The ‘Dream Team’ for sexual, reproductive, maternal, newborn and adolescent health: an adjusted service target model to estimate the ideal mix of health care professionals to cover population need

Human Resources for Health

Methodology

Caroline S. E. Homer¹  Zoë Matthews²  Francisco Pozo-Martin³  Andrea Nove⁴  Laura Sochas⁵  Petra ten Hoope-Bender⁶ 

[1] Centre for Midwifery, Child and Family Health, University of Technology Sydney, Ultimo, NSW, Australia;Department of Social Statistics and Demography, University of Southampton, Southampton, United Kingdom;Instituto de Cooperación Social Integrare, Calle Balmes, 30, 3° - 1, 08007, Barcelona, Spain;Department of Global Health and Development, Faculty of Public Health, London School of Hygiene and Tropical Medicine, London, United Kingdom;Instituto de Cooperación Social Integrare, Calle Balmes, 30, 3° - 1, 08007, Barcelona, Spain;Novametrics Ltd, Derby, United Kingdom;London School of Economics, London, United Kingdom;Technical Adviser Sexual and Reproductive Health and Rights, United Nations Population Fund, Geneva, Switzerland;

关键词: Health workforce planning;    Human resources for health;    Midwifery;    Sexual, reproductive, maternal, newborn and adolescent health;    Universal health coverage;    Sustainable development goals;   

DOI  :  10.1186/s12960-017-0221-4

 received in 2016-09-13, accepted in 2017-06-22,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundA competent, enabled and efficiently deployed health workforce is crucial to the achievement of the health-related sustainable development goals (SDGs). Methods for workforce planning have tended to focus on ‘one size fits all’ benchmarks, but because populations vary in terms of their demography (e.g. fertility rates) and epidemiology (e.g. HIV prevalence), the level of need for sexual, reproductive, maternal, newborn and adolescent health (SRMNAH) workers also varies, as does the ideal composition of the workforce. In this paper, we aim to provide proof of concept for a new method of workforce planning which takes into account these variations, and allocates tasks to SRMNAH workers according to their competencies, so countries can assess not only the needed size of the SRMNAH workforce, but also its ideal composition (the ‘Dream Team’).MethodsAn adjusted service target model was developed, to estimate (i) the amount of health worker time needed to deliver essential SRMNAH care, and (ii) how many workers from different cadres would be required to meet this need if tasks were allocated according to competencies. The model was applied to six low- and middle-income countries, which varied in terms of current levels of need for health workers, geographical location and stage of economic development: Azerbaijan, Malawi, Myanmar, Peru, Uzbekistan and Zambia.ResultsCountries with high rates of fertility and/or HIV need more SRMNAH workers (e.g. Malawi and Zambia each need 44 per 10,000 women of reproductive age, compared with 20–27 in the other four countries). All six countries need between 1.7 and 1.9 midwives per 175 births, i.e. more than the established 1 per 175 births benchmark.ConclusionsThere is a need to move beyond universal benchmarks for SRMNAH workforce planning, by taking into account demography and epidemiology. The number and range of workers needed varies according to context. Allocation of tasks according to health worker competencies represents an efficient way to allocate resources and maximise quality of care, and therefore will be useful for countries working towards SDG targets. Midwives/nurse-midwives who are educated according to established global standards can meet 90% or more of the need, if they are part of a wider team operating within an enabled environment.

【 授权许可】

CC BY   
© The Author(s). 2017