Human resources for maternal, newborn and child health: from measurement and planning to performance for improved health outcomes

Abstract

BackgroundThere is increasing attention, globally and in countries, to monitoring and addressing the health systems and human resources inputs, processes and outputs that impede or facilitate progress towards achieving the Millennium Development Goals for maternal and child health. We reviewed the situation of human resources for health (HRH) in 68 low- and middle-income countries that together account for over 95% of all maternal and child deaths.MethodsWe collected and analysed cross-nationally comparable data on HRH availability, distribution, roles and functions from new and existing sources, and information from country reviews of HRH interventions that are associated with positive impacts on health services delivery and population health outcomes.ResultsFindings from 68 countries demonstrate availability of doctors, nurses and midwives is positively correlated with coverage of skilled birth attendance. Most (78%) of the target countries face acute shortages of highly skilled health personnel, and large variations persist within and across countries in workforce distribution, skills mix and skills utilization. Too few countries appropriately plan for, authorize and support nurses, midwives and community health workers to deliver essential maternal, newborn and child health-care interventions that could save lives.ConclusionsDespite certain limitations of the data and findings, we identify some key areas where governments, international partners and other stakeholders can target efforts to ensure a sufficient, equitably distributed and efficiently utilized health workforce to achieve MDGs 4 and 5.

Vulnerability in the Child Development: Influence of Public Policies and Health Programs*

“…During this period, many advances and setbacks in the area of human resources in health were arising from the clash between the theoretical-conceptual elements and ideological-political reform project with the needs of the SUS implementation. 14 Although Brazil is with above-average number of professionals from developing countries, 15 human resources are not distributed in an equitable manner throughout the national territory, and there is still lack of professionals in many regions (North and Northeast), and concentration of manpower in more developed regions (East and South), where wages and working conditions are more attractive. 16 Even in these regions also have difficulty in allocating human resources in more peripheral locations of large capitals, as the city of Curitiba, where the study was done.…”

Vulnerabilidade da criança diante de situações adversas ao seu desenvolvimento: proposta de matriz analítica

“…It is related to the level of investments that the State provides for the financing of actions of child care (2,7,27) . This scenario is characterized by political commitment (2) , material and institutional sustainability of policies (28) , human and material resources (29) , definition of specific policies for child development (2,(27)(28) , intersectoral activities (14,26) , social and legal responsibility of services (5,7) , social control of the planning and implementation of policies (26) .…”

Maternal and Child Health in South Sudan

“…The availability of skilled birth attendants able to detect, prevent, and manage obstetric complications as well as to provide drugs, equipment, and other supplies is the single most important factor in preventing maternal deaths (Rosenfield & Schwartz, 2005). South Sudan's health worker density is far lower than the minimum threshold recommended by the WHO (Gupta et al, 2011). In 2009-2010, there were a reported total of 189 physicians across 8 states (a doctor/population ratio of 1:65,574) and 309 midwives (a midwife/population ratio of 1:39,088; MoH, 2010).…”