News Release

Poorer countries need more evidence to shape their policies to transform human resources for health

Peer-Reviewed Publication

The Lancet_DELETED

There is not enough evidence upon which middle- and low-income countries can draw upon to guide their policies on human resources for health. This is the conclusion of authors of an Article in this week’s Human Resources for Health Special Issue of The Lancet.

Policy makers face challenges to ensure an appropriate supply and distribution of trained health workers and to manage their performance in delivery of services, especially in low and middle income countries. Dr Mickey Chopra, Health Systems Research Unit, Medical Research Council, Western Cape, South Africa, and colleagues analysed published literature from 1979 onwards for evidence of policy options that could affect the training, distribution, regulation, financing, management, organisation, or performance of health workers. They also assessed whether the policy options were equitable in their effects; suitable for scaling up; and applicable to countries with low and middle incomes.

They found that only 28 of 759 systematic reviews that considered the effects above were eligible for the study, and of these only a few included studies from low- and middle-income countries. Most of the material focussed on organisational mechanisms for human resources, substitution or task-shifting between health workers, education strategies, teamwork, and changes to workflow. Of all policy options, the use of lay health workers had the greatest proportion of reviews in countries with a range of incomes, from high to low.

The authors conclude: “We have identified a need for more systematic reviews on the effects of policy options to improve human resources for health in countries with low and middle incomes, for assessments of any interventions that policy makers introduce to plan and manage human resources for health, and for other research to aid policy makers in these countries…moreover, policy makers must also contend with values and beliefs; stakeholder power; institutional constraints; flows of donor funding; and other types of information such as local assessments of need, costs, and the availability of resources.”

In an accompanying Comment, William Pick, Professor Emeritus University of the Witwatersrand, Johannesburg and honorary Professor Schools of Public Health, Universities of Cape Town and Western Cape, Cape Town, South Africa, says: “At a time when there is a resurgence of interest in this field, Chopra and colleagues’ overview serves as a timely reminder that much more information is needed if we are to persuade those responsible for health services, and especially human resources for health, to take decisions that will contribute to the solution of the global crisis in staffing health systems….I hope that their appeal will not fall on deaf ears.”

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Dr Mickey Chopra, Health Systems Research Unit, Medical Research Council, Western Cape, South Africa T) +91 9872270500 E) mickey.chopra@mrc.ac.za

William Pick, Professor Emeritus University of the Witwatersrand, Johannesburg and honorary Professor Schools of Public Health, Universities of Cape Town and Western Cape, Cape Town, South Africa T) +27-21-556 5678 / +27-72110383 E) pickwm@mweb.co.za

PDF OF ARTICLE: http://multimedia.thelancet.com/pdf/press/Policyarticle.pdf


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