Psychology, Sociology and Education

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Early implementation of WHO recommendations for the retention of health workers in remote and rural areas
(World Health Organization, 2013-11) Buchan, James; Couper, Ian D.; Tangcharoensathien, Viroj; Thepannya, Khampasong; Jaskiewicz, Wanda; Perfilieva, Galina; Dolea, Carmen
Abstract The maldistribution of health workers between urban and rural areas is a policy concern in virtually all countries. It prevents equitable access to health services, can contribute to increased health-care costs and underutilization of health professional skills in urban areas, and is a barrier to universal health coverage. To address this long-standing concern, the World Health Organization (WHO) has issued global recommendations to improve the rural recruitment and retention of the health workforce. This paper presents experiences with local and regional adaptation and adoption of WHO recommendations. It highlights challenges and lessons learnt in implementation in two countries - the Lao People's Democratic Republic and South Africa - and provides a broader perspective in two regions - Asia and Europe. At country level, the use of the recommendations facilitated a more structured and focused policy dialogue, which resulted in the development and adoption of more relevant and evidence-based policies. At regional level, the recommendations sparked a more sustained effort for cross-country policy assessment and joint learning. There is a need for impact assessment and evaluation that focus on the links between the rural availability of health workers and universal health coverage. The effects of any health-financing reforms on incentive structures for health workers will also have to be assessed if the central role of more equitably distributed health workers in achieving universal health coverage is to be supported.
Human resources for health and universal health coverage: fostering equity and effective coverage
(World Health Organization, 2013-11) Campbell, James; Buchan, James; Cometto, Giorgio; David, Benedict; Dussault, Gilles; Fogstad, Helga; Fronteira, Ins; Lozano, Rafael; Nyonator, Frank; Pablos-Mndez, Ariel; Quain, Estelle E.; Starrs, Ann; Tangcharoensathien, Viroj
Achieving universal health coverage (UHC) involves distributing resources, especially human resources for health (HRH), to match population needs. This paper explores the policy lessons on HRH from four countries that have achieved sustained improvements in UHC: Brazil, Ghana, Mexico and Thailand. Its purpose is to inform global policy and financial commitments on HRH in support of UHC. The paper reports on country experiences using an analytical framework that examines effective coverage in relation to the availability, accessibility, acceptability and quality (AAAQ) of HRH. The AAAQ dimensions make it possible to perform tracing analysis on HRH policy actions since 1990 in the four countries of interest in relation to national trends in workforce numbers and population mortality rates. The findings inform key principles for evidence-based decision-making on HRH in support of UHC. First, HRH are critical to the expansion of health service coverage and the package of benefits; second, HRH strategies in each of the AAAQ dimensions collectively support achievements in effective coverage; and third, success is achieved through partnerships involving health and non-health actors. Facing the unprecedented health and development challenges that affect all countries and transforming HRH evidence into policy and practice must be at the heart of UHC and the post-2015 development agenda. It is a political imperative requiring national commitment and leadership to maximize the impact of available financial and human resources, and improve healthy life expectancy, with the recognition that improvements in health care are enabled by a health workforce that is fit for purpose.
Nursing Workforce Policy and the Economic Crisis: A Global Overview
(2013-09-08) Buchan, James; O'May, Fiona; Dussault, G.
Purpose To assess the impact of the global financial crisis on the nursing workforce and identify appropriate policy responses. Organizing Construct and Methods This article draws from international data sources (Organisation for Economic Co-operation and Development [OECD] and World Health Organization), from national data sources (nursing regulatory authorities), and the literature to provide a context in which to examine trends in labor market and health spending indicators, nurse employment, and nurse migration patterns. Findings A variable impact of the crisis at the country level was shown by different changes in unemployment rates and funding of the health sector. Some evidence was obtained of reductions in nurse staffing in a small number of countries. A significant and variable change in the patterns of nurse migration also was observed. Conclusions The crisis has had a variable impact; nursing shortages are likely to reappear in some OECD countries. Policy responses will have to take account of the changed economic reality in many countries. Clinical Relevance This article highlights key trends and issues for the global nursing workforce; it then identifies policy interventions appropriate to the new economic realities in many OECD countries.
Safe staffing levels - a national imperative. The UK nursing Labour Market Review 2013
(The Royal College of Nursing, 2013-09) Buchan, James; Seccombe, Ian; O'May, Fiona
This report is the 2013 annual review of the UK nursing labour market commissioned by the Royal College of Nursing. Events over the last twelve months point to the urgent need to address both the national security of the supply of nurses, and the local ability to determine evidence-based nurse staffing levels.