Comparing Health Workforce Policy during a Major Global Health Crisis: A Critical Conceptual Debate and International Empirical Investigation

Abstract

Background: The health workforce is central to healthcare systems and population health, but marginal in comparative health policy. This study aims to highlight the crucial relevance of the health workforce and contribute comparative evidence to help improve the protection of healthcare workers and prevention of inequalities during a major public health crisis. Methods: Our integrated governance framework considers system, sector, organizational and socio-cultural dimensions of health workforce policy. The COVID-19 pandemic serves as the policy field and Brazil, Canada, Italy, and Germany as illustrative cases. We draw on secondary sources (literature, document analysis, public statistics, reports) and country expert information with a focus on the first COVID-19 waves until the summer of 2021. Results: Our comparative investigation illustrates the benefits of a multi-level governance approach beyond health system typologies. In the selected countries, we found similar problems and governance gaps concerning increased workplace stress, lack of mental health support, and gender and racial inequalities. Health policy across countries failed to adequately respond to the needs of HCWs, thus exacerbating inequalities during a major global health crisis. Conclusions: Comparative health workforce policy research may contribute new knowledge to improve health system resilience and population health during a crisis.

Class‐Rheum for AI: Reflections from a Filipino Rheumatologist and Health Informatics graduate student

“…However, we are also decreasing in terms of workforce number as a specialty and because of the Pandemic, as doctors in general. [8][9][10] We need rapid identification or assessment of conditions in order not to delay treatment. Much rheumatologic research has been shown to be promising in radiographs, 11 magnetic resonance imaging, 12 and even musculoskeletal ultrasound.…”

“…As a clinical rheumatologist, I welcome the opportunity for assistance in clinic or hospital tasks. However, we are also decreasing in terms of workforce number as a specialty and because of the Pandemic, as doctors in general 8–10 . We need rapid identification or assessment of conditions in order not to delay treatment.…”

How can intersectoral collaboration and action help improve the education, recruitment, and retention of the health and care workforce? A scoping review

“…Patient outcomes are worse, care is less efficient, working conditions decline, and staff morale is affected. 17,18 The World Health Organization has championed guidance around fair migration, and has noted the importance of higher-income settings producing, mobilising, and recruiting their own HCWF as opposed to recruiting internationally, especially from countries with low HCWF density. 19 The challenges that we have highlighted here cannot be overcome by the Ministry of Health alone.…”

Standardising Workforce Cost Estimates Across Australian Jurisdictions: Genomic Testing as a Use Case

“…Australia also shares a health workforce market with New Zealand (with many shared regulatory and quasi-regulatory aspects). This remuneration and landscape of worker conditions is complex and can be challenging to assess within the country, let alone in comparison to other countries (5, 6). Differences in workforce costs are important in assessing cost variance between jurisdictions and countries, in health policy decisions and in understanding the impact of labour costs on economic evaluation (7).…”

“…In the context of microcosting a complex health service, diagnostic genomic testing for rare diseases and trying to understand the uncertainty of labour cost for this health service by jurisdiction (10), we identified a gap in available tools and resources for estimating public health workforce costs, specifically for genomics (pathology) workforce. A standardised Australian labour costing tool could be used to support comparative policy research within Australia (6) or for use in comparative health systems research with other countries (5). The application in this particular use case was to undertake a deterministic sensitivity analysis of clinical genomic testing by varying labour prices based on the estimated costs in Australian states with public clinical genomic testing services (10, 11).…”