Human Resources for Health最新文献

{"title":"Career trajectories of master of public health graduates from South African universities.","authors":"Virginia Zweigenthal, Nicola Christofides, Thembelihle Dlungwane, Sogo France Matlala, Mathildah Mpata Mokgatle, Abraham Opare, Sean Mark Patrick, Nikki Schaay, Maylene Shung-King, Takalani Tshitangano, Laetitia Rispel","doi":"10.1186/s12960-026-01063-1","DOIUrl":"10.1186/s12960-026-01063-1","url":null,"abstract":"<p><strong>Background: </strong>The Covid-19 pandemic highlighted the need for public health professionals to be embedded in country health systems. The Master of Public Health (MPH), offered widely, is accepted as the entry degree for public health practice in low- and middle-Income countries (LMICs). The aim of the study was to address the knowledge gaps on the career trajectories of MPH graduates from South African universities.</p><p><strong>Methods: </strong>A research team from the eight South African universities that graduated MPH students between 2012 and 2016 obtained lists of alumni and invited them to participate in an on-line survey. The self-administered questionnaire elicited the demographic characteristics of MPH graduates, their educational and work background, the impact of the MPH on their subsequent work and their perspectives on the roles of MPH graduates.</p><p><strong>Results: </strong>The overall 37% response rate varied by institution. Respondents were mid-career professionals, in their mid-30s with on average, nine years work life. A sizeable proportion came from sub-Saharan Africa and they returned to their home or a neighbouring country to work. Most had been managers or patient-facing health professionals, and the MPH was the route to shift into public health roles. After MPH completion, 91% were employed in government (40%), non-governmental organisations (32%) or academic/research institutions (21%) in technical, managerial or academic roles. The MPH was a stepping stone for career advancement, and 55% of study participants changed their employers post qualification. They envisaged that MPH graduates could assume leadership positions and effectively contribute across both technical and managerial domains, including during public health emergencies.</p><p><strong>Conclusion: </strong>The MPH degree was pivotal to graduates taking on public health roles in their home countries. In view of public health workforce shortages, the study findings contribute to planning for a competent cadre to tackle pressing public health problems and their social determinants and support robust health systems development in Africa.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13185223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595303","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":"Monitoring and evaluation strategies for surgical task-shifting and task-sharing interventions: a scoping review.","authors":"Catherine Binda, Rachel Livergant, Jamie Tersago, Zainab Jami, Le Qi Chen, Leah Birch, Chloe Blackman, Esther Chin, Hannah Wild, Emilie Joos, Shahrzad Joharifard","doi":"10.1186/s12960-026-01056-0","DOIUrl":"10.1186/s12960-026-01056-0","url":null,"abstract":"<p><strong>Background: </strong>Task shifting and task sharing (TS/S) redistribute responsibilities across cadres to expand access to healthcare, particularly in underserved areas. TS/S addresses workforce shortages and improves the availability of essential surgical procedures. The scope and geographical distribution of surgical TS/S programs are well documented, less is known about how TS/S initiatives are monitored and evaluated, especially with respect to trainee, program, and health systems outcomes. This review describes existing approaches to evaluation within surgical TS/S initiatives.</p><p><strong>Methods: </strong>We searched nine electronic databases (MEDLINE [Ovid], Embase [Ovid], CINAHL [EBSCO], Scopus, CABI Digital Library, Clarivate Web of Science, Evidence Aid, Global Index Medicus, and Eldis) on 31 January 2024 and 12 March 2025, using MeSH terms and keywords related to \"Task Sharing\" AND \"Surgery\". All patient populations, practice settings, surgical skills, and study designs were eligible. No language or time restrictions were utilized. Publications that did not describe the evaluation of surgical skills, or that focused on skills within a practitioner's typical scope of practice, were excluded. Two reviewers independently screened and extracted data. Risk of bias was assessed with MINORS. Findings were synthesized using inductive content analysis. Results were tabulated and presented graphically.</p><p><strong>Results: </strong>Of 2483 identified records, 1609 unique publications were screened, 452 underwent full-text review, and 228 were included in the review. Most studies reported surgical TS/S in low-income countries (41.7%, 95/228). Obstetric and gynaecological procedures were most commonly taught (61.4%, 140/228). In total, 1753 examples of evaluation metrics were extracted from the 228 included publications. The evaluation metrics were sorted into three themes, including metrics that evaluated TS/S providers (72.6%, 1272/1753), training programs (7.5%, 132/1753), and systems (19.9%, 349/1753).</p><p><strong>Conclusion: </strong>This scoping review comprehensively describes existing evaluation strategies. While evaluation of surgical TS/S initiatives remains heterogeneous, limiting the generalizability of any single approach, we successfully grouped monitoring and evaluation metrics into three key domains: provider, program, and health systems. Future work should focus on proposing a comprehensive but adaptable monitoring and evaluation framework that can be used by surgical TS/S programs across the globe.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147522502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Future doctors, future scholars: factors influencing China-educated international medical students' career intentions in primary care and academic medicine.","authors":"Wen Li, Robyn M Gillies, Hong Sun, Asaduzzaman Khan","doi":"10.1186/s12960-026-01062-2","DOIUrl":"10.1186/s12960-026-01062-2","url":null,"abstract":"<p><strong>Background: </strong>Critical workforce shortages in primary care (PC) and academic medicine (AM) persist in many low- and middle-income countries (LMICs). China hosts approximately 68,000 international medical students (IMSs), primarily from LMICs, constituting a potential workforce solution. However, little is known about factors shaping their intentions towards PC and AM. This study investigates these influences using established career-choice frameworks in the Chinese context.</p><p><strong>Methods: </strong>An exploratory sequential mixed-methods study was conducted following the instrument development model. Qualitative interviews (n = 20) identified influencing factors, which informed a quantitative survey distributed to IMSs at 17 Chinese institutions. Responses from LMIC-origin IMSs were analysed. Principal component analysis (PCA) extracted viewpoint components, and hierarchical logistic regression examined the effects of individual, institutional, and viewpoint factors on students' intentions toward PC and AM.</p><p><strong>Results: </strong>Qualitative findings revealed IMSs' career intentions were shaped by multiple interacting factors across home- and host-country contexts. Among the 961 surveyed IMSs, 15.6% (n = 150) chose PC specialties, and 36.3% (n = 349) preferred AM. PCA identified three components from viewpoint factors: \"personal needs to satisfy\", \"perceptions of work characteristics\", and \"social needs to satisfy\" (Kaiser-Meyer-Olkin index 0.946, p < 0.001, 60.5% of variance explained). Regression models showed PC preference was positively associated with older age and rural/regional origin, and negatively associated with personal needs to satisfy. AM preference was positively associated with older age, lower study year, originating from the African region compared to other nationalities, and higher-ranked institutions.</p><p><strong>Conclusion: </strong>IMSs' intentions towards PC and AM are shaped by student characteristics, personal needs, and institutional environments, offering valuable insights for LMIC workforce planning. Chinese institutions can strengthen this potential by embedding targeted PC and AM modules, expanding research and mentorship opportunities, refining admissions to prioritise likely candidates, and supporting cross-cultural training. These strategies align international medical education with LMIC health priorities and inform career guidance and tailored support for globally trained physicians.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515594","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 professionalisation paradox: retaining the health advantages of community-based providers in task shifting and task sharing initiatives.","authors":"Shukanto Das, Liz Grant, Aaron Orkin","doi":"10.1186/s12960-026-01059-x","DOIUrl":"10.1186/s12960-026-01059-x","url":null,"abstract":"<p><p>Task shifting and task sharing involve the deliberate redistribution of healthcare responsibilities to non-specialist workers to maximise resources, expand access, and enhance health. Structured training, regulatory measures, and monitoring can transform non-specialist workers into nascent professionals. While this is often assumed to be beneficial, it can create new scarcities and resource pressures. We call this the \"Professionalisation paradox\": task shifting and sharing initiatives are often successful because they bring non-professional workers and approaches into healthcare delivery, but the very success of those programmes frequently prompts the professionalisation of the workers and roles involved. We explore paramedicine as a case study, where emergency responders started as part of a task shifting-based approach from military medicine to fill gaps in civilian emergency care, but have now become a professional group bound by rules that can restrict their flexibility. Professionalisation offers advantages such as improving care standards, safety, and worker employment security. However, this also means that paramedics are less able to act freely and compassionately, as they might feel limited by regulations or fearful of making mistakes. We propose ways to balance the benefits of professionalisation while keeping task shifting and task sharing adaptable and community-focused. Future approaches to creating task shifting and task sharing-based models of service delivery might include combining structured training with more flexible methods. This will allow providers to use their skills without feeling overly restricted. Creating supportive policy frameworks around these roles could help maintain accountability and give them more room to respond to patient needs. Striking this balance will help ensure that task shifting and task sharing retain their core purpose of providing accessible, responsive care.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"24 1","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445553","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":"Health workforce planning methods in rural and remote primary care: a scoping review.","authors":"Geoff Argus, Belinda Gavaghan, Jean Spinks","doi":"10.1186/s12960-026-01060-4","DOIUrl":"10.1186/s12960-026-01060-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Rural and remote communities experience poorer health outcomes and lower life expectancy than their metropolitan counterparts. This is in part due to the lack of access to an appropriately skilled health workforce to meet their primary healthcare needs. Various health workforce planning and forecasting methods have been described in the literature at the country and regional level; however, methods designed specifically for rural and remote communities may be required. The aim of this scoping review is to identify and critically analyse existing methods for health workforce planning and forecasting in rural and remote primary care to improve access to primary care services in those communities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A comprehensive search strategy was developed and conducted in PubMed, SCOPUS, EMBASE and CINAHL for peer-reviewed articles published in English between January 2005 and July 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The search yielded 3938 records for screening and 57 full-text studies were assessed for eligibility, resulting in 26 articles included in the final review. Articles originated from 10 countries with the majority from Australia. Data sources used in planning included administrative registries, census and demographic data, health service utilisation records, workload and service statistics, population surveys, and qualitative inputs such as expert consensus and stakeholder engagement. Five approaches to workforce planning were identified: Workload Indicators of Staffing Need (WISN), geospatial accessibility and catchment models, stock-flow forecasting models, skill-mix and competency-based planning, and synthetic estimation modelling.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Findings highlight a lack of clear guidance for policymakers in how to choose planning methods aligned to the models of care used (or visioned) in rural and remote areas. Whilst a \"whole of system\" approach at a local level shows promise, there is a lack of clearly accepted methods and empirical evidence evaluating the effectiveness of such approaches. Additionally, the limited integration of workforce competency metrics alongside traditional headcount represents a notable gap, constraining opportunities for competency and skills-based planning at scale. Planning undertaken in isolation from the different models of care employed in rural and remote areas is likely to exacerbate workforce maldistribution. Progress requires the creation of integrated, longitudinal, competency-linked workforce datasets that link administrative, clinical and population domains to capture the dynamic realities of practice, including geography, mobility, workload intensity, models of care, scopes of practice and role flexibility to inform responsive rural and remote primary care workforce planning a","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391348","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":"Healthcare conflict management in resource-constrained settings: evidence from two hospitals in Ghana.","authors":"Charles Owusu-Aduomi Botchwey, Juanitta Acquah-Greens, Susana Adutwumwaa, Lawrencia Aggrey-Bluwey, Foster Abrampa Opoku-Mensah, Emmanuel Sei Nkpetri","doi":"10.1186/s12960-026-01053-3","DOIUrl":"10.1186/s12960-026-01053-3","url":null,"abstract":"<p><strong>Background: </strong>Conflict is a recurring feature of healthcare delivery, especially in hospitals that operate with limited staff, inadequate supplies, and heavy workloads. Although conflict among healthcare workers in Ghana has been documented, little research has explored how it emerges within the everyday routines of resource-constrained hospitals or how staff interpret and respond to it. This study examined the causes, effects, and management of institutional conflict in two public hospitals in the Effutu Municipality, using Organizational Information Theory and the Institutional Logics Perspective to guide interpretation.</p><p><strong>Methods: </strong>A qualitative phenomenological approach was used to explore staff experiences of workplace conflict. Thirty healthcare workers from clinical, administrative, and support units were purposively selected based on their direct exposure to work-related conflict. Data were gathered through semi-structured interviews and four focus group discussions, audio-recorded with consent, transcribed verbatim, and analyzed thematically following Braun and Clarke's framework. Trustworthiness was ensured through triangulation, member checking, reflexive journaling, and a clear audit trail.</p><p><strong>Results: </strong>Conflict stemmed from three overlapping sources, namely communication breakdowns, competing professional priorities, and interpersonal or behavioral tensions. Staff described rushed or incomplete handovers, unclear directives, and documentation gaps as frequent triggers. Disagreements between clinicians and administrators over resource use and decision-making authority intensified these tensions, particularly in moments of scarcity. Personal attitudes, tone of communication, and strained relationships further complicated teamwork. The effects were substantial, including threats to patient safety, reduced productivity, emotional exhaustion, and concerns about the hospitals' public reputation. Conflict was managed through management-led mediation, appeals to professional codes of conduct, and informal grouping of staff with shared backgrounds, though these strategies often addressed surface issues rather than underlying structural pressures.</p><p><strong>Conclusion: </strong>Addressing healthcare conflicts requires more than interpersonal mediation. Strengthening communication processes, supporting collaborative decision-making, investing in staff capacity, and improving organizational systems are essential for reducing conflict and improving patient care.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12998051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167005","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":"Wage gap among Iranian nurses: a decomposition analysis in Southern Iran.","authors":"Mohsen Bayati, Ali Keshavarzi, Ali Majidpour Azad Shirazi","doi":"10.1186/s12960-026-01054-2","DOIUrl":"10.1186/s12960-026-01054-2","url":null,"abstract":"<p><strong>Background: </strong>Nurses are crucial for high-quality healthcare, but there's a growing shortage. Wage inequality is a significant problem among nurses, affecting both nurses and patient care. This study investigates the wage gap among nurses in Iran.</p><p><strong>Methods: </strong>This study examined wage inequality among 595 nurses using wage quartiles, Lorenz curves, and a Gini coefficient (GC) decomposition. The decomposition method was used to analyze the contributions of within, between, and overlap subgroups to the overall wage inequality, along with the population share, wage share, and GC for each subgroup of nurses.</p><p><strong>Results: </strong>The findings revealed that nurses in the top quartile earn 2.03 times more than nurses in the bottom quartile, with respective wage rates of $9.31 and $4.58. The total GC for nurses' wages was 0.16, indicating a moderate wage gap. Among nurses, those in specialized roles had the highest wage at $9.10 based on Purchasing Power Parity (PPP). This was followed by nurses aged over 40 years ($8.30), nurses with over 15 years of work experience ($8.15), and those working in psychiatric centers ($8.08). Conversely, the lowest wage rates among nurses were observed in those working in non-provincial hospitals ($5.51), followed by nurses in the private sector ($5.73), and nurses working in general hospitals ($5.76). The GC analysis revealed that the highest wage inequality was among nurses working in hospitals specializing in Ophthalmology and ENT (GC = 0.23), the private sector (GC = 0.18), and emergency departments (GC = 0.18). Conversely, the lowest wage inequality was observed in nurses working at the surgery department (GC = 0.10) and cardiology hospitals (GC = 0.11).</p><p><strong>Conclusions: </strong>The wage gap among Iranian nursing staff was moderate. Work experience, employment type, age, number of children, hospital specialty, workplace sector, and department significantly affected wage inequality among nurses, while gender and academic qualifications had no significant impact on the wage gap. Considering the importance of the wage gap for nurses' motivation and function, policymakers should consider these key determinants and develop targeted strategies to mitigate the wage gap among nurses.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150890","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 nationwide cross-sectional survey on factors affecting turnover intention among hospital pharmacists.","authors":"Junsung Nam, JaeEun Han, Young-Mi Ah, Yun Mi Yu","doi":"10.1186/s12960-026-01052-4","DOIUrl":"10.1186/s12960-026-01052-4","url":null,"abstract":"<p><strong>Background: </strong>Hospital pharmacists play a pivotal role in ensuring the safe and effective use of medications, thereby supporting the quality of care and the resilience of health systems. Identifying the factors influencing turnover intention among hospital pharmacists and implementing strategies to maintain an appropriate talent pool can contribute to strengthening public health and improving patient outcomes. This study aimed to identify the factors influencing turnover intention among hospital pharmacists in South Korea and provide implications for strategies to support pharmacist retention.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted in July 2024 with 592 full-time pharmacists employed in tertiary and general hospitals using proportional stratified sampling by hospital type and region, representing 16.0% of the pharmacists working in these hospitals. The questionnaire incorporated items from Mitchell's Job Embeddedness theory, the Korean Occupational Stress Scale, and Singh's turnover intention scale, and underwent expert content validation and exploratory factor analysis. Multivariable linear and logistic regression analyses were performed to determine the factors associated with turnover intention after adjusting for key demographic and institutional characteristics.</p><p><strong>Results: </strong>Among the 592 respondents, 255 (43.1%) had high turnover intention, with shorter employment durations associated with higher turnover intention scores. Within job embeddedness, factors significantly reducing turnover intention included fit to organization_task, organization-related sacrifice_direct, link to organization_task, and link to community_transverse. Within job stress, the factors that significantly increased turnover intention were lack of rewards, job demand_density, and organizational system_fairness. The identified associations were consistent across both linear and logistic regression models, supporting the robustness of the findings.</p><p><strong>Conclusions: </strong>To retain skilled professionals, hospitals should improve their reward structures, foster a culture of fairness, and provide targeted support to junior pharmacists. Improving role fit in task assignments may help reduce turnover risk and enhance workforce stability.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":" ","pages":"10"},"PeriodicalIF":5.4,"publicationDate":"2026-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12895604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137932","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":"Area remoteness and the distribution and attrition of the rural health workforce in Australia.","authors":"K Shuvo Bakar, Peter Radchenko, Nam Ho-Nguyen, Ellen McDonald, Ross Bailie","doi":"10.1186/s12960-026-01050-6","DOIUrl":"10.1186/s12960-026-01050-6","url":null,"abstract":"<p><strong>Background: </strong>The health workforce (HW) plays an important role in patient care, and in rural Australia its distribution varies substantially. This paper explores trends in Australia's HW full-time equivalent (HW-FTE) rates and estimates the risk of HW attrition phenomena using data from local government areas (LGAs) during 2013-2021.</p><p><strong>Methods: </strong>Trends and spatial analyses were used to understand HW-FTE rates for allied health professionals, medical practitioners, and nurses and midwives in four major types of Australian Statistical Geography Standard (ASGS) remoteness areas. The time-to-event modelling was used to identify HW retention times and probability of HW attrition, by remoteness areas and major states in Australia.</p><p><strong>Results: </strong>On average the HW-FTE rate at the granular geo-spatial LGA level exhibits variation in trends between States, rurality, LGA and health professional groups over the study period. The increase in the HW-FTE rate over time for medical practitioners and allied health professionals is lower for outer regional, remote, and very remote Australia compared to inner regional Australia. The HW-FTE rate is also consistently lower for rural Australia compared to major cities irrespective of HW professions. The average HW retention time estimated for allied health was highest in major cities (5 years), and lowest in outer regional areas (3 years). States such as NSW and QLD had more than 4 years of HW retention time for medical practitioners. For nurses and midwives, the average retention time was less than 3 years for all states in Australia. There is variation in trends in HW-FTE rate between LGAs within and between States, including markedly contrasting trends between geographically adjacent LGAs.</p><p><strong>Conclusions: </strong>Our results provide new insight into variation in HW availability, and trends in availability, between major health professional groupings between States, degrees of rurality and local government areas across Australia. This presents new opportunities for understanding and addressing factors that underly the variation in trends for the purpose of refining policy and programs that aim to address the persistent maldistribution and shortages in health worker availability between major cities and regional and remote parts of Australia.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12930739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146067224","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 impact of comprehensive training on safe cesarean delivery on non-physician surgeons' knowledge in Tigray, Ethiopia: a pre- and post-test embedded mixed-methods study.","authors":"Hale Teka, Mussie Alemayehu, Mengistu Hagazi Tequare, Hailemariam Gebrearegay Haileeyseus, Kiros Tesafy, Hailesllassie Berhe, Rahel Nardos","doi":"10.1186/s12960-026-01051-5","DOIUrl":"10.1186/s12960-026-01051-5","url":null,"abstract":"<p><strong>Background: </strong>In Ethiopia, non-physician surgeons, such as Integrated Emergency Surgical Officers (IESOs) and MSc Clinical Midwives, provide critical comprehensive emergency obstetric and surgical care in areas, where physician shortages persist. Although task shifting has improved access to maternal healthcare services in many low-resource settings, maternal and newborn mortality remain high, particularly in the conflict-affected Tigray region. This study aimed to assess the impact of a comprehensive training program on safe cesarean delivery, essential newborn care, and obstetric anesthesia on IESOs' knowledge.</p><p><strong>Methods: </strong>An embedded mixed-methods design was employed. Quantitative data included a pre-post-test on safe cesarean delivery, early neonatal care, and obstetric anesthesia, as well as a before-and-after training assessment of seven core domains (historical background of cesarean delivery, indications for and safe prevention of cesarean delivery, preoperative preparation, surgical technique, difficult cesarean delivery, early neonatal care, and obstetric anesthesia). Fifty-nine IESOs in Tigray were enrolled. Qualitative data were obtained from two focus group discussions and five in-depth interviews that explored training adequacy and professional competency. Quantitative data were analyzed using R (version 4.6.2), and qualitative data were thematically analyzed using ATLAS.ti (version 7).</p><p><strong>Results: </strong>A total of 59 participants took part in the quantitative component, 94.9% of whom were male. The mean pre-training knowledge test score on safe cesarean delivery, early neonatal care, and obstetric anesthesia was 60.1 (± 8.7). This increased to 75.7 (± 10.58) on post-training test (mean difference 15.6, 95% CI 13.31-17.9, p < 0.001). The self-reported understanding of the seven domains improved from 17.1 (± 4.2) to 21.5 (± 4.3) (p < 0.001). Qualitative findings confirmed high appreciation of the training's relevance and possible practical application but also highlighted concerns about long-term support, career and skills advancement, and resource constraints in the post-conflict environment.</p><p><strong>Conclusions: </strong>Comprehensive and context-specific training significantly enhanced the knowledge of non-physician surgeons in safe cesarean delivery, early neonatal care, and obstetric anestehsia in Tigray. Ongoing mentorship, career development opportunities, and system-level support are crucial for sustaining these gains and rebuilding maternal and newborn health services in conflict-affected and other resource-limited settings.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":" ","pages":"13"},"PeriodicalIF":5.4,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12918043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146067366","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}