Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019

Haakenstad, Annie; Irvine, Caleb Mackay Salpeter; Knight, Megan; Bintz, Corinne; Aravkin, Aleksandr Y.; Zheng, Peng; Gupta, Vin; Abrigo, Michael R.M.; Abushouk, Abdelrahman Ibrahim; Adebayo, Oladimeji; Agarwal, Gina; Alahdab, Fares; Al‐Aly, Ziyad; Alam, Khurshid; Alanzi, Turki; Alcalde‐Rabanal, Jacqueline Elizabeth; Alipour, Vahid; Alvis‐Guzmán, Nelson; Amit, Arianna Maever L.; Andrei, Cătălina Liliana; Andrei, Tudorel; Antonio, Carl Abelardo T.; Arabloo, Jalal; Aremu, Olatunde; Ayanore, Martin Amogre; Banach, Maciej; Bärnighausen, Till; Barthelemy, Celine M.; Bayati, Mohsen; Benzian, Habib; Berman, Adam E.; Bienhoff, Kelly; Bijani, Ali; Bikbov, Boris; Biondi, Antonio; Boloor, Archith; Busse, Reinhard; Butt, Zahid A; Cámera, Luis; Campos-Nonato, Ismael; Cárdenas, Rosario; Carvalho, Félix; Chansa, Collins; Chattu, Soosanna Kumary; Chattu, Vijay Kumar; Chu, Dinh‐Toi; Dai, Xiaochen; Dandona, Lalit; Dandona, Rakhi; Dangel, William James; Daryani, Ahmad; Neve, Jan-Walter De; Dhimal, Meghnath; Dipeolu, Isaac Oluwafemi; Djalalinia, Shirin; Thi, Hoa; Doshi, Chirag; Doshmangir, Leila; Ehsani‐Chimeh, Elham; Tantawi, Maha El; Fernandes, Eduarda; Fischer, Florian; Foigt, Nataliya; Фоменков, А. А.; Foroutan, Masoud; Fukumoto, Takeshi; Fullman, Nancy; Gad, Mohamed M.; Ghadiri, Keyghobad; Ghafourifard, Mansour; Ghashghaee, Ahmad; Glucksman, Thomas; Goudarzi, Houman; Gupta, Rajat Das; Hamadeh, Randah Ribhi; Hamidi, Samer; Haro, Josep María; Hasanpoor, Edris; Hay, Simon I.; Hegazy, Mohamed I.; Heibati, Behzad; Henry, Nathaniel J.; Hole, Michael K.; Hossain, Naznin; Househ, Mowafa; Ilesanmi, Olayinka Stephen; Imani-Nasab, Mohammad-Hasan; Irvani, Seyed Sina Naghibi; Islam, Sheikh Mohammed Shariful; Jahani, Mohammad Ali; Joshi, Ankur; Kalhor, Rohollah; Kayode, Gbenga A; Khalid, Nauman; Khatab, Khaled; Kısa, Adnan; Kochhar, Sonali; Krishan, Kewal; Defo, Barthelemy Kuate; Lal, Dharmesh Kumar; Lami, Faris; Larsson, Anders; Leasher, Janet; LeGrand, Kate E; Lim, Lee‐Ling; Mahotra, Narayan Bahadur; Majeed, Azeem; Maleki, Afshin; Manjunatha, N; Massenburg, Benjamin B.; Meštrović, Tomislav; Mini, GK; Mirică, Andreea; Mirrakhimov, Aibek E.; Mohammad, Yousef; Mohammed, Shafiu; Mokdad, Ali H.; Morrison, Shane D; Naghavi, Mohsen; Ndwandwe, Duduzile; Negoi, Ionuț; Negoi, Ruxandra Irina; Ngunjiri, Josephine W; Nguyen, Cuong Tat; Nigatu, Yeshambel T.; Onwujekwe, Obinna; Ortega-Altamirano, Doris Verónica; Otstavnov, Nikita; Otstavnov, Stanislav S; Owolabi, Mayowa; Pakhare, Abhijit; Pepito, Veincent Christian Filipino; Perico, Norberto; Pham, Hai Quang; Pigott, David M.; Pokhrel, Khem Narayan; Rabiee, Mohammad; Rabiee, Navid; Rahimi‐Movaghar, Vafa; Rawaf, David Laith; Rawaf, Salman; Rawal, Lal; Remuzzi, Giuseppe; Renzaho, Andre Μ Ν; Resnikoff, Serge; Rezaei, Nima; Rezapour, Aziz; Rickard, Jennifer; Roever, Leonardo; Sahu, Maitreyi; Samy, Abdallah M.; Sanabria, Juan; Santric-Milicevic, Milena M; Saraswathy, Sivan Yegnanarayana Iyer; Seedat, Soraya; Senthilkumaran, Subramanian; Serván‐Mori, Edson; Shaikh, Masood Ali; Sheikh, Aziz; Silva, Diego Augusto Santos; Stein, Caroline; Stein, Dan J.; Titova, Mariya Vladimirovna; Topp, Stephanie M.; Tovani‐Palone, Marcos Roberto; Ullah, Saif; Unnikrishnan, B; Vacante, Marco; Valdez, Pascual; Vasankari, Tommi; Venketasubramanian, Narayanaswamy; Vlassov, Vasily; Vos, Theo; Yearwood, Jamal A.; Yonemoto, Naohiro; Younis, Mustafa Z; Yu, Chuanhua; Zadey, Siddhesh; Zaman, Sojib Bin; Zerfu, Taddese Alemu; Zhang, Zhijiang; Ziapour, Arash; Zodpey, Sanjay; Lim, Stephen S; Murray, Christopher J L; Lozano, Rafael

doi:10.1016/s0140-6736(22)00532-3

Cited by 143 publications

(89 citation statements)

References 51 publications

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“…To escape an unfriendly work environment, victims are likely to leave the healthcare industry and join other industries, which is a major concern [ 56 , 57 ]. According to the UN Sustainable Development Goals (SDGs) and the World Health Organization Health Workforce 2030 strategy, the density of physicians is 27.2 per 10,000 population in China compared with central Europe, eastern Europe, and central Asia’s average of 38.3 [ 58 ]. Simultaneously, some scholars have found that most Chinese medical students, as future physicians, had a very strong dropout intention [ 59 ].…”

Section: Discussionmentioning

confidence: 99%

Current Status of Intergroup Threats Perceived by Chinese Physicians and Its Association with Organizational Psychology, Behavior, and Well-Being during the COVID-19 Pandemic: A Cross-Sectional Survey

et al. 2022

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(1) Background: Chinese physicians have encountered serious physical and verbal attacks in recent decades due to poor patient–physician relationships, leading to a broad spectrum of negative consequences. This study aims to assess the status of intergroup threats perceived by physicians and explore its association with organizational psychology, behavior, and well-being during the COVID-19 pandemic. (2) Methods: We conducted a cross-sectional online survey with physicians from November to December 2020 in three provinces: Heilongjiang Province, Henan Province, and Zhejiang Province, in China. A total of 604 physicians were recruited to complete an anonymous questionnaire. There were 423 valid questionnaires. (3) Results: We developed a 25-item intergroup threat scale with four dimensions: interest damage, performance impairment, value derogation, and unjust sentiment. Internal consistency reliability analyses showed that the four dimensions and overall scale exhibited high internal consistency (0.756–0.947). Additionally, the average scores for physicians’ perceived overall intergroup threat, interest damage, performance impairment, value derogation, and unjust sentiment were 4.35 ± 0.51, 4.24 ± 0.73, 4.33 ± 0.58, 4.22 ± 0.65, and 4.53 ± 0.55, respectively. Moreover, this study shows that the intergroup threats perceived positively by physicians were associated with psychological stress (β = 0.270, p < 0.01), emotional exhaustion (β = 0.351, p < 0.01), turnover intention (β = 0.268, p < 0.01), and defensive medical behavior (β = 0.224, p < 0.01), and were negatively associated with job satisfaction (β = −0.194, p < 0.01) and subjective well-being (β = −0.245, p < 0.01). (4) Conclusions: The newly developed scale in this study is a reliable tool for measuring intergroup threats perceived by Chinese physicians. Physicians in China were suffering high-level intergroup threats during the anti-COVID-19 pandemic, which has a significant impact on damage to organizational psychology, behavior, and well-being. Intergroup threats perceived by physicians not only enlarged the risk of emotional exhaustion and psychological stress but also threatened organizational well-being. Moreover, greater intergroup threats were associated with a lower job satisfaction, more frequent defensive medical behavior, and a higher turnover intention for physicians. The results of this study suggest that essential intervention and governance measures should be considered to protect physicians’ well-being and benefits in China, which are urgently needed.

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Section: Discussionmentioning

confidence: 99%

Current Status of Intergroup Threats Perceived by Chinese Physicians and Its Association with Organizational Psychology, Behavior, and Well-Being during the COVID-19 Pandemic: A Cross-Sectional Survey

et al. 2022

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“…CHWs were key for communication outreach, and investment in them would produce benefits by improving their capacities in terms of technology and attention to emergencies. There is a fundamental need to invest in building up capacity, as this would improve service delivery in general and during emergencies [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

A Qualitative Assessment of the Essential Health and Nutrition Service Delivery in the Context of COVID-19 in Bangladesh: The Perspective of Divisional Directors

et al. 2022

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Bangladesh suffered disruptions in the utilization of essential health and nutrition services (EHNS) during the COVID-19 pandemic. The magnitude of the pandemic has been documented, but little is known from the perspectives of health administrators. A rapid qualitative assessment of division-level capacity identified successes and bottlenecks in providing EHNS- and COVID-19-related services during the first months of the pandemic in Bangladesh. Semi-structured interviews were held with the Health and Family Planning Divisional Directors of the Ministry of Health and Family Welfare. The Primary Health Care System Framework guided the content analysis, focusing on (i) service delivery, (ii) communication and community outreach, and (iii) surveillance and service monitoring. Our findings identified low care seeking due to fears of getting infected and unawareness that EHNS were still available. Adaptations to telemedicine were highly heterogeneous between divisions, but collaboration with NGOs were fruitful in reinstating outreach activities. Guidelines were centered on COVID-19 information and less so on EHNS. The inflexibility of spending capacities at divisional and clinic levels hindered service provision. Misinformation and information voids were difficult to handle all around the country. Community health workers were useful for outreach communication. EHNS must be guaranteed during sanitary emergencies, and Bangladesh presented with both significant efforts and areas of opportunity for improvement.

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“…This operational fragmentation often impeded the quality and e ciency of service delivery and added to patients' transport costs and lengthy time spent in queues [15,20,22]. Task shifting has been an important strategy to address the severe health workforce shortages in the sub-Saharan Africa region [24], where low and mid-level healthcare providers usually deliver or dispense preventive therapy [13,14,19]. However, these healthcare providers lacked knowledge or training on CPT [13,14,19,20].…”

Section: Implementation Challengesmentioning

confidence: 99%

“…Poor recording of CPT on patient les has been reported, undermining the facility-based drug demand [13,16]. The disproportional provider-patient ratio [24] and weak information systems that lacked integration and relied on both paper-based and electronic les provided an explanation for inconsistent recording practices [13,14,16,17,20]. Scarcity of CTZ at the medical stores' department or government supplier side [15], ineffective supply chain management [14,17] a lack of support from policymakers, program managers or district health departments has also been reported [14,17].…”

Section: Implementation Challengesmentioning

confidence: 99%

Reasons for implementation success despite health system constraints: qualitative insights on 'what worked' for cotrimoxazole preventive therapy

Müller

Mabasso

Lapão

et al. 2022

Preprint

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Background: Although Cotrimoxazole preventive therapy (CPT) has shown to be highly efficacious in reducing mortality among people living with Human immunodeficiency virus (HIV) under 'ideal world' study conditions, operational challenges are limiting its effectiveness when implementing in countries most affected by the epidemic. The fact that Mozambican authorities reported high coverage of CPT among patients with HIV, has led to this qualitative case study aimed at exploring possible factors responsible for the successful implementation of CPT in the Province of Maputo. Methods: Between February and April 2019, we individually interviewed nine governmental stakeholders, including the person responsible for HIV, TB and Pharmaceutical management at three administrative levels (central, provincial and district level). Interviews were recorded, transcribed, and analysed thematically using MAXQDA Analytics Pro. Findings were translated from Portuguese into English. Results: Five themes iteratively emerged: (a) Role of governance & leadership, (b) Pharmaceutical strategies, (c) Service delivery modifications, (d) Health care provider factors, and (e) Patients' perspectives. Interviews revealed that continuous supply of cotrimoxazole (CTZ) had been facilitated through multiple-source procurement and a push-pull strategy. One part of CTZ arrived in kits that were imported from overseas and distributed to public health facilities based on their number of outpatient consultations (push strategy). Another part of CTZ was locally produced and distributed as per health facility demand (pull strategy). Strong district level accountability seemed to also have facilitated the public availability of CTZ. Interviewees praised models of differentiated care, the integrated HIV service delivery and drug delivery strategies for reducing long queues at the health facility, better accommodating patients' needs and reducing their financial and organisational burden. Conclusions: This study presents aspects that governmental experts believed to be key for the implementation of CPT in the Province of Maputo, Mozambique. Enhancing the implementation outcomes – drug availability and feasibility of the health facility based service delivery – seemed crucial for the implementation progress. Reasons for the remarkable patient acceptability of CPT in our study setting should be further investigated.

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Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019

Cited by 143 publications

References 51 publications

Current Status of Intergroup Threats Perceived by Chinese Physicians and Its Association with Organizational Psychology, Behavior, and Well-Being during the COVID-19 Pandemic: A Cross-Sectional Survey

Current Status of Intergroup Threats Perceived by Chinese Physicians and Its Association with Organizational Psychology, Behavior, and Well-Being during the COVID-19 Pandemic: A Cross-Sectional Survey

A Qualitative Assessment of the Essential Health and Nutrition Service Delivery in the Context of COVID-19 in Bangladesh: The Perspective of Divisional Directors

Reasons for implementation success despite health system constraints: qualitative insights on 'what worked' for cotrimoxazole preventive therapy

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