960-026-01067-x","url":null,"abstract":"<p><strong>Introduction: </strong>The World Health Organization encourages the strengthening of rehabilitation care worldwide through the \"Call for Action to 2030,\" emphasizing primary health care (PHC) as a fundamental strategy.</p><p><strong>Objectives: </strong>To analyze the temporal and spatial evolution of the rehabilitation workforce in PHC in Brazil and its federative units from 2010 to 2023 and to estimate projections up to 2030.</p><p><strong>Methods: </strong>This was an ecological time series and spatial study in which the density of rehabilitation professionals (rate per 10,000 inhabitants) in PHC was projected. Workforce trends and projections were estimated via the SARIMA model; average annual percent change (AAPC) and linear regressions were used to evaluate temporal evolution. The correlation between the Municipal Human Development Index (MHDI) and the workforce was assessed via Moran's I index.</p><p><strong>Results: </strong>Workforce density in PCH increased between 2010 and 2023 (AAPC 6.21%) but remained low and uneven across professions and regions, with slower growth projected to 2030 (AAPC 4.61%). Persistent regional and professional inequalities were observed, particularly among speech-language pathologists and occupational therapists, with a weak association between workforce density and human development.</p><p><strong>Conclusions: </strong>Although the rehabilitation workforce in PHC has expanded in Brazil, projected growth deceleration and persistent territorial inequalities pose challenges to future demand. Strengthening rehabilitation within PHC through integrated workforce and policy strategies is essential to reduce inequities and advance universal health coverage.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building virtual real-time trauma care learning during armed conflict: the case of ECHO in Ukraine.","authors":"Léa Sinno, Yesser Sebeh, Marta Antoniv, Paola Arenas, Nelya Melnitchouk, Katie Murray, Brigg Reilley, Iiris Rinne, Bruce Struminger, Alexandra Zuber, Sean M Kivlehan","doi":"10.1186/s12960-026-01066-y","DOIUrl":"https://doi.org/10.1186/s12960-026-01066-y","url":null,"abstract":"<p><strong>Background: </strong>Armed conflicts threaten the resilience of health systems and the continuity of medical education. The war in Ukraine has impacted the health infrastructure and depleted the workforce, highlighting the need for trauma care training to strengthen healthcare professionals' capacity to provide care. Sustaining training remotely may offer a practical way to overcome limitations of in-person courses. In response, the Harvard Humanitarian Initiative (HHI), in collaboration with Project ECHO (Extension for Community Healthcare Outcomes) at the University of New Mexico, piloted a virtual case-based community of practice (VCoP) to strengthen the delivery of trauma care in Ukraine and bridge initial in-person training.</p><p><strong>Methods: </strong>Ten VCoP sessions were implemented between October and December. Participation was offered to all Ukrainian trauma care trainers who participated in prior in-person training. The assessment survey was sent to all VCoP session participants and evaluated program feasibility, reach, engagement, and perceived impact. Highly engaged participants were invited to an additional virtual interview to provide additional feedback. Implementation and outcomes were measured with a mixed-methods formative evaluation. Analysis included attendance data, post-session and end-of-series surveys, and semi-structured interviews.</p><p><strong>Results: </strong>Forty-four Ukrainian trauma trainers who participated in earlier in-person education participated in at least one session, representing 10 oblasts (administrative regions) in Ukraine. Post-session survey response rate averaged 74%. 94% of participants indicated applying knowledge from the sessions in their practice or teaching and 89% reported changes in their practice and innovation in their teaching methods. 94% of participants reported that the program helped them increase professional connectedness. All participants expressed interest in participating in future VCoP sessions with 77% expressing interest in leading future sessions.</p><p><strong>Conclusion: </strong>The Ukraine Trauma Care VCoP demonstrated that virtual education can be feasible and effective in bridging initial training and capacity strengthening of healthcare providers in conflict settings, providing sustainability. Future efforts should evaluate the ability of this model to adapt and scale in similar contexts.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Professional support to improve rural medical workforce retention, what works in what context: a realist evaluation.","authors":"Belinda O'Sullivan, Kristine Battye, Deborah Roczo","doi":"10.1186/s12960-026-01065-z","DOIUrl":"https://doi.org/10.1186/s12960-026-01065-z","url":null,"abstract":"<p><strong>Background: </strong>Professional support is an important strategy to improve the retention of rural doctors. However, it is poorly defined and understood within the context of rural medicine making it challenging to design and implement. This research aimed to explore what professional support entails and how it works and in what context, to improve whole of rural medical workforce retention.</p><p><strong>Methods: </strong>An online expression of interest was circulated to 143 organisations/key informants potentially involved in professional support activities to which 87 replied. Thirty-three of the longest running and comprehensive professional support activities spread across different medical specialties and career stages, locations and target cohorts were selected. Respondents participated in up to two 1-h semi-structured interviews. Realist evaluation involved drawing out patterns about how professional support worked in what context to drive retention of rural doctors, to develop theory. The theory was developed, refined and confirmed with insights from an internal reference and external project advisory group.</p><p><strong>Results: </strong>A whole of medical workforce conceptualisation of professional support was defined identifying that in the context of rural medicine, three categories of professional support could drive longer term retention of rural doctors in rural work. These were lifelong career support, sustainable practise support and healthcare and social support. Together, these categories are likely to co-stimulate generative mechanisms (rural doctors' sense of comfort, confidence, competence, belonging and bonding) to promote shorter term outcomes of feeling valued and connected on the path to longer term retention. Professional support interventions could be scaled up or down over time and should be responsive to the breadth and complexity of work of rural doctors, their level of isolation/autonomy and their socio-cultural stresses.</p><p><strong>Conclusions: </strong>The findings articulate the concept of professional support across the rural medical workforce. The results suggest that professional support could be bundled and scaled up or down to address the holistic needs of individual doctors to generate better retention. The theory clarifies a range of professional support activity which could be coordinated through health services, education providers, government and wider agencies to more systematically ensure rural medicine is sustainable.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}