No abstract

BackgroundJob satisfaction largely determines the productivity and efficiency of human resource for health. It literally depicts the extent to which professionals like or dislike their jobs. Job satisfaction is said to be linked with the employee’s work environment, job responsibilities and powers and time pressure; the determinants which affect employee’s organizational commitment and consequently the quality of services. The objective of the study was to determine the level of and factors influencing job satisfaction among public health professionals in the public sector.MethodsThis was a cross sectional study conducted in Islamabad, Pakistan. Sample size was universal including 73 public health professionals, with postgraduate qualifications and working in government departments of Islamabad. A validated structured questionnaire was used to collect data from April to October 2011.ResultsOverall satisfaction rate was 41% only, while 45% were somewhat satisfied and 14% of professionals highly dissatisfied with their jobs. For those who were not satisfied, working environment, job description and time pressure were the major causes. Other factors influencing the level of satisfaction were low salaries, lack of training opportunities, improper supervision and inadequate financial rewards.ConclusionOur study documented a relatively low level of overall satisfaction among workers in public sector health care organizations. Considering the factors responsible for this state of affairs, urgent and concrete strategies must be developed to address the concerns of public health professionals as they represent a highly sensitive domain of health system of Pakistan. Improving the overall work environment, review of job descriptions and better remuneration might bring about a positive change.

Severe pre-eclampsia and eclampsia are rare but serious complications of pregnancy that threaten the lives of mothers during childbirth. Evidence supports the use of magnesium sulfate (MgSO4) as the first line treatment option for severe pre-eclampsia and eclampsia. Eclampsia is the third major cause of maternal mortality in Pakistan. As in many other Low- and Middle-Income Countries (LMIC), it is suspected that MgSO4 is critically under-utilized in the country. There is however a lack of information on context-specific health system barriers that prevent optimal use of this life-saving medicine in Pakistan. Combining quantitative and qualitative methods, namely policy document review, key informant interviews, focus group discussions and direct observation at health facility, we explored context-specific health system barriers and enablers that affect access and use of MgSO4 for severe pre-eclampsia and eclampsia in Pakistan. Our study finds that while international recommendations on MgSO4 have been adequately translated in national policies in Pakistan, the gap remains in implementation of national policies into practice. Barriers to access to and effective use of MgSO4 occur at health facility level where the medicine was not available and health staff was reluctant to use it. Low price of the medicine and the small market related to its narrow indications acted as disincentives for effective marketing. Results of our survey were further discussed in a multi-stakeholder round-table meeting and an action plan for increasing access to this life-saving medicine was identified.

and maternal mortality makes US foreign assistance effective.COVID-19 has revealed shortcomings in WHO's powers and funding, warranting substantial reforms. WHO has limited authority to ensure state compliance with the IHR, including constrained ability to independently verify official state reports. But after leaving WHO, the USA would be on the outside looking in, without global influence to promote crucial reforms. Stand-alone US programmes, moreover, could never substitute for a truly global agency. Absent treaty obligations, in a multipolar world, mean there are no guarantees that countries will cooperate with the USA.Health and security in the USA and globally require robust collaboration with WHO-a cornerstone of US funding and policy since 1948. The USA cannot cut ties with WHO without incurring major disruption and damage, making Americans far less safe. That is the last thing the global community needs as the world faces a historic health emergency.LOG is director of the WHO Collaborating Center on National and Global Health Law. MAH is co-chair of the WHO Expert Advisory Committee on Developing Global Standards for Governance and Oversight of Human Genome Editing and receives no compensation for this work apart from travel-related expenses. The other authors declare no competing interests.