Health labour market policies in support of universal health coverage: a comprehensive analysis in four African countries

Human Resources for Health

Jennifer Nyoni⁵  Harrison M M’kiambati⁶  Ayat Abu-Agla¹  Symplice Ngah Ngah²  Grayson Koyi⁴  Richard M Scheffler³  Angelica Sousa⁷ 

[1] National Human Resources for Health Observatory, Ministry of Health, Khartoum, Sudan;Subregional Institute of Statistics and Applied Economy (ISSEA), Yaoundé, Cameroon;School of Public Health and the Goldman School of Public Policy, University of California, 50 University Hall, MC 7360, Berkeley, CA 94720, USA;Institute of Economic and Social Research (INESOR), University of Zambia, Lusaka, Zambia;Human Resources for Health, Division of Health Systems and Services, World Health Organization Regional Office for Africa, Brazzaville, Congo;Technical Planning and Coordination, Ministry of Medical Services, Nairobi, Kenya;Human Resources for Health, Department of Health Systems Policies and Workforce, World Health Organization, Geneva, Switzerland

关键词: Zambia;    Universal health coverage;    Sudan;    Kenya;    Human resources for health;    Health workforce policies;    Health workforce;    Health labour market;    Cameroon;    Africa;   

Others  :  1139379
DOI  :  10.1186/1478-4491-12-55

 received in 2013-11-21, accepted in 2014-08-07,  发布年份 2014

【 摘 要 】

Background

Progress toward universal health coverage in many low- and middle-income countries is hindered by the lack of an adequate health workforce that can deliver quality services accessible to the entire population.

Methods

We used a health labour market framework to investigate the key indicators of the dynamics of the health labour market in Cameroon, Kenya, Sudan, and Zambia, and identified the main policies implemented in these countries in the past ten years to address shortages and maldistribution of health workers.

Results

Despite increased availability of health workers in the four countries, major shortages and maldistribution persist. Several factors aggravate these problems, including migration, an aging workforce, and imbalances in skill mix composition.

Conclusions

In this paper, we provide new evidence to inform decision-making for health workforce planning and analysis in low- and middle-income countries. Partial health workforce policies are not sufficient to address these issues. It is crucial to perform a comprehensive analysis in order to understand the dynamics of the health labour market and develop effective polices to address health workforce shortages and maldistribution as part of efforts to attain universal health coverage.

【 授权许可】

   
2014 Sousa et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Report TWH: Health Systems Financing – the Path to Universal Coverage. Geneva: World Health Organization; 2010.
• [2]Report TWH: Working Together for Health. Geneva: World Health Organization; 2006.
• [3]Anand S: Measuring Health Workforce Inequalities: Methods and Application to China and India. Human Resources for Health Observer, No. 5, 2010. Geneva: Department of Human Resources for Health, World Health Organization; 2010.
• [4]Sousa A, Dal Poz MR, Carvalho CL: Monitoring inequalities in the health workforce: the case study of Brazil 1991–2005. PLoS One 2012, 7(3):e33399.
• [5]Sousa A, Scheffler R, Nyoni J, Boerma T: A comprehensive health labour market framework for universal health coverage. Bull World Health Organ 2013, 91:892-894.
• [6]WHO Global Code of Practice on the International Recruitment of Health Personnel. Geneva: World Health Organization; 2010. [http://www.who.int/hrh/migration/code/WHO_global_code_of_practice_EN.pdf webcite] Accessed September 11, 2013
• [7]World Health Statistics. Geneva: World Health Organization; 2013. [http://apps.who.int/gho/data/node.main.1?lang=en webcite] Accessed March 2013
• [8]Taylor-Gooby P: Root and branch restructuring to achieve major cuts: the social Policy Programme of the 2010 UK Coalition Government. Soc Policy Admin 2012, 46:61-82.
• [9]Fields G: Labour market for developing countries. Labour Econ 2011, 18:S16-S22.
• [10]Folland S, Goodman AC, Stano M: The Economics of Health and Health Care. 6th edition. Oxford: Prentice Hall; 2010.
• [11]Kernen G, Dzenowagis J: Connecting for Health; Global Vision, Local Insight. Geneva: World Health Organization; 2005. [http://apps.who.int/iris/bitstream/10665/43385/1/9241593903_eng.pdf?ua=1 webcite] Accessed July 20, 2014
• [12]Kernen G, Dzenowagis J: Connecting for Health; Cameroon. Geneva: World Health Organization; 2005. [http://www.who.int/ehealth/resources/sudan.pdf?ua=1 webcite] Accessed July 20, 2014
• [13]Kernen G, Dzenowagis J: Connecting for Health; Cameroon. Geneva: World Health Organization; 2005. [http://www.who.int/ehealth/resources/zambia.pdf?ua=1 webcite] Accessed July 20, 2014
• [14]Country Indicators. Washington, DC: World Bank; 2013. [http://data.worldbank.org/indicator/NY.GDP.PCAP.CD webcite] Accessed March 2013
• [15]Kernen G, Dzenowagis J: Connecting for Health; Global Vision, Local Insight. Geneva: World Health Organization; 2005. [http://www.who.int/ehealth/resources/cameroon.pdf?ua=1 webcite] Accessed July 20, 2014
• [16]Kernen G, Dzenowagis J: Connecting for Health; Cameroon. Geneva: World Health Organization; 2005. [http://www.who.int/ehealth/resources/kenya.pdf?ua webcite] Accessed July 20, 2014
• [17]Sousa A, Flores G: Transforming and Scaling Up Health Professional Education: Policy Brief on Financing Education of Health Professionals. Geneva: Department for Health Systems Policies and Workforce, World Health Organization; 2013.
• [18]Scheffler R, Bruckner T, Spetz J: The Labour Market for Human Resources for Health in Low and Middle Income Countries. Human Resources for Health Observer, No. 11, 2012. Geneva: Department of Health Systems Policies and Workforce, World Health Organization; 2010. [http://www.who.int/hrh/tools/labour_market/en/ webcite]
• [19]Glassman A, Becker L, Makinen M, De Ferranti D: Planning and costing human resources for health. Lancet 2008, 371:693-695.
• [20]Kiambati H, Kiio CK, Toweett J: Understanding the Labour Market of Human Resources for Health in Kenya. Geneva: Department for Health Systems Policies and Workforce, World Health Organization; 2013. [http://www.who.int/hrh/tools/labour_market/en/ webcite]
• [21]Kamwanga J, Koyi G, Mwila J, Musonda M, Bwalya R: Understanding the Labour Market of Human Resources for Health in Zambia. Geneva: Department for Health Systems Policies and Workforce, World Health Organization; 2013. [http://www.who.int/hrh/tools/labour_market/en/ webcite]
• [22]Ngah-Ngah S, Kingue S, Peyou MN, Bela AC: Understanding the Labour Market of Human Resources for Health in Cameroon. Geneva: Department for Health Systems Policies and Workforce, World Health Organization; 2013. [http://www.who.int/hrh/tools/labour_market/en/ webcite]
• [23]Abu-Agla A, Yousif N, Badr E: Understanding the Labour Market of Human Resources for Health in Sudan. Geneva: Department for Health Systems Policies and Workforce, World Health Organization; 2013. [http://www.who.int/hrh/tools/labour_market/en/ webcite]
• [24]Allen SM, Ciambrone D: Community care for people with disability: blurring boundaries between formal and informal caregivers. Qual Health Res 2003, 13:207-226.
• [25]Gilks CF, Crowley S, Ekpini R, Gove S, Perriens J, Souteyrand Y, Sutherland D, Vitoria M, Guerma T, De Cock K: The WHO public-health approach to antiretroviral treatment against HIV in resource-limited settings. Lancet 2006, 368:505-510.
• [26]Fulton B, Scheffler R, Sparkes S, Auh E, Vujicic M, Soucat A: Health workforce skill mix and task shifting in low income countries: a review of recent evidence. Hum Resour Health 2011, 9:1. BioMed Central Full Text