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Implementing a health labour market analysis to address health workforce gaps in a rural region of India

BACKGROUND: Human Resources for Health (HRH) are essential for making meaningful progress towards universal health coverage (UHC), but health systems in most of the developing countries continue to suffer from serious gaps in health workforce. The Global Strategy on Human Resources for Health—Workfo...

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Autores principales: Garg, Samir, Tripathi, Narayan, McIsaac, Michelle, Zurn, Pascal, Zapata, Tomas, Mairembam, Dilip S., Singh, Niharika Barik, de Graeve, Hilde
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9167498/
https://www.ncbi.nlm.nih.gov/pubmed/35659250
http://dx.doi.org/10.1186/s12960-022-00749-6
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author Garg, Samir
Tripathi, Narayan
McIsaac, Michelle
Zurn, Pascal
Zapata, Tomas
Mairembam, Dilip S.
Singh, Niharika Barik
de Graeve, Hilde
author_facet Garg, Samir
Tripathi, Narayan
McIsaac, Michelle
Zurn, Pascal
Zapata, Tomas
Mairembam, Dilip S.
Singh, Niharika Barik
de Graeve, Hilde
author_sort Garg, Samir
collection PubMed
description BACKGROUND: Human Resources for Health (HRH) are essential for making meaningful progress towards universal health coverage (UHC), but health systems in most of the developing countries continue to suffer from serious gaps in health workforce. The Global Strategy on Human Resources for Health—Workforce 2030, adopted in 2016, includes Health Labor Market Analysis (HLMA) as a tool for evidence based health workforce improvements. HLMA offers certain advantages over the traditional approach of workforce planning. In 2018, WHO supported a HLMA exercise in Chhattisgarh, one of the predominantly rural states of India. METHODS: The HLMA included a stakeholder consultation for identifying policy questions relevant to the context. The HLMA focused on state HRH at district-level and below. Mixed methods were used for data collection and analysis. Detailed district-wise data on HRH availability were collected from state’s health department. Data were also collected on policies implemented on HRH during the 3 year period after the start of HLMA and changes in health workforce. RESULTS: The state had increased the production of doctors but vacancies persisted until 2018. The availability of doctors and other qualified health workers was uneven with severe shortages of private as well as public HRH in rural areas. In case of nurses, there was a substantial production of nurses, particularly from private schools, however there was a lack of trusted accreditation mechanism and vacancies in public sector persisted alongside unemployment among nurses. Based on the HLMA, pragmatic recommendations were decided and followed up. Over the past 3 years since the HLMA began an additional 4547 health workers including 1141 doctors have been absorbed by the public sector. The vacancies in most of the clinical cadres were brought below 20%. CONCLUSION: The HLMA played an important role in identifying the key HRH gaps and clarifying the underlying issues. The HLMA and the pursuant recommendations were instrumental in development and implementation of appropriate policies to improve rural HRH in Chhattisgarh. This demonstrates important progress on key 2030 Global Strategy milestones of reducing inequalities in access to health workers and improving financing, retention and training of HRH. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12960-022-00749-6.
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spelling pubmed-91674982022-06-06 Implementing a health labour market analysis to address health workforce gaps in a rural region of India Garg, Samir Tripathi, Narayan McIsaac, Michelle Zurn, Pascal Zapata, Tomas Mairembam, Dilip S. Singh, Niharika Barik de Graeve, Hilde Hum Resour Health Research BACKGROUND: Human Resources for Health (HRH) are essential for making meaningful progress towards universal health coverage (UHC), but health systems in most of the developing countries continue to suffer from serious gaps in health workforce. The Global Strategy on Human Resources for Health—Workforce 2030, adopted in 2016, includes Health Labor Market Analysis (HLMA) as a tool for evidence based health workforce improvements. HLMA offers certain advantages over the traditional approach of workforce planning. In 2018, WHO supported a HLMA exercise in Chhattisgarh, one of the predominantly rural states of India. METHODS: The HLMA included a stakeholder consultation for identifying policy questions relevant to the context. The HLMA focused on state HRH at district-level and below. Mixed methods were used for data collection and analysis. Detailed district-wise data on HRH availability were collected from state’s health department. Data were also collected on policies implemented on HRH during the 3 year period after the start of HLMA and changes in health workforce. RESULTS: The state had increased the production of doctors but vacancies persisted until 2018. The availability of doctors and other qualified health workers was uneven with severe shortages of private as well as public HRH in rural areas. In case of nurses, there was a substantial production of nurses, particularly from private schools, however there was a lack of trusted accreditation mechanism and vacancies in public sector persisted alongside unemployment among nurses. Based on the HLMA, pragmatic recommendations were decided and followed up. Over the past 3 years since the HLMA began an additional 4547 health workers including 1141 doctors have been absorbed by the public sector. The vacancies in most of the clinical cadres were brought below 20%. CONCLUSION: The HLMA played an important role in identifying the key HRH gaps and clarifying the underlying issues. The HLMA and the pursuant recommendations were instrumental in development and implementation of appropriate policies to improve rural HRH in Chhattisgarh. This demonstrates important progress on key 2030 Global Strategy milestones of reducing inequalities in access to health workers and improving financing, retention and training of HRH. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12960-022-00749-6. BioMed Central 2022-06-04 /pmc/articles/PMC9167498/ /pubmed/35659250 http://dx.doi.org/10.1186/s12960-022-00749-6 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Garg, Samir
Tripathi, Narayan
McIsaac, Michelle
Zurn, Pascal
Zapata, Tomas
Mairembam, Dilip S.
Singh, Niharika Barik
de Graeve, Hilde
Implementing a health labour market analysis to address health workforce gaps in a rural region of India
title Implementing a health labour market analysis to address health workforce gaps in a rural region of India
title_full Implementing a health labour market analysis to address health workforce gaps in a rural region of India
title_fullStr Implementing a health labour market analysis to address health workforce gaps in a rural region of India
title_full_unstemmed Implementing a health labour market analysis to address health workforce gaps in a rural region of India
title_short Implementing a health labour market analysis to address health workforce gaps in a rural region of India
title_sort implementing a health labour market analysis to address health workforce gaps in a rural region of india
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9167498/
https://www.ncbi.nlm.nih.gov/pubmed/35659250
http://dx.doi.org/10.1186/s12960-022-00749-6
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