Human Resources for Health最新文献

{"title":"Digitalized human resources for health information systems in low- and middle-income countries: a scoping review.","authors":"Mari Nagai, Raymond Mufwaya-Nsene, Moe Moe Thandar, Sadatoshi Matsuoka, Sumiyo Okawa, Noriko Fujita","doi":"10.1186/s12960-025-01043-x","DOIUrl":"10.1186/s12960-025-01043-x","url":null,"abstract":"<p><strong>Background: </strong>Tracking country-wide human resources for health (HRH) information is a milestone in the global strategy for HRH 2030, and digitalized HRH information systems have been recommended by the World Health Organization. However, the implementation status differs among countries, and most systematic reviews on this topic have been conducted in high-income countries. This scoping review aimed to identify (1) stages of implementation, (2) functional components, (3) facilitators and barriers, and (4) policy impacts or outcomes of digitalized HRH information systems in low- and middle-income countries (LMICs).</p><p><strong>Methods: </strong>The methodological framework of the Johanna Briggs Institute was used in this scoping review. English articles in two databases (PubMed and Web of Science) with publication dates ranging from inception to August 2023 were gathered, followed by a gray literature search and a reference search. Two author pairs independently performed the study selection. Data were extracted, analyzed, and presented in tabular form alongside a narrative summary.</p><p><strong>Results: </strong>Forty studies and gray literature from 26 LMICs in Asia and Africa were included in the scoping review. Thirty-three studies and gray literature covered different stages of digitalized HRH information systems' implementation, including development, pilot, rollout, and maintenance. The HRH registry was the most common, whereas finances and migration were the least common functional components. Thirty-two studies and gray literature reported barriers and facilitators, stratified into four factors and stages. Many barriers were identified in organizational and environmental factors, especially in governance. Interoperability among multiple HRH information systems within a country is the key facilitator, where development partners play a critical role. Sixteen studies and gray literature from nine countries reported positive policy impacts/outcomes. Political commitment, strong national and subnational leadership, and coordination mechanisms among national stakeholders and development partners were key to gaining policy impact.</p><p><strong>Conclusions: </strong>Barriers and facilitators were common across the studies, and governance factors were particularly crucial at all stages of digitalization. Our stratified methodology for analyzing facilitators and barriers can serve as an analytical framework for evaluating HRH information systems in any country. Data on the private sector and migration could be further strengthened as system components.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":" ","pages":"3"},"PeriodicalIF":4.3,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12809960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795177","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":"What drives participation? A look at personal influences on Tanzanian nurses in project ECHO.","authors":"Godfrey Kacholi, Bahati Mfaki, Idda Lyatonga Swai, Mackfallen G Anasel","doi":"10.1186/s12960-025-00995-4","DOIUrl":"10.1186/s12960-025-00995-4","url":null,"abstract":"<p><strong>Introduction: </strong>The Project Extension for Community Health Care Outcomes (Project ECHO) is a renowned collaborative model of medical education and care management. This model enhances the capabilities of primary care providers through telementoring, providing a promising and cost-effective approach to augmenting healthcare professionals' knowledge. Participation in weekly ECHO sessions often falls short of expectations despite its benefits. This study examined the personal factors that influence Tanzanian nurses' engagement with Project ECHO.</p><p><strong>Methods: </strong>We conducted a cross-sectional study involving 450 nurses from 42 primary healthcare facilities in Dar es Salaam, Tanzania. A standardised questionnaire served as the data collection tool. Descriptive analysis was performed to calculate means, frequencies and percentages for socio-demographic variables and the level of participation of nurses. Bivariate and multivariate logistic regression were used to test the association between the level of participation of nurses in ECHO sessions and their socio-demographic factors.</p><p><strong>Results: </strong>Only 36% (n = 162) of 450 nurses attended at least two ECHO sessions (median 2, IQR 1-2). Paediatric ECHO sessions had the highest attendance (43.8%, n = 71). Ease of computer use (AOR = 1.95, p = 0.015) and ICT self-motivation (AOR = 2.08, p = 0.003) significantly increased attendance. A majority (58%) lacked personal computers. Surprisingly, adequate ICT skills lowered the likelihood of attending at least two sessions (AOR = 0.37, p < 0.001).</p><p><strong>Conclusion: </strong>The study found low participation of nurses in ECHO sessions, with paediatric ECHO sessions showing the highest engagement. Comfort with online format and ease of instructions motivated attendance, while computer proficiency and ICT motivation were positive predictors. Surprisingly, adequate ICT skills correlated with lower participation. Enhancing basic computer literacy and ICT motivation is crucial for improved engagement. Future research should explore reasons for lower participation among digitally skilled nurses and tailor session content accordingly.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":" ","pages":"1"},"PeriodicalIF":4.3,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12781590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783310","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 relationship between effort-reward imbalance and job satisfaction among primary care general practitioners in Gansu of China: the mediating role of public service motivation.","authors":"Hongjing Wang, Jing Han, Jiahuan Wang, Yue Wu, Hui Cai","doi":"10.1186/s12960-025-01036-w","DOIUrl":"10.1186/s12960-025-01036-w","url":null,"abstract":"<p><strong>Background: </strong>With the development of society and the economy, along with the aging population, the demand for primary health care services is growing. As the core providers of primary healthcare services, the job satisfaction of general practitioners (GPs) directly affects the quality of healthcare services and patient satisfaction, and it is one of the key indicators for assessing the effectiveness of relevant policy implementations. However, the heavy workload of Chinese primary care physicians, their low income levels, and their weak sense of professional identity may lead to an effort-reward imbalance (ERI). Therefore, analyzing the mechanisms behind ERI in relation to GPs' job satisfaction is crucial for advancing their professional growth. This is particularly relevant in less developed regions, as it can significantly boost the performance of healthcare services, elevate the standard of primary healthcare, and ultimately contribute to the realization of universal health coverage.</p><p><strong>Methods: </strong>This study, conducted from December 2023 to March 2024, employed a cross-sectional analysis of primary care GPs in Gansu Province, China, based on social exchange theory, to investigate whether and how ERI affects job satisfaction among primary care GPs. An electronic questionnaire survey was distributed to resident doctors who had completed their training through standardized residency training bases to test the theoretical hypotheses.</p><p><strong>Findings: </strong>This study found that the ERI among primary care GPs in China was relatively significant (3.57/5.00). The ERI negatively affected primary care GPs' job satisfaction (B = - 0.381, p < 0.01), explaining 23.6% of the variance in job satisfaction. Additionally, public service motivation (PSM) fully mediated the relationship between ERI and primary care GPs' job satisfaction (mediation effect of - 0.500, 95% bootstrap confidence interval [- 0.818 to - 0.156]). The study also revealed that GPs in primary hospitals had higher job satisfaction, while rural order-oriented GPs experienced lower job satisfaction.</p><p><strong>Conclusion: </strong>This study examines the detrimental effects and underlying mechanisms of ERI on the job satisfaction of primary care GPs, thereby contributing to the body of research on the factors influencing their job satisfaction. The findings underscore the importance of considering PSM as a critical intermediary when addressing ERI among primary care GPs. The conclusions offer practical insights for enhancing the job satisfaction of GPs, which, in turn, may lead to improved medical service performance in underdeveloped regions of China.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":" ","pages":"2"},"PeriodicalIF":4.3,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12801639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640790","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":"Activity-based planning of primary care utilization in a model of prospective demand for workforce.","authors":"Ilja Stepanov, Igor Sheiman","doi":"10.1186/s12960-025-01040-0","DOIUrl":"10.1186/s12960-025-01040-0","url":null,"abstract":"","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":" ","pages":"70"},"PeriodicalIF":4.3,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12717764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640887","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":"Demand-capacity estimation using queueing theory: application to hospital resource planning in the 2023 Türkiye earthquake.","authors":"Bircan Kara, Ali Utku Şahin","doi":"10.1186/s12960-025-01033-z","DOIUrl":"10.1186/s12960-025-01033-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to develop and validate a mathematical model for estimating the number of emergency physicians required in post-earthquake scenarios, using actual data from the 2023 Kahramanmaraş earthquakes in Türkiye.</p><p><strong>Methodology: </strong>The methodology follows a structured five-step framework to assess earthquake impact and emergency healthcare demand. First, population impact is analyzed using USGS PAGER data to estimate exposure levels. Second, household and building stock characteristics are profiled from TurkStat, focusing on construction year and building types, which influence structural vulnerability. Third, collapse probabilities are determined through empirical fragility functions that relate earthquake intensity to building failure rates. Fourth, casualties are estimated by combining structural damage with fatality and injury ratios specific to building types. Finally, physician demand is calculated using the M/M/s queuing theory model, incorporating key variables, such as emergency healthcare capacity, patient arrival rates, and examination duration, to forecast medical staffing needs in the aftermath of a disaster.</p><p><strong>Findings: </strong>The model estimated 11,645 potential emergency department visits in Hatay province within the first 144 h post-earthquake. Based on this, 27 emergency physicians per shift-or 81 total physicians across three shifts-are required to operate at full capacity. These figures closely align with actual post-disaster hospital admission data, validating the model.</p><p><strong>Conclusions: </strong>This study presents a scalable, actual-data-validated model for physician workforce planning in disaster scenarios. The queuing-based approach supports strategic resource allocation and enhances organizational resilience. Unlike existing models, this study directly integrates field-specific damage and population data to forecast real-time health system needs.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"69"},"PeriodicalIF":5.4,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12659379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640847","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 scoping review on medical students' international migration: trends, determinants, and implications for global health workforce planning.","authors":"Gerald Tze Zhen Ser, Zhi Sean Teng, Yady Zikry Yusni, Krisada Shen Yang Ooi, Zhi Yong Wong, Prashwin Singh Tejpal Singh, Wei-Han Hong","doi":"10.1186/s12960-025-01027-x","DOIUrl":"10.1186/s12960-025-01027-x","url":null,"abstract":"<p><strong>Background: </strong>Physician migration is a known global phenomenon, with the migration intention of medical students serving as early indicators of the trends in workforce mobility. Understanding the factors influencing their decision to migrate is crucial in the planning of human resources for health in a country and the sustainability of a healthcare system, particularly in low- and middle-income countries (LMIC). This scoping review synthesises current available evidence on the trends, determinants, and implications of medical student international migration.</p><p><strong>Methods: </strong>A systematic search was conducted on PubMed, Scopus, and Proquest from July 2013 to May 2025, following the PRISMA for Scoping Reviews framework. The selected articles included primary research investigating factors influencing migration intention among medical students. Articles were excluded if the study only explored on perception of migration. Included studies were assessed for quality according to Joanna Briggs Institute (JBI) Critical Appraisal tool, and extracted factors were reclassified and regrouped into domains of Academic and Personal Development, Economic and Working Conditions, and Social and Living Environment factors.</p><p><strong>Results: </strong>517 articles were screened, of which 33 articles were included, covering medical students from diverse geographical locations. Migration intentions were varied across regions, with studies from 6 countries each reporting that over 80% of sampled medical students intended to migrate. The most common push factors included income, working culture and environment, and career progression. The most frequently cited stay factors were family, financial, and patriotism.</p><p><strong>Conclusion: </strong>Migration intentions were widely reported among medical students across different regions, though the proportions varied by country. This serves as a predictor and could indicate the evolving global trend of physician migration in the years to come. Financial prospects, career opportunities, and working conditions play critical roles in determining the migration intentions of medical students. Targeted retention strategies should be implemented especially in resource-limited settings to address brain drain, although at the same time achieving balance in ethical recruitment practices in high-income countries. Future research is warranted to study the longitudinal trends of migration intention and assess the impact of policies on retention.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"67"},"PeriodicalIF":5.4,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12642250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145597690","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 competency-based assessment tool for public health workers in Shanghai community health centers: a population-based study.","authors":"Ruijie Chang, Meihui Zhang, Rui Li, Qianqian Zhu, Yinqiao Dong, Yujie Liu, Yufei Chen, Zuxin Wang, Hong Huang, Yong Cai","doi":"10.1186/s12960-025-01034-y","DOIUrl":"10.1186/s12960-025-01034-y","url":null,"abstract":"<p><strong>Background: </strong>The competence of public health workers is crucial for grassroots public health service capabilities. This study aimed to establish a competency model for public health workers and to test the reliability and validity of the model.</p><p><strong>Methods: </strong>An evaluation indicators scale of competency of public health workers in Shanghai community health service centers (CHSCs) was constructed through a literature review, expert consultation, behavioral event interviews and questionnaire surveys. A questionnaire survey was carried out with 3809 public health workers from 249 Shanghai CHSCs to test the reliability and validity of the constructed scale.</p><p><strong>Results: </strong>Exploratory factor analysis identified 5 common factors: comprehensive ability, professional spirit, professional knowledge, professional skills, research and development ability. The cumulative variance contribution rate was 62.241%. The factor load for each item ranged from 0.495 to 0.868. The overall Cronbach's alpha coefficient for the questionnaire was 0.985, for the five dimensions ranged from 0.916 to 0.969. The overall split-half reliability of the questionnaire was 0.842, and that of the five dimensions ranged from 0.913 to 0.952, with the Guttman split-half reliability coefficient ranging from 0.912 to 0.949. The correlation coefficients for all scale items with the total score ranged from 0.591 to 0.854 (p < 0.01). The correlation coefficients between each item and each dimension ranged from 0.434 to 0.925. Confirmatory factor analysis showed that the model had a good fitting effect (χ²/df = 2.288, TLI = 0.943, CFI = 0.957, IFI = 0.958, NFI = 0.928, RMSEA = 0.081). Using self-efficacy, self-esteem, work pressure, work motivation, and job satisfaction as benchmarks, all dimensions of the scale demonstrated significant positive correlations with the total scores of various benchmark questionnaires.</p><p><strong>Conclusions: </strong>The constructed scale of competency of public health workers in Shanghai CHSCs has good reliability and validity and can be used as a tool to evaluate the competency level of public health workers.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"68"},"PeriodicalIF":5.4,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12642289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145597771","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":"Workplace violence and burnout among emergency medical service workers and nurses in Germany: a cross-sectional study.","authors":"Karsten Roth, Julia Köppen, Cornelia Henschke","doi":"10.1186/s12960-025-01026-y","DOIUrl":"10.1186/s12960-025-01026-y","url":null,"abstract":"<p><strong>Background: </strong>Nonphysician healthcare workers play a crucial role in patient care, often under challenging conditions. Workplace violence puts professionals such as nurses and emergency medical service (EMS) workers at risk for (emotional) stress. This study comparatively analyzed the burden of workplace violence, burnout risk, and their associations among nurses and EMS workers.</p><p><strong>Methods: </strong>Two surveys were conducted using (i) a paper-pencil questionnaire for nurses and (ii) an online questionnaire for EMS workers in 2015. The surveys assessed experiences of workplace complaints, violence, and burnout risk measured by the Maslach Burnout Inventory (MBI). Data were analyzed descriptively (frequencies, means, percentages, Pearson correlation coefficients). Associations between workplace violence and burnout were estimated using binary logistic regression, adjusting for gender, employment status, work experience, education, and working conditions.</p><p><strong>Results: </strong>Data from 3,169 nurses (84.7% female) and 1,024 EMS workers (13.6% female) were analyzed. Frequent verbal abuse-ranging from daily incidents to several times a month-was reported by 44.7% of nurses and 59.9% of EMS workers, while 12.2% and 23.5%, respectively, experienced physical violence from patients or their families. Overall, a large proportion of employees in both professions have a moderate to high risk of burnout in the dimension of emotional exhaustion (EE) (nurses: 58.1%, EMS workers: 56.3%) and in the dimension of depersonalization (DP) (nurses: 58.4%, EMS workers: 74.4%). Logistic regression revealed that physical violence was significantly associated with a high risk of burnout in the dimensions EE and DP in nurses, and EE in EMS workers. Verbal abuse by patients was significantly associated with EE and DP in nurses, and with DP in EMS workers. In addition, an increased risk of burnout in both MBI dimensions was significantly associated with variables of working conditions and work experience for both professions.</p><p><strong>Conclusions: </strong>This is the first comparative study to examine the association between workplace violence and the risk of burnout among nurses and EMS workers. These findings highlight the need for strengthened measures to address workplace violence, prevent burnout among employees, and support staff in coping with these challenges. Improvements in working conditions must also be considered.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"66"},"PeriodicalIF":5.4,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12632002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565745","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":"Competency gaps and training needs in infectious disease control among public health professionals: a nationwide survey in China.","authors":"Yiguo Zhou, Xiaona Na, Wan-Xue Zhang, Shan-Shan Zhang, Ning-Hua Huang, Jing Zeng, Han Yang, Qin-Yi Ma, Le Ao, Ya-Qiong Liu, Juan Du, Qing-Bin Lu, Fuqiang Cui","doi":"10.1186/s12960-025-01035-x","DOIUrl":"10.1186/s12960-025-01035-x","url":null,"abstract":"<p><strong>Background: </strong>Infectious diseases pose significant challenges to global public health security, which necessitates robust prevention and control capabilities within national public health systems. This study aimed to assess the infectious disease control competencies of provincial and prefecture-level public health professionals in China and investigate their willingness and demand for professional training to inform future training plans.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted from June 2023 to December 2023 among public health professionals from 15 provinces in China. The infectious disease control competency scale was utilized to evaluate professionals' competencies across four dimensions: knowledge, practical skills, leadership, and personal qualities. Descriptive statistics and multivariable analyses were performed.</p><p><strong>Results: </strong>Among 883 participants enrolled in the study, the median total competency score was 74.70 (IQR 67.97-81.00) out of 100. The most deficient areas identified were scientific research abilities (scoring rate 63.76%), knowledge of public health emergency management (65.35%), and skills in infectious disease prevention and emergency preparedness (70.15%). Higher education level (OR 1.565; 95% CI 1.137-2.153), longer work experience (OR 2.448; 95% CI 1.354-4.427), more frequent outbreak response involvement (OR 3.931; 95% CI 2.517-6.141), continued professional development through training (OR 4.100; 95% CI 2.096-8.019), and higher job satisfaction (OR 6.199; 95% CI 3.659-10.502) were all associated with enhanced competency scores. Most participants (87.5%) expressed willingness to participate in future training, with preferences for case analysis, scenario simulations, public health response to infectious diseases, research design, and report and paper writing.</p><p><strong>Conclusions: </strong>This nationwide survey revealed moderate infectious disease control competencies among Chinese public health professionals, with specific areas for improvement. Tailored training initiatives focusing on identified gaps and preferred topics, coupled with strategies to foster continuous professional development, are crucial for enhancing the public health workforce's capabilities.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"65"},"PeriodicalIF":5.4,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12629072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551381","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":"Neonatal unit human resources: coverage for six cadres and trends for staff-to-baby ratios in 65 neonatal units implementing with NEST360 in Kenya, Malawi, Nigeria, and Tanzania.","authors":"Rebecca E Penzias, Eric O Ohuma, Opeyemi Odedere, Olabisi Dosunmu, George Okello, Hannah Mwaniki, Robert Tillya, Josephine Shabani, Samuel K Ngwala, Evelyn Zimba, Morris Ondieki Ogero, Christine A Bohne, Olukemi Tongo, Veronica Chinyere Ezeaka, Vincent O Ochieng, Ekran Rashid, William M Macharia, John Wainaina, Irabi Kassim, Donat Shamba, Nahya Salim, Grace T Soko, Msandeni Chiume, Alice Tarus, Edith Gicheha, Julius Thomas, Georgia Jenkins, James H Cross, Rosemary Kamuyu, Junwei Chen, Simon Cousens, Elizabeth M Molyneux, Maria Oden, Rebecca Richards-Kortum, Joy E Lawn, David Gathara","doi":"10.1186/s12960-025-01031-1","DOIUrl":"10.1186/s12960-025-01031-1","url":null,"abstract":"<p><strong>Background: </strong>Implementing small and sick newborn care (SSNC) requires skilled health workers; however, there is a shortage, adversely impacting patient outcomes and health worker well-being. There are limited data and no current World Health Organization (WHO) standards for staff-to-baby ratios in neonatal units in low- and middle-income countries (LMICs) to inform policy, planning, and investment.</p><p><strong>Methods: </strong>In 65 neonatal units (36 in Malawi, 13 in Kenya, 7 in Tanzania, and 9 in Nigeria), a health facility assessment (HFA) for SSNC and government-led quality improvement (QI) processes were implemented. Staffing data were collated from baseline HFA (Sept 2019-March 2021) and mid-2023 HFAs, and quarterly QI processes. The unit of analysis was the neonatal unit with day and night staff-to-baby ratios calculated. Ratios were aggregated overall, by country, by hospital level, and by neonatal unit occupancy rates. Staff coverage and skill-mix were also analysed for nurses, doctors, clinical officers, laboratory technicians, data clerks, biomedical technicians, and engineers.</p><p><strong>Results: </strong>For 65 neonatal units, the median time between baseline and 2023 HFAs was 31 months (Interquartile Range (IQR) 29-34 months). In 2023, only 3 (5%) neonatal units had zero neonatal ward-specific nurses compared to 8 (12%) at baseline during the day. Between baseline and 2023 HFAs, median nurse-to-baby ratios were 1:6 (IQR 1:3-1:11) during the day and 1:10 (IQR 1:6-1:17) at night, with consistency over time. At baseline, only one third of neonatal units had a doctor providing care, or on-call coverage, at all times of day and night (n = 20, 31%), and half of hospitals lacked 24 h laboratory coverage (n = 25, 45%) with no change over time. There were improvements in neonatal data clerk (n = 32, 49% to n = 58, 89%) and biomedical technician (n = 45, 69% to n = 56, 86%) coverage between baseline and 2023 HFAs.</p><p><strong>Discussion: </strong>Evaluation revealed variability by country and hospital level, and important shortfalls remain in the number of staff providing care. Neonatal survival in hospitals requires better staff-to-baby ratios and more skilled staff. To meet the projected shortfall in the health workforce, governments must invest in training more health workers for neonatal care.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":"23 1","pages":"64"},"PeriodicalIF":5.4,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12613486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507493","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}