Human Resources for Health最新文献

{"title":"Self-sufficiency in the healthcare workforce: a system dynamics model of the domestic and foreign educated nursing and midwifery workforce in Ireland.","authors":"Terence Hynes, Paul Caulfield, Peter O'Connor, John Cullinan","doi":"10.1186/s12960-025-01004-4","DOIUrl":"https://doi.org/10.1186/s12960-025-01004-4","url":null,"abstract":"<p><strong>Background: </strong>World Health Organization (WHO) projections point to an increasing global demand for nurses and midwives, leading to shortages in many countries, particularly in less developed regions. Ireland, the context for this study, currently relies heavily on foreign educated nurses and midwives to meet its demand, with Government policy moving towards a domestic recruitment model. This paper estimates the recruitment requirement and associated nursing and midwifery student intake over time under different reform scenarios. It also highlights policy considerations for countries, like Ireland, aiming to comply with the WHO Code of Conduct on the International Recruitment of Health Personnel.</p><p><strong>Methods: </strong>This paper develops and applies a system dynamics model of the domestic and foreign educated workforce supply by age and gender and is based on regulatory data on stocks and flows from the national professional regulator for nurses and midwives. The model scope and design was informed by a problem statement developed in a series of workshops with officials in the Office of the Chief Nursing Officer. A range of scenario and sensitivity analyses are also undertaken.</p><p><strong>Results: </strong>In 2021, the base year of our projection horizon, we estimate that Ireland needed to recruit 3019 professionally active whole-time-equivalent (WTE) nurses and midwives. This would have required 3965 student places four years earlier in 2017 to meet this demand domestically. This is 153% higher than the 1570 student places that were available in that year. The recruitment requirement rises to 4497 by 2051, a 49% increase on 2021 levels. Foreign educated nurses and midwives, in terms of WTEs, start at 45% of projected demand in 2021 and range from 57% in the baseline scenario to 16% in the most ambitious reform scenario in 2051.</p><p><strong>Conclusions: </strong>The analysis suggests that Ireland requires a significant increase in nursing and midwifery student places to achieve self-sufficiency and that this will take time to achieve. Moreover, in addition to a sufficient domestic supply of nurses and midwives, self-sufficiency will also depend on managing demand volatility. Finally, countries anticipating a shift to a predominantly older population should ensure they have enough student places available before the demographic transition occurs to meet the associated health workforce requirements through the domestic education system.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"44"},"PeriodicalIF":4.3,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women in healthcare leadership: assessment of experiences, challenges, and opportunities.","authors":"Kani A Mohamadamin, Nazar P Shabila","doi":"10.1186/s12960-025-01016-0","DOIUrl":"10.1186/s12960-025-01016-0","url":null,"abstract":"<p><strong>Background: </strong>Women play a vital role in the healthcare sector, but the level of their involvement in leadership and the related challenges are not well-understood in the Iraqi context. Therefore, this study aimed to investigate women's experiences in healthcare leadership and identify the challenges and opportunities to improve their leadership roles.</p><p><strong>Methods: </strong>This cross-sectional study was based on a self-administered questionnaire survey conducted from July to December 2024 in Erbil, Iraq, on a random sample of 371 female healthcare staff members selected from healthcare settings. Women's viewpoints and experiences were measured based on Likert-scale questions.</p><p><strong>Results: </strong>Of the 371 participants, 13.2% had received training on leadership and 27% had been in leadership positions, most as heads of hospital and primary healthcare center units (72.3%), and most evaluated this experience as positive (92.1%). Most of the study participants had experienced a woman as a leader in the workplace (84.6%) and positively evaluated this experience (45.3%), with 13.5% reporting a negative experience. More than half of the participants (58.5%) were ready to take leadership positions. Most participants (69.6%) perceived women as successful leaders, with 63.3% accepting women in leadership roles and 82.8% believing women possess sufficient self-confidence for leadership. Most participants considered offering daycare services for mothers (89.2%) and providing leadership training programs (78.2%) essential opportunities for women to take leadership positions. Postgraduate education [OR = 2.7 (95%CI 1.1-6.3)], working in the directorate of health [OR = 5.3 (95%CI 2.2-13.0)], and receiving training [OR = 6.3 (95%CI 3.0-13.4)] were independent factors significantly associated with taking leadership positions by women.</p><p><strong>Conclusions: </strong>This study highlights the untapped potential of women in healthcare leadership, with many women demonstrating readiness for leadership roles and reporting positive leadership experiences. Addressing societal barriers through institutional policies and leadership programs, including structured leadership training, and childcare support, is crucial to advancing women in healthcare leadership. Further in-depth investigations are critical to exploring the sociocultural and communal factors.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"43"},"PeriodicalIF":4.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of postgraduate medical education: lessons from history to shape the future.","authors":"Gohar Yerimyan, Davit Abrahamyan, Anna Isahakyan, Gevorg Yaghjyan, Alexander Bazarchyan","doi":"10.1186/s12960-025-01005-3","DOIUrl":"10.1186/s12960-025-01005-3","url":null,"abstract":"<p><p>Ensuring professional competencies of medical specialists remains a major and ongoing concern. This study focuses on the historical evolution of personnel development in different countries, emphasizing postgraduate specialization and the educational models that emerged as a result. The study goes beyond a chronological analysis of events, seeking to identify and compare the major turning points in the postgraduate medical education (PGME) systems in different developed countries. In parallel, the events related to the formation of the postgraduate education system in Armenia were also considered, since a number of procedures related to the postgraduate education system are currently being revised in Armenia. This study also includes the overview of the Soviet educational model, since it also had a significant impact on the formation of the Armenian model. Such comparisons provide insight into the influence of these milestones on the development of modern educational models. Through a comprehensive analysis of various sources, including academic publications, reports, books, archival materials and legal documents related to the history of medicine, the study reveals significant historical trends, events and ideas in the field of medical education (ME). Models operating in different countries have undergone their own developmental journeys, during which they have been refined, improved, and shaped specific cultures and traditions. The historical analysis of PGME provided a broader understanding of the systems operating in different countries, revealing similarities, differences, and key lessons from each. Specific turning points in the different systems were identified that played a transformative role in the evolution of educational models and practices. A comparative analysis of models used in countries with developed PGME systems and the current structure of Armenian PGME system has identified key areas where revision could help shape the future of Armenian system and bring it in line with leading global educational standards.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"42"},"PeriodicalIF":4.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Future gaps in the public provision of health services in Austria? A mixed-methods analysis for specialists in internal medicine.","authors":"Clemens Zech, Monika Riedel","doi":"10.1186/s12960-025-01013-3","DOIUrl":"10.1186/s12960-025-01013-3","url":null,"abstract":"<p><strong>Background: </strong>Population growth and aging are likely to increase demand for healthcare providers, even in countries with high provider-to-population ratios. To plan appropriate policy measures, detailed information on supply and demand trends in the physician workforce for each medical specialty is essential. This article assesses the current supply of all specialists in internal medicine (general and subspecialties) in Austria and projects future supply and demand until 2035.</p><p><strong>Methods: </strong>Our analysis follows a framework for workforce planning consisting of four stages: (1) horizon scanning, (2) scenario generation, (3) workforce modelling, and (4) policy analysis. We use stakeholder workshops, interviews and an online survey (n = 484) in the first two stages. Future supply is modelled using stock-flow models, whereas demand is projected using regression modelling based on existing forecasts and extrapolations of historical care use. Different scenarios are used to account for uncertain developments. The two main settings of care in Austria-public hospitals and publicly financed outpatient care-are modelled separately.</p><p><strong>Results: </strong>Overall, no severe shortage of specialists in internal medicine is expected in Austria until 2035. However, our analysis suggests that the two settings of care will experience very different developments: while the gap between supply and demand in public hospitals is expected to be small (± 5 percent), the supply of specialists in publicly financed outpatient care is projected to fall between 10 and 25 percent short of demand.</p><p><strong>Conclusions: </strong>Without major reforms, capacity constraints will likely affect the publicly financed outpatient sector, hindering the desired shift from inpatient to outpatient care or driving patients into the private outpatient sector where higher user charges apply. Therefore, it is essential for policy makers to incentivize physicians to work in publicly financed outpatient care. Increasing enrolment in medical schools is not a suitable policy measure, as no significant shortage of specialists in internal medicine is expected overall.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"41"},"PeriodicalIF":4.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physician turnover in China, 2011-2021: a nationwide longitudinal study.","authors":"Xiaoxu Wang, Qiufen Sun, Lijin Chen, Yaoguang Zhang, Yue Cai, Ruixian Wu, Shuai Wang, Xiang Cui, Jun Lv, Shiyong Wu, Liming Li","doi":"10.1186/s12960-025-01009-z","DOIUrl":"10.1186/s12960-025-01009-z","url":null,"abstract":"<p><strong>Background: </strong>There have been a globally paucity of comprehensive quantitative studies on the physician turnover trends. This study aimed to investigate the trajectory and magnitude of Chinese physician turnover, as well as its influencing factors.</p><p><strong>Methods: </strong>We established a retrospective cohort by combining annual physician surveillance data and annual medical institution report data between 2011 and 2021. Turnover was defined as physicians who changed their practice institution at least once between 2011 and 2021. We reported the national annual turnover rate, net turnover rate of different regions and types of healthcare institutions. The direction of turnover across provinces and institutions was exhibited using Sankey diagrams. A time-dependent Cox regression analysis was used to examine the factors that influence physician turnover.</p><p><strong>Results: </strong>This study included 3.7 million physicians, with 19.4% changing practice institutions between 2011 and 2021. The national annual turnover rate has risen from 1.6% to 4.4%. The majority of turnover occurred within provinces and the same type of healthcare institutions. Eastern regions and urban areas experienced net turnover inflow. Factors that increased the likelihood of physician turnover include: being younger, male, more educated, having senior professional titles, having non-permanent employment contracts, working in rural, non-hospital, or private institutions, and working in institutions with relatively low revenue or high workload.</p><p><strong>Conclusions: </strong>This study suggests that the physician turnover rate is rising in China. Polices should pay more attention to physician retention in less-developed regions. The underlying causes of physician turnover should be thoroughly investigated. Continuous monitoring of physician turnover is critical to leverage its potential positive impact on revitalizing the healthcare system and to avoid its possible negative impact on equal geographic distribution of physicians.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"40"},"PeriodicalIF":4.3,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing maternal, neonatal, and child mortality and improving quality of health care through a national task-shifting program for public hospitals in Liberia.","authors":"Bernice Dahn, Rhona MacDonald, Obed W Dolo, Angela Benson, Korpo Borzoi, Austine Menlor, Jessica Fofana, Hassan Abdulkadir, Kola Adeyemo, Sarah Diane Watson, Sarah Band, Alison Earley, David Southall","doi":"10.1186/s12960-025-01001-7","DOIUrl":"10.1186/s12960-025-01001-7","url":null,"abstract":"<p><strong>Background: </strong>Contributing to the high hospital-based maternal, neonatal, and child mortalities in low resource countries and conflict zones is a shortage of health workers, especially physicians. Training programs, conducted over 12 years, have enhanced the skills of midwives, and nurses, to provide high quality, hospital-based, care to pregnant women, newborn infants, children, and adolescents.</p><p><strong>Methods: </strong>A task-shifting partnership between the Ministry of Health, World Health Organisation, United Nations Population Fund, United Nations Children's Emergency Fund and the charity Maternal and Childhealth Advocacy International was established in 2012. Rural county health teams selected 37 midwives, 20 nurses, 1 nurse/midwife and 2 physician assistants, for advanced training. They were appointed following a written examination and interview. Obstetric clinician trainees underwent a 3-year programme, which included operative procedures. The training programs for neonatal and paediatric clinician trainees were 2 years and 2.3 years, respectively. Training consisted of apprenticeship-based training and distance learning. It was delivered by Liberian and international specialists. Trainee competence was established by continuous clinical assessment, oral, and written clinical examinations. The programme also upgraded hospital buildings and provided essential equipment and drugs.</p><p><strong>Results: </strong>59 trainees completed training, 2 failed and 57 qualified in final examinations. 27 are working as obstetric clinicians, 15 are working as neonatal clinicians, and 11 are working as paediatric clinicians. Therefore, 53 are working in 18 hospitals and 4 Comprehensive Emergency Obstetric and Newborn Care (CEmONC) facilities. Obstetric clinicians manage major obstetric emergencies. They perform abdominal surgery, including the management of ruptured ectopic pregnancy and basic and complicated caesarean sections. Neonatal clinicians resuscitate and care for sick and premature babies to WHO Special Care Level 2. Paediatric clinicians manage the main paediatric emergencies that contribute to high mortality. Before the arrival of the international trainer, paediatric mortality in the training hospital was 9.5% and was 4.1% in the final year of training.</p><p><strong>Conclusions: </strong>This task shifting programme in Liberia has shown that midwives and nurses can be trained to provide safe and effective hospital care for pregnant women, newborn infants and children. This approach is one solution to the health workforce problem in low resource and conflict settings.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"39"},"PeriodicalIF":4.3,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12323219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Capacity building models for managing multiple long-term conditions in low-and-middle-income countries: a systematic review and gap analysis.","authors":"Abhinav Sinha, Krushna Chandra Sahoo, Pranab Mahapatra, Sandipana Pati, Jayasingh Kshatri, Srikanta Kanungo, Sandro R Batista, Bruno P Nunes, David Weller, Stewart W Mercer, Sanghamitra Pati","doi":"10.1186/s12960-025-00996-3","DOIUrl":"10.1186/s12960-025-00996-3","url":null,"abstract":"<p><strong>Background: </strong>The global prevalence of multiple long-term conditions (MLTCs) is increasing, challenging healthcare providers worldwide. In low- and middle-income countries (LMICs), healthcare professionals face additional obstacles in managing MLTCs due to the presence of disease-specific guidelines. This issue is exacerbated by the limited emphasis on both pre-service and in-service training of healthcare professionals on MLTCs within LMICs. Therefore, we conducted a systematic review to synthesize the scientific evidence on training and educational initiatives on MLTCs for health professionals in LMICs.</p><p><strong>Methods: </strong>We conducted a search across PubMed, Embase, and CINAHL within the domains of 'multiple long-term conditions' and capacity-building and systematically reviewed the articles retrieved. The data were synthesized using a healthcare training framework that encompasses objectives, target audience, content and curriculum, training methodology, trainers and facilitators, logistics and implementation, participant engagement and satisfaction, and outcomes. Our findings were reported according to PRISMA guidelines. This systematic review was prospectively registered with the International Prospective Register of Systematic Reviews (CRD42022348483).</p><p><strong>Results: </strong>Out of 15,981 initial records, 3614 duplicates were removed, leaving 12,367 for title and abstract screening. After full-text review of 204 articles, only four met the inclusion criteria-two from India, one from Ukraine, and one covering multiple African countries (South Africa, Uganda, Ethiopia, and Kenya) demonstrating a scarcity of literature in the field. These studies focused on increasing healthcare providers' capacity to manage multiple chronic conditions through knowledge, skills, and competency-based training. A 'train-the-trainer' approach was emphasized for broader impact in low-income settings. Training methods varied, incorporating interactive sessions and interdisciplinary modular programs. Key recommendations included integrating updated curricula into medical education and addressing logistical barriers. While participants reported improved skills, challenges included sustaining support and adapting programs to local contexts.</p><p><strong>Conclusions: </strong>MLTC-focused training in LMICs remains limited, with existing programs emphasizing competency-based learning and a 'train-the-trainer' approach. Key challenges include sustainability, logistical barriers, and local adaptation. Integrating structured, interdisciplinary training into medical education and professional development, alongside policy support and stakeholder collaboration, is important for future implementation.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"38"},"PeriodicalIF":4.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12312530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse working conditions in Romanian out-of-hours primary care (OOH-PC): an interview study.","authors":"Simona Ciotlăuș, Marius Ionuț Ungureanu, Florin Oprescu","doi":"10.1186/s12960-025-00985-6","DOIUrl":"10.1186/s12960-025-00985-6","url":null,"abstract":"<p><strong>Background: </strong>Adverse working conditions in Romanian out-of-hours primary care (OOH-PC) are a growing concern due to the shortage of healthcare professionals, outmigration, and inadequate measures to address the retirement of family doctors. This has led to significant fluctuations in the number of OOH-PC centres across the country. To address the existing knowledge gaps regarding the OOH-PC services, this study aimed to explore the challenges faced by healthcare workers in after-hours care.</p><p><strong>Methods: </strong>A qualitative approach was used to gather insights from 14 healthcare professionals, including family doctors, nurses, representatives of professional associations, emergency doctors, and paediatricians. Through thematically analyzed in-depth semi-structured interviews, the researchers examined the working conditions in OOH-PC in Romania from the perspective of healthcare workers.</p><p><strong>Results: </strong>Data analysis yielded five key themes related to adverse working conditions in OOH-PC: working hours and shift length, increasing workload and patient influx, obstacles to achieving work-life balance, inconveniences related to OOH center premises (rest space, security), and insufficient financial compensation for after-hours health service provision.</p><p><strong>Conclusions: </strong>In the context of systemic changes in the Romanian health system, this article provides valuable information on the current working conditions of primary care health workers in OOH care. It highlights the importance of improving working conditions to attract and retain healthcare professionals in OOH-PC.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"37"},"PeriodicalIF":4.3,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors affecting the turnover intention of newly graduated Generation Z nurses in Korea: multilevel analysis.","authors":"Mee Sun Lee, Sujin Shin","doi":"10.1186/s12960-025-01011-5","DOIUrl":"10.1186/s12960-025-01011-5","url":null,"abstract":"<p><strong>Background: </strong>The turnover rate of newly graduated nurses is very high, and their turnover intention is affected not only by individual-level factors, but also by organizational-level factors. However, the multilevel factors reflecting the characteristics of newly graduated nurses in Generation Z and their turnover intention have not been identified previously.</p><p><strong>Objective: </strong>To identify the individual- and organizational-level factors that affect the turnover intention of newly graduated nurses in Generation Z.</p><p><strong>Methods: </strong>This study was a cross-sectional questionnaire survey. Online survey was performed from August to November 2022. Participants were a total of 283 newly graduated nurses and 45 nurse managers to respond to each individual and organization-level questionnaire. The collected data were analyzed for frequency, descriptive statistics, and multilevel analysis.</p><p><strong>Results: </strong>The multilevel analysis indicated that the individual-level factors that affected the lower turnover intention of newly graduated nurses in Generation Z were higher work-life balance (β = - 0.320, p < 0.001), higher organizational commitment (β = - 0. 384, p < - 0.001), and desired nursing unit placement (β = - 0.209, p < 0.001). The organization-level factors associated with lower turnover intention were lower average number of night shifts per month (β = 0.303, p < 0.05), higher salary (β = - 0.263, p < 0.05), longer orientation period (β = - 0.612, p < .01), preceptor-preceptee ratio of 1:1 (β = - 0.409, p < 0.05), and existence of a mentoring program (β = - 0.318, p < 0.05). Furthermore, the nursing work environment was the most influential factor, and a supportive environment for nursing work (β = - 0.630, p < 0.01), efficient computer-related environment (β = - 0.251, p < 0.05), and recognition and respect (β = - 0.564, p < 0.05) were associated with lower turnover intention.</p><p><strong>Conclusions: </strong>The findings indicate that improvements to the nursing work environment and human resources of the organization should be prioritized to prevent the turnover of newly graduated nurses in Generation Z.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"36"},"PeriodicalIF":4.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disjunctions between contractual and civil service recruitment: public sector doctors' perspectives from two Indian states.","authors":"Bhaskar Purohit, Peter S Hill","doi":"10.1186/s12960-025-00990-9","DOIUrl":"10.1186/s12960-025-00990-9","url":null,"abstract":"<p><strong>Background: </strong>Civil service and contractual recruitment are common recruitment pathways with significant differences in terms of security and benefits for rural doctors and their career trajectories. However, there are tensions between doctors' expectations of the systems and the systems' imaginings of what it offers in terms of recruitment. In this paper, we explore these tensions from the perspective of frontline public sector doctors.</p><p><strong>Methods: </strong>This qualitative multiple-case study research was carried out in two Indian states. We used semi-structured interviews with 33 doctors and 28 key informants from the two states. Thematic analysis, using the framework approach, was used to arrange and synthesize qualitative data. In addition, job histories were constructed from the doctors' interviews to examine their experiences with recruitment and analyzed using simple numbers.</p><p><strong>Results: </strong>The findings suggest that in one study State, the doctors and the administration perceive civil service and contractual recruitment differently with tensions between personal and systemic perspectives. Findings from this State suggest that contractual doctors conceive the progression from contractual to civil service recruitment as sequential. Contrary to doctors, health administration regards these two forms of recruitment as distinct-potentially complementary, but certainly strategic, but not necessarily sequential. However, there are several obstacles faced by doctors that negatively affect their expectations of progressing to civil service recruitment and their career trajectories. The critical obstacles are: prolonged contractual employment, irregular PSC evaluations, and decreasing opportunities to become civil servants. All these factors lead to discontent among contractual employees, with critical consequences for their career trajectories and job satisfaction. However, findings from the other State indicate the use of alternative approaches in recruitment, leading to frequent civil service recruitment and positive perceptions among doctors.</p><p><strong>Conclusions: </strong>The idea that civil service recruitment forms a continuum with contractual recruitment is a misconception held by rural doctors, while the administration sees important distinctions between them. This disjunction in perspectives is problematic, leading to negative perceptions and breach of doctors' assumptions, with broader implications. From a health systems and workforce perspective, the need for the administration to acknowledge and address disjunctions through effective human resource approaches is critical.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"35"},"PeriodicalIF":3.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}