Human Resources for Health最新文献

{"title":"Developing a Global Strategy for strengthening the occupational therapy workforce: a two-phased mixed-methods consultation of country representatives shows the need for clarifying task-sharing strategies.","authors":"Sutanuka Bhattacharjya, Sarah Curtis, Supakorn Kueakomoldej, Claudia von Zweck, Giuliano Russo, Karthik Mani, Sureshkumar Kamalakannan, Ritchard Ledgerd, Tiago S Jesus","doi":"10.1186/s12960-024-00948-3","DOIUrl":"10.1186/s12960-024-00948-3","url":null,"abstract":"<p><strong>Introduction: </strong>Occupational therapy has been underdeveloped and often neglected in the global health workforce agenda, contrasting with the global rise of population needs for services. The World Federation of Occupational Therapists (WFOT) is utilizing a research-based, multi-step process for developing a Global Strategy for strengthening the occupational therapist workforce. A multi-pronged scoping review, situational analysis, and expert input process enabled the drafting of a provisional Global Strategy. Here, feedback on that draft from representatives of WFOT member organizations was obtained and analyzed as one key intermediate step toward shaping the in-developing Strategy's content and structure.</p><p><strong>Methods: </strong>Two-phased, mixed-methods consultation consisting of: (1) online survey with score ratings and comments on the utility of each strategy and (2) four in-person focus groups discussions on low-scoring items involving a total of 76 representatives of WFOT member organizations. The focus group discussions were analyzed using an inductive thematic analysis approach.</p><p><strong>Results: </strong>Strategies involving 'task shifting/task sharing' or the 'harmonization of workforce data-collection requirements' received the lowest scores in the initial survey and were thereby addressed in the focus groups discussions. The overarching theme of the focus groups was the need to: \"clarify, specify, and contextualize the strategies\", including: (1) \"clarify the terminology and specify the application\", for example, describe the meaning of task shifting, specify which tasks can (and cannot) be shifted and to whom, to address concerns regarding scope-of-practice, service demand, and safety; and (2) \"outline the context of need and the context for the implementation\" of the strategies, elucidating why the strategies are needed and how they can be feasibly implemented across the different jurisdictional contexts.</p><p><strong>Conclusion: </strong>Within a mixed-methods consultation, WFOT representatives identified challenging topics on the draft workforce strategies and suggested methods to improve the Global Strategy, its acceptability, and implementation. The terms 'task shifting/task sharing' raised the greatest discussion among the profession leaders, when the strategy was not sufficiently clarified, specified, or contextualized.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141327","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":"Public service motivation, public sector preference and employment of Kenyan medical doctor interns: a cross-sectional and prospective study.","authors":"Daniel Mbuthia, Yingxi Zhao, David Gathara, Catia Nicodemo, Gerry McGivern, Jacinta Nzinga, Mike English","doi":"10.1186/s12960-024-00945-6","DOIUrl":"10.1186/s12960-024-00945-6","url":null,"abstract":"<p><strong>Background: </strong>Kenya grapples with a paradox; severe public sector workforce shortages co-exist with rising unemployment among healthcare professionals. Medical schools have increased trainee outputs, but only 45% of newly qualified/registered doctors were absorbed by the public sector during 2015-2018. In such a context, we explore what influences doctors' career choices at labour market entry, specifically understanding the role of public service motivation (PSM).</p><p><strong>Methods: </strong>We conducted a cross-sectional and prospective study of interns and recently graduated doctors to examine PSM, their intention to work in the public sector and their final employment sector and status. We surveyed them on their PSM and job intentions and conducted a prospective follow-up survey of the interns, around one year later, to understand their employment status.</p><p><strong>Findings: </strong>We recruited 356 baseline participants and followed up 76 out of 129 eligible interns. The overall PSM score was high among all participants (rated 4.50/5.00) irrespective of sector preferences. 48% (171/356) of the participants preferred to work in the public sector immediately after internship, alongside 16% (57/356) preferring direct entry into specialist training-commonly in the public sector. Only 13% (46/356) and 7% (25/365) preferred to work in the private or faith-based sector. Despite the high proportion of interns preferring public sector jobs, only 17% (13/76) were employed in the public sector at follow-up and 13% (10/76) were unemployed, due to lack of job availability.</p><p><strong>Conclusion: </strong>High PSM scores irrespective of sector preferences suggest that doctors are generally committed to serving the 'public good'. Many intended to work in the public sector but were unable to due to lack of job opportunities. Policymakers have an opportunity to tackle workforce gaps in the public sector as young doctors continue to express a preference for such work. To do this they should prioritise creating adequate and sustainable job opportunities.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120804","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":"Effectiveness of eLearning programme for capacity building of healthcare professionals: a systematic review.","authors":"Gifty Francisca Ben Aryee, Mustapha Amoadu, Paul Obeng, Hammond Nii Sarkwah, Ebenezer Malcalm, Susanna Aba Abraham, Jones Abekah Baah, Dorcas Frempomaa Agyare, Nartey Edmond Banafo, Daprim Ogaji","doi":"10.1186/s12960-024-00924-x","DOIUrl":"10.1186/s12960-024-00924-x","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of eLearning in enhancing healthcare professionals' capacity has received substantial attention globally. This review sought to synthesis evidence on the effectiveness of various types of eLearning programmes, and the facilitators and barriers to its use.</p><p><strong>Methods: </strong>The review was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Four main databases (PubMed, Web of Science, JSTOR, and Scopus) in July 2023 and 44 articles met the eligibility criteria and were included in the review. The JBI critical appraisal checklist was used to appraise the methodological quality of the studies. The data were examined using narrative review to determine the effectiveness of the intervention as well as the barriers and facilitators to its use.</p><p><strong>Results: </strong>This review found that asynchronous, synchronous, blended, and self-learning methodologies are effective eLearning approaches for continuous professional development. Previous positive experiences, user-friendly interfaces and relevance of the eLearning content to daily practice are critical elements that facilitate eLearning usage. Poor computer competence and literacy, lack of personal computers and high family duties were the main personal factors that hindered eLearning use. Some systemic barriers included; heavy workloads, shortage of specialised eLearning facilitators poor management involvement, and technical inadequacies within the ICT departments. Environmental issues such as poor infrastructure, including limited internet and frequent power outages acted as barriers.</p><p><strong>Conclusion: </strong>The review highlights the effectiveness of various eLearning approaches among health professionals and presents the disparities between developing and developed economies in relation to the facilitators and barriers.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120803","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":"Malaysian Medical Students' Career Intention (MMSCI): a cross-sectional study.","authors":"Zhi Sean Teng, Gerald Tze Zhen Ser, Wei-Han Hong, Chin Hai Teo, Yang Faridah Abdul Aziz, Jamunarani Vadivelu","doi":"10.1186/s12960-024-00939-4","DOIUrl":"10.1186/s12960-024-00939-4","url":null,"abstract":"<p><strong>Background: </strong>In recent years, there have been many instances of negative sentiments expressed by and resignations observed from doctors working in the Ministry of Health (MOH), Malaysia. However, little is known about the perspectives of medical students and their career intentions. This study aims to determine the current Malaysian medical students' career intentions immediately after graduation and upon completing the 2 years of housemanship and to establish the factors influencing these intentions.</p><p><strong>Methods: </strong>This was a cross-sectional study of 859 Malaysian medical students from 21 medical schools who voluntarily completed a self-administered online questionnaire that was disseminated by representatives from medical schools nationwide and social media platforms of a national medical student society.</p><p><strong>Results: </strong>37.8% of the respondents were optimistic about a career with the Ministry of Health (MOH), Malaysia in the future. Most of the respondents (91.2%) plan to join and complete the MOH Housemanship programme as soon as possible after graduation, with the majority of them (66.2%) planning to complete it in their state of origin. After 2 years of Housemanship programme, only more than half of the respondents (63.1%) plan to continue their careers in MOH. Slightly more than a quarter (27.1%) of the total respondents plan to emigrate to practise medicine, with 80.7% of them planning to return to Malaysia to practise medicine after some years or after completing specialisation training. Combining the career intentions of Malaysian medical students immediately after graduation and upon completion of the 2 years housemanship programme, only a slight majority (57.5%) of the respondents plan to continue their career in MOH eventually. Most of the respondents (85.0%) intend to specialise.</p><p><strong>Conclusion: </strong>A concerning number of Malaysian medical students plan to leave the Ministry of Health workforce, the main healthcare provider in Malaysia, in the future. Urgent government interventions are needed to address the underlying factors contributing to the potential exodus of future doctors to prevent further straining of the already overburdened healthcare system, posing a significant threat to public well-being. An annual national study to track medical students' career intentions is recommended to gather crucial data for the human resources for health planning in Malaysia.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11340133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037321","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":"Patterns of health workforce turnover and retention in Aboriginal Community Controlled Health Services in remote communities of the Northern Territory and Western Australia, 2017-2019.","authors":"Prabhakar Veginadu, Deborah J Russell, Yuejen Zhao, Steven Guthridge, Mark Ramjan, Michael P Jones, Supriya Mathew, Michelle S Fitts, Lorna Murakami-Gold, Narelle Campbell, Annie Tangey, John Boffa, Bronwyn Rossingh, Rosalie Schultz, John Humphreys, John Wakerman","doi":"10.1186/s12960-024-00942-9","DOIUrl":"10.1186/s12960-024-00942-9","url":null,"abstract":"<p><strong>Background: </strong>Aboriginal Community Controlled Health Services (ACCHSs) in Australia aim to optimise access to comprehensive and culturally safe primary health care (PHC) for Aboriginal populations. Central to quality service provision is the retention of staff. However, there is lack of published research reporting patterns of staff turnover and retention specific to ACCHSs. This study quantified staff turnover and retention in regional and remote ACCHSs in the Northern Territory (NT) and Western Australia (WA), and examined correlations between turnover and retention metrics, and ACCHSs' geographical and demographic characteristics.</p><p><strong>Methods: </strong>The study used 2017-2019 payroll data for health workers in 22 regional and remote PHC clinics managed by 11 ACCHSs. Primary outcome measures included annual turnover and 12-month stability rates, calculated at both clinic and organisation levels.</p><p><strong>Results: </strong>There was a median of five client-facing (Aboriginal health practitioners, allied health professionals, doctors, nurses/midwives, and 'other health workers' combined) and two non-client-facing (administrative and physical) staff per remote clinic, at any timepoint. Mean annual turnover rates for staff were very high, with 151% turnover rates at the clinic level and 81% turnover rates at the organisation level. Mean annual turnover rates for client-facing staff were 164% and 75%, compared to 120% and 98% for non-client-facing staff, at clinic and organisational levels, respectively. Mean 12-month stability rates were low, with clinic-level stability rates of only 49% and organisation-level stability rates of 58%. Mean annual clinic-level turnover rates were 162% for non-Aboriginal staff and 81% for Aboriginal staff. Both workforce metrics were moderately to highly correlated with the relative remoteness of clinics, size of regular clients serviced, and average annual headcount of employees in each clinic (p values < 0.01).</p><p><strong>Conclusions: </strong>Participating ACCHSs in remote NT and WA have very high turnover and low retention of healthcare staff. Overall, clinic-level turnover rates increase as distance from regional centres increases and are lower for Aboriginal staff, suggesting that greater employment of Aboriginal staff could help stabilise staffing. Improved retention could reduce burden on ACCHSs' resources and may also support quality of service delivery due to improved cultural safety and continuity of care.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11340071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037322","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":"Exploring healthcare workers' perceptions of child health research at Kamuzu Central Hospital, Malawi: an interpretative phenomenological analysis.","authors":"Myness Kasanda Ndambo, Tuntufye Brighton Ndambo, Lucinda Manda-Taylor","doi":"10.1186/s12960-024-00938-5","DOIUrl":"10.1186/s12960-024-00938-5","url":null,"abstract":"<p><strong>Background: </strong>Children's health is a global public health priority and a determinant of development and sustainability. Its effective delivery and further improvements require constant and dedicated research on children, especially by child healthcare workers (HCWs). Studies have shown a high involvement of child HCWs from developed countries in child health research, with an under-representation from the global south in authorship and leadership in international collaborations. To our knowledge, there is very little literature on challenges faced by child HCWs in Malawi in conducting child health research. We sought to explore the lived experiences of child HCWs at Kamuzu Central Hospital (KCH) in Malawi by examining their perceptions of child health research and assessing the availability of child health research opportunities.</p><p><strong>Methods: </strong>From July 2023 to August 2023, we conducted five key informant interviews with purposively sampled policymakers and 20 in-depth interviews with child HCWs at KCH. The interviews were conducted in English, audio-recorded, and transcribed verbatim. We utilised interpretative phenomenological analysis by reviewing initial transcripts for familiarity, generating codes manually, and refining them into broader themes through comparisons and iterative processes.</p><p><strong>Results: </strong>The analysis revealed three main themes on perceptions of child HCWs at KCH in child health research. These are (i) perceived motivation and challenges for engaging in child health research, (ii) perceptions of resource availability and research opportunities at KCH, and (iii) perceptions of gaps in research training and participation among child HCWs.</p><p><strong>Conclusions: </strong>Our study has uncovered critical factors influencing the low participation of child HCWs in child health research at KCH. Lack of collaboration, limited financial opportunities, and non-research-based training were the key barriers to participation in child health research among child HCWs at KCH. We advocate for the inclusion of child HCWs at all stages of collaborative health research, transparency on funding opportunities for child health research, and inclusion of research in the training of HCWs. These initiatives can strengthen the participation of child HCWs in child health research and ultimately enhance child health outcomes in Malawi.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11334372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009648","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":"Challenges affecting migrant healthcare workers while adjusting to new healthcare environments: a scoping review.","authors":"Asem Al-Btoush, Charbel El-Bcheraoui","doi":"10.1186/s12960-024-00941-w","DOIUrl":"10.1186/s12960-024-00941-w","url":null,"abstract":"<p><strong>Introduction: </strong>Shifting demographics, an aging population, and increased healthcare needs contribute to the global healthcare worker shortage. Migrant Health Care Workers (MHCWs) are crucial contributors to reducing this shortage by moving from low-and middle-income countries (LMICs) to high-income countries (HICs) for better opportunities. Economic factors and health workforce demand drive their migration, but they also face challenges adapting to a new country and new working environments. To effectively address these challenges, it is crucial to establish evidence-based policies. Failure to do so may result in the departure of Migrant Healthcare Workers (MHCWs) from host countries, thereby worsening the shortage of healthcare workers.</p><p><strong>Aim: </strong>To review and synthesize the barriers experienced by MHCWs as they adjust to a new country and their new foreign working environments.</p><p><strong>Methodology: </strong>We followed the PRISMA guidelines and conducted a search in the PubMed and Embase databases. We included cross-sectional studies published after the year 2000, addressing MHCWs from LMIC countries migrating to high-income countries, and published in English. We established a data extraction tool and used the Appraisal tool for Cross-Sectional Studies (AXIS) to assess article quality based on predetermined categories.</p><p><strong>Results: </strong>Through a targeted search, we identified fourteen articles. These articles covered 11,025 MHCWS from low- to medium-income countries, focusing on Europe, the USA, Canada, Australia, New Zealand, and Israel. Participants and respondents' rates were diverse ranging from 12% to 90%. Studies encompassed various healthcare roles and age ranges, mainly 25-45 years, with a significant female presence. Participants resided in host countries for 3-10 years on average. Results are categorized based on the Riverside Acculturation Stress Inventory (RASI) and expanded to include bureaucratic and employment barriers, Gender differences, Natives vs. non-natives, and orientation programs.</p><p><strong>Conclusions: </strong>The findings emphasize the importance of cultural competence training and tailored support for MHCWs integration and job satisfaction. Time spent in the new healthcare setting and the influence of orientation programs are key factors in shaping their intentions to stay or leave. Despite limitations, these studies provide valuable insights, emphasizing the ongoing need for holistic strategies to facilitate successful integration, ultimately benefiting healthcare systems and well-being for all stakeholders.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11323648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976907","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":"Primary health care coverage in Portugal: the promise of a general practitioner for all.","authors":"Eduardo Costa, Joana Pestana, Pedro Pita Barros","doi":"10.1186/s12960-024-00936-7","DOIUrl":"10.1186/s12960-024-00936-7","url":null,"abstract":"<p><strong>Background: </strong>Primary care is an essential pillar of health systems. Many countries have implemented different policies to improve access to primary care. However, persistent challenges remain. This paper offers a critical analysis of the evolution of primary care coverage in Portugal, focusing on the number of patients without an assigned general practitioner (GP).</p><p><strong>Methods: </strong>We collected and analyzed publicly available data from 2009 to 2023 to decompose primary care coverage in three components: the number of patients enrolled in primary care units (demand-side effect), the number of GPs measured in full-time equivalent (supply-side effect), and the average number of patients on each GP's list (patient-to-GP ratio, capturing a productivity effect). We provide national and local level estimates for these three components.</p><p><strong>Results: </strong>Between 2009 and 2023, there was an overall decline in the number of patients enrolled in primary health care units. Concurrently, there was also a net decrease of GPs measured in full-time equivalent. Additionally, there was a progressive reduction in the average number of patients on each GP's list. The rise in the number of patients without an assigned GP is attributed not only to a reduction in the number of physicians, but also to a decrease in the patient load per doctor.</p><p><strong>Conclusions: </strong>Hiring additional GPs may not suffice to enhance coverage. Achieving higher coverage may imply revisiting patient load per doctor or considering alternative care models. Understanding the challenges related to GP coverage is critical for improving the efficiency of primary care.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914249","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":"Increasing the number of midwives is necessary but not sufficient: using global data to support the case for investment in both midwife availability and the enabling work environment in low- and middle-income countries.","authors":"Andrea Nove, Martin Boyce, Sarah Neal, Caroline S E Homer, Tina Lavender, Zoë Matthews, Soo Downe","doi":"10.1186/s12960-024-00925-w","DOIUrl":"10.1186/s12960-024-00925-w","url":null,"abstract":"<p><strong>Background: </strong>Most countries are off-track to achieve global maternal and newborn health goals. Global stakeholders agree that investment in midwifery is an important element of the solution. During a global shortage of health workers, strategic decisions must be made about how to configure services to achieve the best possible outcomes with the available resources. This paper aims to assess the relationship between the strength of low- and middle-income countries' (LMICs') midwifery profession and key maternal and newborn health outcomes, and thus to prompt policy dialogue about service configuration.</p><p><strong>Methods: </strong>Using the most recent available data from publicly available global databases for the period 2000-2020, we conducted an ecological study to examine the association between the number of midwives per 10,000 population and: (i) maternal mortality, (ii) neonatal mortality, and (iii) caesarean birth rate in LMICs. We developed a composite measure of the strength of the midwifery profession, and examined its relationship with maternal mortality.</p><p><strong>Results: </strong>In LMICs (especially low-income countries), higher availability of midwives is associated with lower maternal and neonatal mortality. In upper-middle-income countries, higher availability of midwives is associated with caesarean birth rates close to 10-15%. However, some countries achieved good outcomes without increasing midwife availability, and some have increased midwife availability and not achieved good outcomes. Similarly, while stronger midwifery service structures are associated with greater reductions in maternal mortality, this is not true in every country.</p><p><strong>Conclusions: </strong>A complex web of health system factors and social determinants contribute to maternal and newborn health outcomes, but there is enough evidence from this and other studies to indicate that midwives can be a highly cost-effective element of national strategies to improve these outcomes.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11264417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749253","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":"Love over gold and mind over matter? Identifying capabilities that preserve medical assistants' sustainable employability.","authors":"Bram P I Fleuren, Alden Yuanhong Lai, Lynda Gruenewald-Schmitz, Jennifer Larkin, Christina T Yuan","doi":"10.1186/s12960-024-00937-6","DOIUrl":"10.1186/s12960-024-00937-6","url":null,"abstract":"<p><strong>Background: </strong>Medical assistants (MAs) are crucial for affordable, high-quality primary care, but what motivates this low-wage occupational group to stay in their job remains underexplored. This paper identifies the work aspects that MAs value (\"capabilities\"), and how they affect sustainable employability, which refers to employees' long-term ability to function and remain in their job.</p><p><strong>Methods: </strong>We used structural equation modelling to assess how capabilities relate to four outcomes among MAs: burnout, job satisfaction, intention to quit, and experiencing work as meaningful.</p><p><strong>Results: </strong>We find that earning a good income, developing knowledge and skills, and having meaningful relationships at work relate to the outcomes. Meaningful relationships represent a stronger predictor than salary for one's intention to quit.</p><p><strong>Conclusions: </strong>Competitive salaries are necessary but not sufficient to motivate low-wage health care workers like MAs to stay in their job. Health care leaders and managers should also structure work so that MAs can foster meaningful relationships with others as well as develop competencies.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11265115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749254","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}