Human Resources for Health最新文献

{"title":"Adapting organizational culture scale into healthcare professional education: a scale validity and reliability analysis.","authors":"Aysel Başer, Ömer Faruk Sönmez, Duygu Kürklü Arpaçay, Hatice Şahin","doi":"10.1186/s12960-025-01006-2","DOIUrl":"10.1186/s12960-025-01006-2","url":null,"abstract":"<p><strong>Background: </strong>Organizational culture significantly influences the quality of healthcare services and healthcare professional education. Although various scales exist to measure organizational culture at the undergraduate level, validated instruments specifically tailored for healthcare professional education remain scarce. The study aims to validate the adapted scale and provide empirical insights into organizational culture in healthcare professional education.</p><p><strong>Methods: </strong>The adaptation process involved expert consultations to ensure content and face validity, followed by a mixed-methods approach. Quantitative data were collected from 402 students enrolled in the Faculties of Medicine, Dentistry, and Health Sciences during the 2023-2024 academic year. Exploratory and confirmatory factor analyses were performed to examine the scale's structure. Reliability was assessed using Cronbach's alpha and McDonald's omega coefficients.</p><p><strong>Results: </strong>Expert review led to the removal of redundant and unclear items, refining the scale to 30 items across five subscales: Structural Order and Formality, Belonging and Collective Responsibility, Achievement and Performance Orientation, Authority and Hierarchy, and Competition Orientation. The Kaiser-Meyer-Olkin measure (0.846) and Bartlett's test confirmed sample adequacy. Exploratory factor analysis explained 40% of the total variance. Confirmatory factor analysis showed acceptable model fit indices (χ²/df = 3.37, RMSEA = 0.091, CFI = 0.95, TLI = 0.94). The scale demonstrated strong internal consistency (overall McDonald's ω = 0.878; Cronbach's α = 0.874), although lower reliability was noted for Authority and Hierarchy and Competition Orientation subscales.</p><p><strong>Conclusions: </strong>The adapted organizational culture scale is a valid and reliable tool for assessing organizational culture in healthcare professional education. Its use is recommended for tracking cultural changes and supporting strategic educational improvements. Further validation across different institutions and cultural contexts is encouraged to reinforce its generalizability.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"33"},"PeriodicalIF":3.9,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643685","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":"Inequalities in the distribution of the nursing workforce in the Kingdom of Saudi Arabia: a regional analysis.","authors":"Waleed Kattan, Mohammed Khaled Al-Hanawi","doi":"10.1186/s12960-025-01010-6","DOIUrl":"10.1186/s12960-025-01010-6","url":null,"abstract":"<p><strong>Background: </strong>The global nursing shortage is a growing concern, particularly in regions experiencing rapid population growth and healthcare transformation. This study examines trends and regional inequalities in Saudi Arabia's nursing workforce distribution from 2019 to 2023 within the context of Saudi Vision 2030 and the Health Sector Transformation Program.</p><p><strong>Methods: </strong>Data from the Ministry of Health's 2023 Statistical Yearbook were used for this study. Nurse-to-1 000 population ratios were calculated across 20 health regions. Inequality in the nursing distribution was assessed using Gini coefficients and Lorenz curves, disaggregated by sector (Ministry of Health vs. private health sector) and nationality (Saudi vs. non-Saudi).</p><p><strong>Results: </strong>The national nursing workforce increased by 9% from 2019 to 2023, reaching 213 110 nurses. However, nurse-to-population ratios varied significantly across regions, ranging from 3.13 to 9.89 per 1 000 people. The overall Gini coefficient was 0.48, indicating a relatively unequal distribution of nurses across regions. Inequalities were more pronounced in the private health sector (Gini coefficient = 0.69) and among non-Saudi nurses (Gini coefficient = 0.59). While Saudization efforts led to a modest increase-Saudi nationals comprised 44.22% of the nursing workforce in 2023-localization remained uneven across regions and healthcare sectors.</p><p><strong>Conclusion: </strong>Despite workforce growth and increased localization, Saudi Arabia continues to face considerable regional inequalities in nursing distribution. These disparities require targeted workforce policy interventions, including expanding nursing education opportunities, optimizing working conditions, and implementing strategic workforce plans to distribute nursing resources more equitably. Additionally, offering incentives for deployment in underserved regions will be critical.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"34"},"PeriodicalIF":3.9,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643751","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 an incentives package to attract and retain physicians to underserved areas: a case study from Portugal.","authors":"Sara Alidina, Jesus Cortes, Inês Fronteira","doi":"10.1186/s12960-025-00999-0","DOIUrl":"10.1186/s12960-025-00999-0","url":null,"abstract":"<p><strong>Background: </strong>Physician shortages in underserved areas constitute a common challenge for governments and policymakers worldwide, including in European countries. The health sector in Portugal is characterized by geographical asymmetries in the distribution of physicians and the difficulty in retaining these professionals in certain areas of the country. In 2015, the Portuguese government created an incentive package to attract and retain physicians in underserved areas. In this case study, we describe the process that led to the creation of the incentives package, its main features, and the physicians that have benefited from it, and assess the effectiveness in terms of retention of physicians in the National Health Service (NHS) and the underserved areas.</p><p><strong>Case presentation: </strong>Decree-Law no. 101/2015, published on 4 June, established the terms and conditions for awarding financial and non-financial incentives for physicians who work in underserved areas. It has been a fundamental instrument for attracting and retaining professionals to areas of geographical need, especially in the inner territories, seeking to fill needs and reduce asymmetries in the distribution of resources. In 2017 and 2021, the incentives package was reviewed to meet NHS demands and physicians' expectations.</p><p><strong>Conclusions: </strong>The incentives package implemented in Portugal effectively deployed physicians to underserved areas. The several amendments to the package led to a 14-fold increase in physicians benefiting from the incentives and a 59% retention rate of these physicians in the same underserved health institution. However, the difference between the retention levels of physicians under the incentives package and those not covered is minimal. The financial and non-financial incentives need to be reviewed to better suit physicians' needs and expectations, as well as those of the NHS.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"32"},"PeriodicalIF":3.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12243323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609851","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":"Mitigating health workforce migration in Romania: policy lessons for Europe.","authors":"Tomas Zapata, Teodor Cristian Blidaru, Alexandru Rafila, Radu Comsa, Natasha Azzopardi Muscat, Yanina Andersen, Cris Scotter, James Buchan, Ioana Novac, Khamis Al-Alawy, Nicolae Dragoș Garofil","doi":"10.1186/s12960-025-01003-5","DOIUrl":"10.1186/s12960-025-01003-5","url":null,"abstract":"<p><p>Health workforce migration is an important challenge for healthcare systems across Europe, with Romania facing one of the most significant impacts following its accession into the European Union. This article examines the trends, drivers, and consequences of health workforce migration in Romania, particularly physicians and nurses, explores policy interventions aimed at mitigating its effects and assesses their effectiveness. The analysis highlights the strategies employed to retain and attract healthcare workers, including financial incentives, regulatory reforms, and expanded educational opportunities. The study shows a two-thirds reduction in the annual migration of Romanian doctors to mainly countries of the WHO European Region, decreasing from 1532 in 2012 to just 461 in 2021, demonstrating the significant impact of policy interventions on workforce retention. While these interventions have successfully increased the overall number of health professionals in Romania and reduced overseas migration, challenges remain in ensuring equitable distribution and addressing workforce shortages in key specialties and occupations. Romania's experience offers valuable lessons for other European countries facing similar challenges and offers policy lessons for addressing one of Europe's most pressing healthcare priorities.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"31"},"PeriodicalIF":3.9,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585202","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 influencing work performance and prospective mobile health applications among village health support groups: a formative study for i-MoMCARE development to enhance maternal, newborn, and child healthcare in Cambodia.","authors":"Hendra Goh, Chhavarath Dary, Mengieng Ung, Sreymom Oy, Yan Fang Lee, Sovatha Mam, Sophea Chhorn, Chanthou Ny, Sveng Chea Ath Chhay, Chhorlika Khim, Dyna Khuon, Michiko Nagashima-Hayashi, Sovanthida Suy, Rattana Kim, Siyan Yi, Vonthanak Saphonn","doi":"10.1186/s12960-025-01002-6","DOIUrl":"10.1186/s12960-025-01002-6","url":null,"abstract":"<p><strong>Background: </strong>Village Health Support Groups (VHSGs) are pivotal in delivering maternal, newborn, and child health (MNCH) in underserved Cambodian regions. However, their work performance is influenced by multifaceted determinants, hampering capacity in service delivery. While mobile health applications (mHealth apps) offer a promising avenue to overcome some of these challenges, research on mHealth apps in Cambodia remains scarce. Therefore, this study aims to explore the sociocultural and environmental factors influencing VHSGs' work performance and assess the dynamic influencing their willingness to adopt mHealth apps.</p><p><strong>Methods: </strong>A qualitative study was conducted in Battambang province in May 2023. 38 stakeholders engaged in MNCH service planning and provision were interviewed. We collected data on the factors influencing VHSGs' work performance in delivering MNCH services and examined how these factors impact the potential adoption of mHealth apps. Data were analyzed according to reflexive thematic approach.</p><p><strong>Results: </strong>Findings demonstrated that work performance is influenced by factors spanning all five domains of the socio-ecological model. At the micro-level, intrinsic motivation, strong interpersonal relationships and adequate working knowledge were identified as key enablers. However, main challenges remained at the meso and macro-level, including manpower and resources shortages, limited community trust and the absence of a sustainable financial framework to support VHSGs operations. While stakeholders recognized the potential of mHealth apps as handy job aids to improve work performance, a digital divide exists due to uneven digital literacy, immense workload, and poor digital infrastructure, hampering intention to use.</p><p><strong>Conclusion: </strong>Our findings highlight the pressing need for a stepwise reevaluation of VHSGs employment model to address existing challenges in work performance. This three-pronged approach entails a gradual transition to remunerated positions, accreditation and opportunities for professional development, implemented in successive phases. Additionally, to further boost VHSGs' work performance through mHealth apps, strategies such as cultivating a digitally competent workforce and strengthening digital infrastructure can collectively reduce barriers to adoption and sustain long-term engagement.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"30"},"PeriodicalIF":3.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545386","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":"Development and validation of a tool to assess core competencies of public health professionals in low-income settings: findings from Uttar Pradesh, India.","authors":"Sudip Bhandari, Sara Bennett, David H Peters","doi":"10.1186/s12960-025-00994-5","DOIUrl":"10.1186/s12960-025-00994-5","url":null,"abstract":"<p><strong>Background: </strong>Many low- and middle-income countries (LMICs) lack instruments to measure gaps in the public health competency of health professionals. The objective of this study is to develop a validated and reliable Core Public Health Competency (COPHEC) index by assessing the knowledge, skills, abilities, and attitudes of senior and mid-level public health professionals with supervisory and management responsibilities in Uttar Pradesh (UP), India.</p><p><strong>Methods: </strong>Using the Core Competency framework that was developed in UP, we generated a draft COPHEC tool with 37 items, measured on a four-point Likert scale. We administered the tool to a total of 166 public health professionals that included two samples-84 senior and 82 mid-level public health professionals. To extract factors and assign factor scores to the instrument, we performed an exploratory factor analysis (EFA) using principal component analysis (PCA). Content and face validities were assessed by examining the steps used for the construction of the draft tool. Construct validity was measured by assessing the average factor loading of the items onto the component extracted from EFA. Internal consistency was used as a measure of reliability.</p><p><strong>Results: </strong>The final COPHEC index had 37 items loaded on one factor in the sample. Content and face validities were assured through a participatory process with relevant stakeholders who identified the initial set of items as part of a Core Competency framework. Construct validity of the COPHEC scale was confirmed by the high average factor loading of components ranging from 0.58 to 0.81. The final index showed adequate reliability with Cronbach's alpha (α) = 0.97.</p><p><strong>Conclusions: </strong>The COPHEC index is a valid and reliable measure of core competencies in public health in UP. We recommend that governments adapt the index in LMICs to conduct assessments of health workers to identify training needs, evaluate the effectiveness of training programs through participants' competency acquisition pre- and post-training, and inform workforce development efforts in recruitment and performance management.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"29"},"PeriodicalIF":3.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477193","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 perceptions of work motivation through the experiences of healthcare professionals who provided end-of-life care during the COVID-19 pandemic (PRECA-C project): a qualitative study.","authors":"Makiko Sano, Hiroko Mori, Akira Kuriyama, Haruki Imura, Mayumi Nishimura, Mayumi Toyama, Takeo Nakayama","doi":"10.1186/s12960-025-00997-2","DOIUrl":"10.1186/s12960-025-00997-2","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic posed unprecedented challenges for frontline healthcare professionals (HCPs), leading to high rates of burnout and decreased work motivation. Limited ability to provide adequate end-of-life (EOL) care caused moral distress and ethical dilemmas. However, factors that prevent burnout, reduce intent to leave, and enhance professional fulfillment remain underexplored. This study aimed to explore HCPs' perceptions of work motivation during the pandemic, seeking insights to support their continued dedication.</p><p><strong>Methods: </strong>A qualitative descriptive study was conducted through online semi-structured interviews (from August to December 2021) with HCPs who provided EOL care, working at intensive care units, specialized COVID-19 wards, and general wards across Japan. Aiming for a diverse sample in terms of gender, occupation, hospital size, and location, interviewees were recruited via the network of the Department of Health Informatics, School of Public Health, Kyoto University. Inductive thematic analysis was applied to interpret the data semantically.</p><p><strong>Results: </strong>The study participants were 33 HCPs (15 physicians and 18 nurses) from 13 prefectures. The following four main themes with 13 categories were revealed: Developing proficiency in COVID-19 EOL care through HCP experiences, Unity as a multidisciplinary COVID-19 team, Managerial personnel who understand and support staff in fluctuating work, and Social voices from outside of hospitals. These themes uncovered possibilities beyond the personal traits of HCPs and influenced their motivation by incorporating factors associated with healthcare teams, organizations, and wider societal contexts.</p><p><strong>Conclusion: </strong>In this study, four themes, including the importance of organizational management to prevent isolation, maintaining connections among colleagues, and the need for supportive social voices from outside the hospital, emerged from interviews regarding HCPs' work motivation during the pandemic. These findings highlight the complex interplay of individual, organizational, and societal factors in shaping HCPs' motivation during pandemic waves.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"28"},"PeriodicalIF":3.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295089","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":"Optimizing the health workforce for Universal Health Coverage: a framework for analysis and action.","authors":"Gafar B Alawode, Abdul-Rahman A Ajibola, Morohunranti S Sanusi, Ayomide B Adewoyin, Kafayat A Alawode","doi":"10.1186/s12960-025-01000-8","DOIUrl":"10.1186/s12960-025-01000-8","url":null,"abstract":"<p><strong>Background: </strong>The health workforce or human resources for health (HRH) is the bedrock of an efficient healthcare system, and the consequences of HRH shortage are evident in poor health service delivery. Many low- and middle-income countries (LMICs) have a suboptimal HRH density, far from the Sustainable Development Goals (SDG) target of 4.45 doctors, nurses, and midwives per 1000 population. Despite income levels influencing HRH density, variations in the number of health workers per capita and their performance highlight the need to optimize HRH within any economic context. This study presents a practical framework for optimizing the health workforce in LMICs, using Nigeria as a case study.</p><p><strong>Methods: </strong>This research introduces a comprehensive HRH optimization framework derived from a strategic blend of existing frameworks, mainly the International HRH Action Framework, the WHO HRH Assessment Guidelines, and the WHO Health System Governance Action Plan for UHC. The study used a qualitative approach to apply this framework in assessing the HRH challenges and potential optimization strategies in Nigeria using data from a review of relevant documents and key informant interviews at the national and state levels.</p><p><strong>Results: </strong>The study reveals a complex HRH landscape in Nigeria, where policies such as Task Shifting and National HRH Policy coexist with challenges in implementation, funding, and political interference. Institutional arrangements show potential for HRH optimization in states such as Gombe and Kaduna but face staffing and funding limitations. Data utilization for HRH decision-making is hindered by integration issues, while political dynamics influence policies and practices, leading to disparities in healthcare access. Challenges in workforce planning, recruitment, administration, and motivation underscore the need for targeted interventions and systemic reforms to optimize HRH density, distribution, skill mix, performance, service coverage, quality of care, and equity of access, crucial for improving healthcare delivery and ensuring equity nationwide.</p><p><strong>Conclusion: </strong>As demonstrated in Nigeria, the HRH optimization framework effectively assesses and plans HRH optimization strategies. LMICs facing HRH shortages can use this framework to identify HRH optimization opportunities within their health systems, leading to improved health service.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"27"},"PeriodicalIF":3.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276220","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":"Labour precariousness in the Mexican health workforce: taking to the surface a neglected problematic issue.","authors":"Gustavo Nigenda, Edson Serván-Mori, Patricia Aristizabal, Rosa Amarilis Zárate-Grajales, Germán Fajardo-Dolci, Rafael Lozano","doi":"10.1186/s12960-025-00975-8","DOIUrl":"10.1186/s12960-025-00975-8","url":null,"abstract":"<p><strong>Background: </strong>Little attention has been paid to quantifying job precariousness among health workers in low- and middle-income countries. Analytical models of human resources for health omit work precarity as a relevant phenomenon. However, analysing job precariousness is critical to improving health systems' performance.</p><p><strong>Methods: </strong>We analysed pooled cross-sectional population-based data from Mexico's National Occupation and Employment Survey for 31,394 physicians and nurses between 2005 and 2022, representing almost 7, 8 million nationally throughout the study period. We used a pooled state and year fixed-effects multiple logistic regression to estimate the likelihood of having precarious employment for each survey year in both groups and according to the private/public employment sector. We conducted post hoc comparisons of quintiles of changes (2005-2022) in the adjusted percentage of labour precariousness according to the employment sector and of the private-public labour precariousness gap by state.</p><p><strong>Findings: </strong>There was sustained growth in labour precariousness (from 58.7 and 49.0% in 2005 to 75.5% and 67.3% in 2022 among physicians and nurses, respectively). In both groups of professionals, labour precariousness was steadily higher in the private sector. However, the private-public gap narrowed to a greater extent and more accelerated among physicians than among nurses. The reduction in the private-public precariousness gap was not territorially random either (range - 39.5% to - 46.9%), with higher levels of convergence between both labour sectors, especially in the poorest socioeconomic regions.</p><p><strong>Conclusions: </strong>The differences in the nursing and medical labour market composition have exposed the latter to the growth of precariousness due to their historical link with the private sector. The closing of the gap between public and private is a result of the recent expansion of precarious work in the latter. It is essential to develop regulatory policies to reduce precariousness and its effects on the health system applicable to both sectors.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"26"},"PeriodicalIF":3.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227066","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":"Effect of differentiated service delivery models for HIV treatment on healthcare providers' job satisfaction and workloads in sub-Saharan Africa: a mixed methods study from Malawi, Zambia, and South Africa.","authors":"Vinolia Ntjikelane, Bevis Phiri, Jeanette L Kaiser, Sydney Rosen, Allison J Morgan, Amy Huber, Idah Mokhele, Timothy Tchereni, Stanley Ngoma, Priscilla Lumano-Mulenga, Sophie Pascoe, Nancy Scott","doi":"10.1186/s12960-025-00993-6","DOIUrl":"10.1186/s12960-025-00993-6","url":null,"abstract":"<p><strong>Introduction: </strong>HIV care providers are often overworked and suffer from burnout and low job satisfaction. Differentiated service delivery (DSD) models for HIV treatment aim to decongest clinics and improve providers' quality of professional life by reducing the client/provider ratio and allowing for more time with clients in need. We investigated current job satisfaction and perceived changes in job satisfaction among HIV care providers in Malawi, South Africa, and Zambia after the adoption of DSD models of care in each country.</p><p><strong>Methods: </strong>We conducted a concurrent, cross-sectional mixed methods survey with clinical and non-clinical HIV care providers between April 2021 and January 2022 at public sector clinics in Malawi (n = 12), South Africa (n = 21), and Zambia (n = 12). Questions investigated the effect of DSD models on provider responsibilities, work burden, time allocation, and job satisfaction. We conducted a principal components analysis of survey responses to create a job satisfaction index and estimated odds ratios (OR) using logistic regression for associations between key variables and low reported job satisfaction. We reported emerging qualitative themes. We used Herzberg's two-factor theory to organize and interpret results, identifying motivating factors (which lead to job satisfaction) and hygiene factors (which we refer to as maintenance factors, that lead to dissatisfaction if lacking).</p><p><strong>Results: </strong>Providers had generally high job satisfaction. Providers from Malawi were more likely to report lower job satisfaction than those from South Africa or Zambia (adjusted OR (aOR) 4.56; 95% confidence interval (CI) [2.12-9.80]). Providers who believed that their jobs became harder after the introduction of DSD models (2.82; [1.14-6.96]) or that their jobs did not change (6.50; [2.50-16.89]) were more likely to report lower job satisfaction than those who believed their jobs became easier. Qualitatively, providers felt DSD models improved their working conditions by easing clinic congestion and allowing them to spend more time on other tasks. Providers were particularly motivated when they could spend more time with clients.</p><p><strong>Conclusion: </strong>Findings highlight the importance of DSD models in maintaining or improving healthcare providers' quality of professional life and underscore the need for continued monitoring of the impact of these models on job satisfaction among HIV care providers in resource-constrained settings.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"25"},"PeriodicalIF":3.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152254","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}