Human resources for health in southeast Asia: shortages, distributional challenges, and international trade in health services

Kanchanachitra, Churnrurtai; Lindelöw, Magnus; Johnston, Timothy; Hanvoravongchai, Piya; Lorenzo, Fely Marilyn E.; Hương, Nguyễn Lan; Wilopo, Siswanto Agus; Rosa, Jennifer Frances dela

doi:10.1016/s0140-6736(10)62035-1

Cited by 273 publications

(260 citation statements)

References 22 publications

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“…In Cambodia, a developing nation in Southeast Asia, many factors locally co-exist and contribute to sub-optimal quality of patient care and increasing the risk of health-care associated infections (HAI): irregular supply of medical consumables, limited hospital operational budgets, low salaries of health staff [9], poor knowledge of infection control practices, irregular repartition of health services causing overload of work [10], and co-existence of other major health problems.…”

Section: Introductionmentioning

confidence: 99%

Surveillance of post-caesarean surgical site infections in a hospital with limited resources, Cambodia

Srun

Yin

Seng

et al. 2013

J Infect Dev Ctries

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Introduction: In Cambodia, we implemented a pilot surveillance of superficial surgical site infections (SSSI) following caesarean deliveries (CD) in a provincial hospital, to estimate their incidence, describe their clinical management, and determine their causative pathogens. Methodology: Between October 2010 and February 2011, all women admitted for CD were included in the surveillance. Their clinical condition was monitored for a post-operative period of 30 days, including two assessments performed by surgeons. Cases were clinically diagnosed by surgeons, with bacterial cultures performed. Results: Of the 222 patients admitted for CD, 176 (79.3%) were monitored for 30 days. Of these, 11 were diagnosed with a SSSI, giving an incidence rate of 6.25% (95% CI 3.2-10.9). Four of the cases (36.4%) were detected after hospital discharge. Length of hospitalization was significantly longer for the SSSI cases. All 222 patients were prescribed antibiotics. Ampicillin was administered intravenously to 98.6% of them, with subsequent oral amoxicillin given to 82.9%. Three of six pus samples collected were positive on culture: two with Staphylococcus aureus and one with Staphylococcus lugdunensis. One S.aureus was methicillin resistant (MRSA). The other was clindamycin and erythromycin resistant. Conclusion: Surveillance of health-care associated infections in a setting with limited resources is challenging but feasible. Effective postdischarge surveillance was essential for the estimation of the incidence rate of SSSI following caesarean deliveries. This surveillance led to a peer-review of medical practices.

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Section: Introductionmentioning

confidence: 99%

Surveillance of post-caesarean surgical site infections in a hospital with limited resources, Cambodia

Srun

Yin

Seng

et al. 2013

J Infect Dev Ctries

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“…Crossborder health care is a great challenge to public health systems of host countries because it leads to critical accessibility issues and, importantly, equity and financial security of the affected health care systems. On a governmental level, cross-border health care is directly related to treaty structures with neighboring countries, and the organization and capability of their domestic social security and health care systems that comes with cross-border health care [23][24][25]. In light of the establishment of the ASEAN Economic Community (AEC) scheduled for 2015, Thailand has been facing a gradual increase in the use of crossborder health care.…”

Section: Brief Communication (Original)mentioning

confidence: 99%

Factors influencing decisions of Laotian patients to use health care services in Thailand

et al. 2014

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Background: Thailand has been facing a gradual increase in use of cross-border health care. Nevertheless, no evidence regarding factors influencing cross-border use of health care by Laotian patients in public Thai hospitals among this group has been established. Objectives: To assess the use of cross-border health care by Laotian patients, and factors that may influence health services in public Thai hospitals along the border. Methods: This study consisted of two parts. (1) Site-visits to 53 Thai public hospitals along the Thai-Laos border during May to July 2011 and collection of data regarding the use of health care services by Laotian patients. (2) A structured questionnaire survey was conducted via face interviews by trained researchers. Findings were analyzed using descriptive statistics and multiple logistic regression. Results: The most common conditions for which treatment was sought were common diseases and basic operative procedures. All hospitals had been facing substantial financial burden, particularly for inpatient care. The analysis of use indicated that a perception of differences in the quality of health services, ability to pay for treatment anywhere, and distance to health services were three major factors affecting the decision of Laotian patients to cross the border to obtain health care in Thailand. Interviews with hospital directors and staff revealed that more financial support and a clear policy for care of Laotian patients was needed. Conclusions:The perception of better quality of health care in Thailand by Laotian patients was the major factor affecting cross-border use of health care services. Assistance to improve healthcare in Laos and financial support for subsidizing care for the indigent Laotian patients is needed.

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“…Reasons for migration have been economic. A nurse earns USD 5000 a month in the US or the UK, almost 50 to 100 times what she would earn in Manila (USD 58-115 per month) (22) .…”

Section: Philippinesmentioning

confidence: 99%

“…In 2009, an estimated 400 000 licensed nurses in the Philippines were not employed in the nursing profession (22) .…”

Section: Philippinesmentioning

confidence: 99%

Abordando la crisis de los Recursos Humanos para la Salud: ¿Hasta dónde hemos llegado? ¿Qué podemos esperar lograr al 2015?

Dayrit¹,

Dolea²,

Dreesch³

2011

Rev Peru Med Exp Salud Publica

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The World Health Report 2006 identified 57 countries world-wide whose health worker to population density fell below a critical threshold of 2.3 per 1,000 population. This meant that below this critical threshold, a country could not provide the basic health services to its population, defined here as 80% immunization coverage and 80% skilled birth attendance at delivery. Of the 57 countries, 36 are located in Africa.This article reviews the progress countries have made in addressing their health workforce crisis. It cites 3 of the most recent global studies and the indicators used to measure progress. It also features the experiences of 8 countries, namely Malawi, Peru, Ethiopia, Brazil, Thailand, Philippines, Zambia, Mali. Their situations provide a diverse picture of country efforts, challenges, and successes. The article asks the question of whether the target of 25% reduction in the number of crisis countries can be achieved by 2015. This was a goal set by the World Health Assembly in 2008. While the authors wish to remain optimistic about the striving towards this target, their optimism must be matched by an adequate level of investment in countries on HRH development. The next four years will show how much will really be achieved.

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Human resources for health in southeast Asia: shortages, distributional challenges, and international trade in health services

Cited by 273 publications

References 22 publications

Surveillance of post-caesarean surgical site infections in a hospital with limited resources, Cambodia

Surveillance of post-caesarean surgical site infections in a hospital with limited resources, Cambodia

Factors influencing decisions of Laotian patients to use health care services in Thailand

Abordando la crisis de los Recursos Humanos para la Salud: ¿Hasta dónde hemos llegado? ¿Qué podemos esperar lograr al 2015?

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