Human Resources for Health最新文献

{"title":"Mapping the viral battlefield: SARS-CoV-2 infection dynamics among healthcare workers in Brazil.","authors":"Antonio Luiz Dal Bello Gasparoto, Samara Vilas-Bôas Graeff, Wellyngton Matheus de Souza Santiago, Danielle Gomes da Silva, Thaynara Azevedo Dos Santos, Leandro Martin Paulino, Wellington Santos Fava, Fernanda Paes Reis, Claudia Stutz, Adriana de Oliveira França, Ana Tereza Gomes Guerrero Moureau, Camila Amato Montalbano, Everton Ferreira Lemos, Crhistinne Cavalheiro Maymone Gonçalves, Carlos Alberto Bento Júnior, Rodrigo Pires Dallacqua, Julio Croda, Aline Pedroso Lorenz, Cristina Souza, Taynara Nogueira Martins, Kassia Roberta Nogueira da Silva, Alda Maria Teixeira Ferreira, Adriana Carla Garcia Negri, Anamaria Mello Miranda Paniago, Ana Rita Coimbra Motta-Castro, James Venturini, Ana Paula da Costa Marques, Sandra Maria do Valle Leone de Oliveira","doi":"10.1186/s12960-024-00968-z","DOIUrl":"10.1186/s12960-024-00968-z","url":null,"abstract":"<p><strong>Background: </strong>Understanding the dynamics of SARS-CoV-2 viral infection and factors associated with in-hospital transmission rates among healthcare workers (HCW) is crucial for their protection. Brazil experienced high mortality rates due to COVID-19, and limited data are available on transmission of SARS-CoV-2 infection among HCW. This cohort study aimed to assess the dynamic of SARS-CoV-2 infections in HCW from two tertiary hospitals in central Brazil, one of them a Reference Hospital for COVID-19.</p><p><strong>Methods: </strong>From May 2020 to January 2021, 554 HCW directly involved with COVID-19 care were followed through 12 biweekly visits. During these visits, blood, nasal, and oropharyngeal samples were collected, and participants underwent interviews. SARS-CoV-2 detection was carried out using RT-qPCR, while the assessment of seroprevalence was based on IgG detection. Additionally, 35 positive samples underwent viral whole-genome sequencing.</p><p><strong>Results: </strong>The infection prevalence, as per RT-qPCR, was 28.5% (24.9-32.4), reflecting an overall attack rate ranging from 0.5% to 9.5%, marked by two peaks in August and December 2020. Oligosymptomatic and asymptomatic infections accounted for 14% of prevalent infections. The seroprevalence rate stood at 25.8%. The hospitalization rate was 8.2%, with a fatality rate of 1.3%. Risk factors associated with a positive diagnosis of COVID-19 included being male, working at the referral hospital, having a graduate-education level, and using hydroxychloroquine and zinc for prevention or treatment. One reinfection was identified. Absenteeism was 56.6%. The infection dynamics mirrored the pattern observed in the general population.</p><p><strong>Conclusion: </strong>One-third of the professionals in the followed cohort were infected. Being male, working in a COVID-19 referral center, having a low level of education, and using medications for preventive treatment represented risk factors. Healthcare workers at the COVID-19 referral hospital exhibited a higher incidence rate compared to those at the non-referral hospital, increasing the plausibility that some of the infections occur in the hospital environment.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"8"},"PeriodicalIF":3.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11817727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400310","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":"Principles to award learning achievements for lifelong learning in health using micro-credentials: an international Delphi study.","authors":"Sharon Mitchell, John Hart, Muntaha Gharaibeh, Graham T McMahon, Anthea Rhoda, Siobhan Fitzpatrick, Tana Wuliji, Janusz Janczukowicz","doi":"10.1186/s12960-024-00969-y","DOIUrl":"10.1186/s12960-024-00969-y","url":null,"abstract":"<p><strong>Background: </strong>This research investigates micro-credentialing as an approach to recognise learning achievements in health. Establishing international standards can ensure consistency, promote equity, and enhance quality of recognition systems. Achieving stakeholder consensus on the key topic areas is an important precursor to lead to relevant topics from which to build appropriate standards. This research supports the efforts by UN agency representatives and experts in qualification systems, medical education, the health and care sector, regulation, and accreditation, to build foundations from which to launch normative work on the application of micro-credentials to award learning achievements for health and care workers.</p><p><strong>Methods: </strong>A modified Delphi study following methodological steps was conducted. From April to May 2021, a literature review investigated existing standards in continuing professional development and the use of micro-credentialing in health. Results from the review informed the initial draft of statements that were then refined through three iterative Delphi rounds between May to September 2021. The process culminated in a final workshop in March 2023.</p><p><strong>Results: </strong>A total of 53 participants completed the Delphi, with results analysed by researchers using qualitative analysis. Consensus was achieved on the core principles to recognise learning achievements. The expert panel agreed on the need for standards that are competency-based, and require evidence of learning indicating what a learner can do. There was also consensus that the characteristics of a valid digital award or micro-credential should be portable, standardised, secure, interoperable, stackable and verifiable.</p><p><strong>Conclusions: </strong>The growing body of literature on micro-credentialing highlights its potential as a method to recognise learning achievements. The interest in alternative pathways to award health practitioners, through short competency-based micro-learning opportunities, has spurred discussions on the practical application of micro-credentials. This research outlines the categories and principles for a proposed framework to implement micro-credentialing to recognise learning achievements within the health and care sector.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"7"},"PeriodicalIF":3.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366137","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":"Rapid assessment of pre-service midwifery education in conflict settings: findings from a cross-sectional study in Nigeria and Somalia.","authors":"Emilia Iwu, Shatha Elnakib, Hawa Abdullahi, Rejoice Helma Abimiku, Charity Maina, Asia Mohamed, Kazeem Olalekan Ayodeji, George Odonye, Rifkatu Sunday, Maryan Abdulkadir Ahmed, Mohamed Ahmed Omar, Abdirisak A Dalmar, Emilie Grant, Hannah Tappis","doi":"10.1186/s12960-025-00977-6","DOIUrl":"10.1186/s12960-025-00977-6","url":null,"abstract":"<p><strong>Background: </strong>There is a dearth of evidence on the scale, scope and quality of midwifery education programs in conflict-affected settings. This study sought to assess the extent to which midwifery pre-service education programs meet national and global standards, and to explore how conflict affects pre-service midwifery education in Yobe State Nigeria and the Benadir and Galgaduud regions of Somalia.</p><p><strong>Methods: </strong>A rapid assessment of midwifery education programs was conducted in the two midwifery education programs in Yobe State, Nigeria and in seven purposively selected programs in Somalia using an adaptation of the Midwifery Education Rapid Assessment Tool. Information was collected through interviews with program leadership, teachers, students, and clinical preceptors during school and clinical practice site visits. Researchers adapted the tool to reflect national and international standards, incorporating supplementary questions to capture considerations specific to conflict-affected contexts. Data were analyzed by program and country using Stata and Excel.</p><p><strong>Results: </strong>In Nigeria, each school met 17 and 18 standards, respectively, out of 22 across assessment domains (77.3%-81.8%). In contrast, in Somalia, schools met between 6 and 10 standards out of the 18 standards for which data were available (33.3%-55.6%). The biggest gaps in Somalia were in leadership, infrastructure and resources. No schools in either setting had sufficient space or clinical practice sites that met International Confederation of Midwives (ICM) criteria, and only two were led by midwives. In Nigeria, all infrastructure, curriculum and student- and regulatory-related standards examined were met, but gaps were identified in program staffing and preceptor capacity, and support for faculty and clinical practice sites. In both countries, none of the programs met the average number of clinical practice experiences stipulated in the ICM guidelines due to a lack of teaching hospitals. Students in both countries felt safe on campus but did not feel safe traveling to and from the schools and clinical practice sites.</p><p><strong>Conclusions: </strong>More investment in midwifery education is needed to ensure international standards for quality education are met. Proactive measures are needed to enhance student safety between school and practice settings in conflict-affected settings. By addressing these gaps, we can strive toward improving midwifery education.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"6"},"PeriodicalIF":3.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123789","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":"Perspectives of physicians on risk factors for patient aggression and violence against physicians in Chinese hospitals: a Q-methodology study.","authors":"Yuhan Wu, Kees Ahaus, Jiaming Shi, Dahai Zhao, Martina Buljac-Samardzic","doi":"10.1186/s12960-025-00976-7","DOIUrl":"10.1186/s12960-025-00976-7","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of patient (and their relatives/friends) aggression and violence against healthcare professionals in general, and physicians in particular, is a recognized problem worldwide. While numerous risk factors for such aggression and violence from patients (and their relatives/friends) have been identified, little is known about which risk factors are perceived as relatively most important in a specific context and among a particular group, and about the potentially differing views on the relative importance. This lack of insight prohibits preventive measures being tailored to address the main risk factors.</p><p><strong>Method: </strong>We conducted a Q-methodology study to investigate physicians' perspectives on risk factors for aggression and violence from patients (and their relatives/friends) against physicians in Chinese hospitals. A total of 33 physicians from public Chinese hospitals participated in this study and were asked to rank 30 risk factors according to their importance in triggering violent incidents. In addition, respondents were asked to explain their ranking of most and least important risk factors.</p><p><strong>Results: </strong>By employing a by-person factor analysis, four distinct perspectives on the importance of risk factors were identified: (1) unmet expectations of treatment and lack of resources; (2) perpetrator's educational background and personal characteristics; (3) distrust and limited protection measures; and (4) perpetrator's emotional well-being and poor interaction. There was a consensus across perspectives that failure to meet perpetrator's expectations is one of the most important risk factors and that physician's gender is one of the least important risk factors in the occurrence of patient (and their relatives/friends) aggression and violence against physicians in Chinese hospitals.</p><p><strong>Conclusions: </strong>This study has identified four distinct perspectives held among physicians on the risk factors for patient aggression and violence against physicians in Chinese hospitals. These insights enable the development and prioritization of targeted measures to address specific risk factors according to the dominant views among physicians.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"5"},"PeriodicalIF":3.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013487","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":"A contentious intervention to support the medical workforce: a case study of the policy of introducing physician associates in the United Kingdom.","authors":"Martin McKee, Louella K Vaughan, Giuliano Russo","doi":"10.1186/s12960-024-00966-1","DOIUrl":"10.1186/s12960-024-00966-1","url":null,"abstract":"<p><strong>Background: </strong>Health systems across Europe are facing a workforce crisis, with some experiencing severe shortages of doctors. In response, many are exploring greater task-sharing, across established professions, such as doctors, nurses, and pharmacists, with patients and carers, and with new occupational groups, in particular ones that can assist doctors and relieve their workload.</p><p><strong>Case presentation: </strong>In the early 2000s the United Kingdom created a new occupational role, that of physician assistant. They had a science degree and then underwent a 2-year postgraduate training course. The name soon changed, to physician associate, and the range of roles and responsibilities expanded greatly, although in a largely unregulated manner; by 2024, some were undertaking complex procedures or managing undifferentiated patients in primary care. Catalysed by some high-profile failings, this expansion has generated major concerns, over patient safety and consent, the scope of practice and preferential employment conditions of this group, the adverse consequences for medical training, and the additional medical workload involved in supervision. This has led to a widespread grassroots backlash by the medical profession, often challenging their leaders who had supported this idea. As a consequence, professional bodies that were initially in favour are now expressing serious concerns and it seems likely that the roles and responsibilities of physician associates (and related occupations) will be curtailed. We review published literature and official documentation about this policy to understand the drivers of its development, its benefits, and risks.</p><p><strong>Conclusions: </strong>The experience in the UK offers cautionary lessons for other European countries contemplating similar ideas. It underscores the importance of maintaining trust with those affected by change, undertaking a detailed systems analysis with attention to risks of unintended consequences, agreeing clear role definitions, providing adequate regulatory oversight, and the need to avoid damaging training of future doctors. This case study highlights the need for a carefully thought-out approach that considers both the potential benefits and pitfalls of integrating new roles like physician associates into a healthcare system. The failure to do so has created a new occupational group with unrealistic expectations and has further demoralised an already unhappy medical profession.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"4"},"PeriodicalIF":3.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013546","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":"Gains and pains: a qualitative study on the implications of value-based health care for professionals.","authors":"Veerle van Engen, Igna Bonfrer, Fabio Mieris, Malou Ensink, Anne Stiggelbout, Kees Ahaus, Martina Buljac-Samardzic","doi":"10.1186/s12960-025-00972-x","DOIUrl":"10.1186/s12960-025-00972-x","url":null,"abstract":"<p><strong>Background: </strong>While aiming to optimize patient value, the shift towards Value-Based Health Care (VBHC) in hospitals worldwide has been argued to benefit healthcare professionals as well. However, robust evidence regarding VBHC's workforce implications is lacking. This gap is problematic, as the motivation and health of healthcare professionals are central to the quality of care and crucial amidst contemporary workforce challenges. This study aims to qualitatively examine the implications of VBHC for healthcare professionals' motivation, job strain, and ongoing participation in VBHC. In addition, it explores how these outcomes are regulated at both the individual and organizational levels.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with 26 healthcare professionals across six Dutch hospitals. Interviewees engaged in three VBHC activities: (1) value-based outpatient consultations and/or; (2) value-based quality improvement activities; as well as in; (3) VBHC implementation. Interview questions and data analysis were guided by the Job Demands-Resources model.</p><p><strong>Results: </strong>VBHC interacts with four themes perceived to affect professional's motivation (perception of making a positive impact, enjoyability of job activities, personal development, and sense of community and support) and three themes perceived to affect job strain (workload, cognitive demands, and confidence). VBHC creates both gains (primarily increasing motivation; occasionally reducing strain) and pains (primarily increasing strain; sometimes reducing motivation). The perceived impact of VBHC depends on the fit between the individual, one's activities in VBHC, the working conditions, and the pace of VBHC implementation. An observation that warrants attention is that healthcare professionals with a 'do-er' mentality and high ambitions to optimize patient value can become demotivated to continue advancing VBHC with the same intensity, particularly due to perceived slow progress.</p><p><strong>Conclusions: </strong>While VBHC is centered around patients, this study emphasizes that the needs, experiences and changing role identities of healthcare professionals cannot be overlooked in this transition. VBHC currently presents as a double-edged sword for healthcare professionals: resulting in both gains and pains. In the move to VBHC, it is crucial to maintain alignment between the individual, their job activities, the work environment, and the pace at which VBHC unfolds. This is essential for fostering and retaining motivated individuals, who are not only vital to the workforce but also pivotal in advancing VBHC.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"3"},"PeriodicalIF":3.9,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984919","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":"The equivalent value (EV)-based workload assessment of primary healthcare workers in Beijing, China.","authors":"Shasha Yuan, Tao Yin, Naijie Weng, Zheng Wang, Delu Yin","doi":"10.1186/s12960-024-00970-5","DOIUrl":"10.1186/s12960-024-00970-5","url":null,"abstract":"<p><strong>Background: </strong>Quantitative methods for estimating the workload of primary healthcare (PHC) workers are essential for improving the performance of PHC institutions. However, measuring the workload of PHC workers is challenging due to the diverse and complex range of services covered by PHC. This study aims to use an equivalent value (EV)-based approach to assess the workload of PHC workers and inform policymakers about the current workload burden in Beijing, China.</p><p><strong>Methods: </strong>The EV-based workload assessment system was designed by three main steps: identifying the list of essential PHC service items provided by PHC workers, quantifying the EV of each service item, and calculating the corresponding workload for PHC workers and community health centers (CHCs). The study included 18 CHCs, which were divided into three groups based on population density and topography: Group I (eight urban CHCs), Group II (six CHCs in semi-mountainous areas), and Group III (four CHCs in mountainous areas). Data were collected from local health information system, which automatically collected real-time service volume data for 500 PHC service items at 18 CHCs in the sample district in Beijing from 2017 to 2021.</p><p><strong>Results: </strong>This study identified 503 essential PHC service items and defined their EVs. The theoretical full-capacity workload per PHC worker was 6024 EVs, serving as the base workload. The actual annual workload per PHC worker was 7240.0 EVs during 2017-2021. The base workload per budgeted position for the three types of CHCs was 6468.6 EVs for Group I, 5268.5 EVs for Group II, and 5038.7 EVs for Group III. Compared with the actual workload of 7702.3 EVs, 6568.3 EVs, and 5979.0 EVs in each group, respectively, all PHC workers in the sample district were overburdened during the study period.</p><p><strong>Conclusions: </strong>The EV-based method provides a feasible solution for comprehensively assessing the workload of publicly funded PHC institutions in other regions. This study offers valuable insights to help local policymakers understand the workload burden of PHC workers, objectively evaluate their performance, and guide future health workforce planning.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"2"},"PeriodicalIF":3.9,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11720310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956469","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":"Correction: Informing policy with health labour market analysis to improve availability of family doctors in Tajikistan.","authors":"Jamoliddin Abdullozoda, Salomudin Yusufi, Sulakshana Nandi, Parvina Makhmudova, Juana Paola Bustamante, Margrieta Langins, Alba Llop-Gironés, Ilker Dastan, Victor Olsavszky, Shukhrat Sultonov, Zebo Najmuddinova, Natasha Azzopardi-Muscat, Tomas Zapata","doi":"10.1186/s12960-024-00963-4","DOIUrl":"10.1186/s12960-024-00963-4","url":null,"abstract":"","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"1"},"PeriodicalIF":3.9,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956466","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":"Tackling the primary healthcare workforce crisis: time to talk about health systems and governance-a comparative assessment of nine countries in the WHO European region.","authors":"Ellen Kuhlmann, Michelle Falkenbach, Monica Georgina Brînzac, Tiago Correia, Maria Panagioti, Bernd Rechel, Anna Sagan, Milena Santric-Milicevic, Marius-Ionuț Ungureanu, Iris Wallenburg, Viola Burau","doi":"10.1186/s12960-024-00965-2","DOIUrl":"10.1186/s12960-024-00965-2","url":null,"abstract":"<p><strong>Background: </strong>Primary healthcare has emerged as a powerful global concept, but little attention has been directed towards the pivotal role of the healthcare workforce and the diverse institutional setting in which they work. This study aims to bridge the gap between the primary healthcare policy and the ongoing healthcare workforce crisis debate by introducing a health system and governance approach to identify capacities that may help respond effectively to the HCWF crisis in health system contexts.</p><p><strong>Methods: </strong>A qualitative comparative methodology was employed, and a rapid assessment of the primary healthcare workforce was conducted across nine countries: Denmark, Germany, Kazakhstan, Netherlands, Portugal, Romania, Serbia, Switzerland, and the United Kingdom/ England.</p><p><strong>Results: </strong>Our findings reveal both convergence and pronounced diversity across the healthcare systems, with none fully aligning with the ideal attributes of primary healthcare suggested by WHO. However, across all categories, Denmark, the Netherlands, and to a lesser extent Kazakhstan, depict closer alignment to this model than the other countries. Workforce composition and skill-mix vary strongly, while disparities persist in education and data availability, particularly within Social Health Insurance systems. Policy responses and interventions span governance, organisational, and professional realms, although with weaknesses in the implementation of policies and a systematic lack of data and evaluation.</p><p><strong>Conclusions: </strong>Aligning primary healthcare and workforce considerations within the broader health system context may help move the debate forward and build governance capacities to improve resilience in both areas.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"22 1","pages":"83"},"PeriodicalIF":3.9,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910902","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":"Building health systems resilience in Central Asia through nursing and midwifery: evidence to inform policy action.","authors":"Alba Llop-Gironés, Gulnaz Kachkynovna Azhymambetova, Aizat Kubanysbekovna Asanova, Yusufi Salomuddin, Malohat Hikmatulloevna Boynazarova, Firdavs Orifovich Raupov, Nazira Usenovna Zholzhanova, Naila Beksautovna Ruzdenova, Gulnora Sheraliyevna Tojiboyeva, Rikhsi Kamilovna Salikhodjayeva, Margrieta Langins","doi":"10.1186/s12960-024-00964-3","DOIUrl":"10.1186/s12960-024-00964-3","url":null,"abstract":"<p><strong>Background: </strong>The recent announcement of the next WHO State of the World's Nursing and Midwifery Reports calls for a review of the state of nursing and midwifery worldwide. In the WHO European region, a broad set of health system reforms have been introduced in Central Asian countries (CACs), namely, the Republic of Kazakhstan, the Kyrgyz Republic, the Republic of Tajikistan, Turkmenistan and the Republic of Uzbekistan. These reforms have become the focus of a series of sub-regional policy dialogs between CACs, led by government chief nursing and midwifery officers, to accelerate the implementation of a package of policies to strengthen the capacity of nurses and midwives and build health system resilience. This study reviews the current state of nursing and midwifery capacity and documents future actions that can be taken in CACs.</p><p><strong>Case presentation: </strong>A systematic approach was used to describe trends, capacity and gaps in CACs' education, practice, regulation, leadership, and working conditions of nurses and midwives. Currently, CACs face challenges in increasing the level, quality and evidence-base of nursing and midwifery education, require efforts to expand the role of nurses, with emphasis on PHC and particular attention is required to decent working conditions, including fair income and security in the workplace. The GCNMOs have demonstrated experience in the oversight of both workforces and require support for effective work in making policies. To build health systems resilience in CACs through nursing and midwifery, a strategic package of evidence-informed actions that addresses education, practice, regulation, leadership, and working conditions of nurses and midwives is suggested for the period up to 2030.</p><p><strong>Conclusions: </strong>Current educational reforms and curricular development, combined with innovations in clinical practice and working environment can be pursued to foster better access to quality of care, enhance workplace satisfaction and improve recruitment and retention of nurses and midwives. However, to fully achieve this, CACs will require increased institutional capacity; strengthened data for nursing and midwifery planning in the context of health workforce policy and health priorities, and financial and non-financial investment in the nursing and midwifery workforce.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"22 1","pages":"82"},"PeriodicalIF":3.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855688","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}