Health labour market policies in support of universal health coverage: a comprehensive analysis in four African countries

Abstract

BackgroundProgress toward universal health coverage in many low- and middle-income countries is hindered by the lack of an adequate health workforce that can deliver quality services accessible to the entire population.MethodsWe used a health labour market framework to investigate the key indicators of the dynamics of the health labour market in Cameroon, Kenya, Sudan, and Zambia, and identified the main policies implemented in these countries in the past ten years to address shortages and maldistribution of health workers.ResultsDespite increased availability of health workers in the four countries, major shortages and maldistribution persist. Several factors aggravate these problems, including migration, an aging workforce, and imbalances in skill mix composition.ConclusionsIn this paper, we provide new evidence to inform decision-making for health workforce planning and analysis in low- and middle-income countries. Partial health workforce policies are not sufficient to address these issues. It is crucial to perform a comprehensive analysis in order to understand the dynamics of the health labour market and develop effective polices to address health workforce shortages and maldistribution as part of efforts to attain universal health coverage.

Health sector employment: a tracer indicator for universal health coverage in national Social Protection Floors

“…This concerns particularly employment in the public sector if working conditions are less attractive than in the private sector. Besides policies that increase retention rates due to better working conditions, it may also be necessary to regulate the private sector with a view to ensure equity in access [ 10 ].…”

A Review of Realizing the Universal Health Coverage (UHC) Goals by 2030: Part 2- What is the Role of eHealth and Technology?

“…The lack of qualified HRH hinders the progress in achieving UHC in many high-income countries in general [24], and in the developing countries in particular [25,26]. Consequently, UHC requires a paradigm shift in HRH polices in order to develop more dynamic HRH forecasting models based on the analysis of labor market [24,27].…”

“…According to this framework, countries can develop their own HRH strategies that address the myriad of economic, professional, individual, and social factors [26]. For example, a comprehensive analysis of the health labor market polices in support of UHC was performed in four African countriesnamely, Cameroon, Kenya, Sudan, and Zambia -as described in [25].…”

How to create more supportive supervision for primary healthcare: lessons from Ngamiland district of Botswana: co-operative inquiry group

“…Primary healthcare makes an important contribution to achieving equitable access to comprehensive and cost-effective health services ( 1 ). Effective primary healthcare services in many low- and-middle-income countries, however, have been hampered by severe shortages and inequitable distribution of the health workforce ( 2 – 5 ). Migration of health workers has exacerbated the shortage and inequity in many of these countries ( 3 , 4 , 6 ).…”

“…Multiple innovative strategies have been tried to increase the number of healthcare workers and to distribute and retain them, especially in rural and remote areas ( 7 , 8 ). These innovations comprised educational, fiscal, and regulatory approaches as well as diverse incentives and have had varying degrees of success ( 5 , 7 – 10 ). Based on existing evidence of effective retention strategies, Buykx et al ( 11 ) developed a framework to guide retention interventions.…”