The gap in human resources to deliver the guaranteed package of prevention and health promotion services at urban and rural primary care facilities in Mexico

Human Resources for Health

Research

Jacqueline Elizabeth Alcalde-Rabanal¹  Blair Grant Darney²  Héctor Eduardo Velasco-Mondragón³  Till Bärnighausen⁴  Gustavo Nigenda⁵ 

[1] Center for Health Systems Research, National Institute of Public Health - Instituto Nacional de Salud Pública, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, CP 62100, Cuernavaca, Morelos, Mexico;Center for Health Systems Research, National Institute of Public Health - Instituto Nacional de Salud Pública, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, CP 62100, Cuernavaca, Morelos, Mexico;Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, United States of America;College of Osteopathic Medicine, Touro University California, 1310 Club Drive, Mare Island, 94592, Vallejo, CA, United States of America;Department of Global Health and Population, Harvard School of Public Health, 677 Huntington Ave, 02115, Boston, MA, United States of America;Institute of Public Health, University of Heidelberg, Heidelberg, Germany;Partners in Health, Calle Primera Poniente Sur # 25, Angel Albino Corzo, CP 30370, Chiapas, Mexico;

关键词: Health promotion;    Preventive health services;    Human resources planning;    Health manpower;    Health workforce;    Health personnel;    Primary health care;    Mexico;   

DOI  :  10.1186/s12960-017-0220-5

 received in 2017-06-01, accepted in 2017-06-22,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe purpose of this study was to estimate the gap between the available and the ideal supply of human resources (physicians, nurses, and health promoters) to deliver the guaranteed package of prevention and health promotion services at urban and rural primary care facilities in Mexico.MethodsWe conducted a cross-sectional observational study using a convenience sample. We selected 20 primary health facilities in urban and rural areas in 10 states of Mexico. We calculated the available and the ideal supply of human resources in these facilities using estimates of time available, used, and required to deliver health prevention and promotion services. We performed descriptive statistics and bivariate hypothesis testing using Wilcoxon and Friedman tests. Finally, we conducted a sensitivity analysis to test whether the non-normal distribution of our time variables biased estimation of available and ideal supply of human resources.ResultsThe comparison between available and ideal supply for urban and rural primary health care facilities reveals a low supply of physicians. On average, primary health care facilities are lacking five physicians when they were estimated with time used and nine if they were estimated with time required (P < 0.05). No difference was observed between available and ideal supply of nurses in either urban or rural primary health care facilities. There is a shortage of health promoters in urban primary health facilities (P < 0.05).ConclusionThe available supply of physicians and health promoters is lower than the ideal supply to deliver the guaranteed package of prevention and health promotion services. Policies must address the level and distribution of human resources in primary health facilities.

【 授权许可】

CC BY   
© The Author(s). 2017

【 图 表 】

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Fig. 2