Workforce analysis using data mining and linear regression to understand HIV/AIDS prevalence patterns

Madigan, Elizabeth A.; Curet, Olivier Louis; Zrı́nyi, Miklós

doi:10.1186/1478-4491-6-2

Cited by 14 publications

(8 citation statements)

References 11 publications

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“…The exact nature of the relationship between the physician workforce and the achievement of MDGs in any one country is doubtlessly affected by a large number of context-specific factors, as well as by factors which may not be context specific, but for which we did not have a good source of data, such as a systematic record, across many nations, of other health worker density levels. We are also not the first study [ 11 ] to note the relationship between the health workforce (and particularly physician density) and MDG outcomes. However, we do offer this report as iterative and new evidence that the relationship is real and must be taken into account in future planning efforts for developmental goals going forward.…”

Section: Discussionmentioning

confidence: 99%

“…The WHO estimates that healthcare systems comprised of fewer than 23 healthcare workers per 10,000 population are unable to properly deliver necessary health services to a given region [ 7 ]. Several studies from across the world have suggested that an increase in physician or skilled healthcare worker density can produce a significant reduction in maternal and child mortality rates [ 8 – 10 ], and other studies have demonstrated the relationship between physician density and HIV/AIDS prevalence [ 11 ]. However, healthcare improvement in developing nations is often handled in response to distinct crises, or with internationally-based non-governmental agencies (NGOs) providing distinct and specific services.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of the association between millennium development goals 4 & 5 and the physician workforce across international economic strata

Morley

Wang

Mader

et al. 2017

BMC Int Health Hum Rights

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BackgroundThe Millennium Development Goals (MDGs) are 8 international development goals voluntarily adopted by 189 nations. The goals included health related aims to reduce the under-five child mortality rate by two-thirds (MDG4), and to reduce the maternal mortality ratio by three-quarters (MDG5). To assess the relationship between the healthcare workforce and MDGs 4–5, we examined the physician workforces of countries around the globe, in terms of the Physician Density Level (PDL, or number of physicians per 1000 population), and compared this rate across a number of years to several indicator variables specified as markers of progress towards MDG4 and MDG5.MethodsData for each variable of interest were obtained from the World Bank’s Millennium Development Goals and World Development Indicators databases for 208 countries and territories from 2004 to 2014, representing a ten-year period for which the most information is available. We analyzed the relationships between MDG outcomes and PDL, controlling for national income levels and other covariates, using linear mixed model regression. Dependent variables were logarithmically transformed to meet assumptions necessary for multivariate analysis.ResultsIn unadjusted models, an increase of every one physician per 1000 population (one unit change in PDL) lowered the risk of not being vaccinated for measles-mumps-rubella (MMR) to 29.3% (p < 0.001, 95% CI: 22.2%–38.7%) and for not receiving diphtheria-tetanus-pertussis (DTaP) vaccination rate decreased to 38.5% (p < 0.001, 95% CI: 28.7% - 51.7%). Maternal mortality rate decreased to 76.6% (p < 0.001, 95% CI: 74.3% - 79.0%), neonatal mortality decreased to 58.8% (p < 0.001, 95% CI: 54.8% - 63.2%) and under-5 mortality rate decreased to 52.1% (p < 0.001, 95% CI: 48.0% - 56.4%), with every one-unit change in PDL. Adjusted models tended to reflect unadjusted risk assessments.ConclusionThe maintenance and improvement of the health workforce is a vital consideration when assessing how to achieve global development goals related to health outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Analysis of the association between millennium development goals 4 & 5 and the physician workforce across international economic strata

Morley

Wang

Mader

et al. 2017

BMC Int Health Hum Rights

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“…We are not aware of any study that has argued convincingly that the number of health workers per capita is a strong predictor of HIV prevalence. (Note: Madigan et al [ 31 ] argue that health worker density has an impact on HIV/AIDS prevalence. However, their regression analysis fails to control for variables that one would expect are important predictors of HIV/AIDS prevalence, such as sexual behaviour and attitudes, and knowledge about the transmission of the disease.…”

Section: Methodsmentioning

confidence: 99%

Measuring inequalities in the distribution of health workers: the case of Tanzania

2009

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Background: The overall human resource shortages and the distributional inequalities in the health workforce in many developing countries are well acknowledged. However, little has been done to measure the degree of inequality systematically. Moreover, few attempts have been made to analyse the implications of using alternative measures of health care needs in the measurement of health workforce distributional inequalities. Most studies have implicitly relied on population levels as the only criterion for measuring health care needs. This paper attempts to achieve two objectives. First, it describes and measures health worker distributional inequalities in Tanzania on a per capita basis; second, it suggests and applies additional health care needs indicators in the measurement of distributional inequalities.

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“…Many reports in low and middle income countries have highlighted acute shortages of health workers who are outpaced by the actual needs for health care services (Anand &Barnighaussen, 2004WHO, 2006;Lehman et al, 2008;Madigan et al, 2008;). Imbalanced distribution of the fewer health workers available is also an important policy issue which has been attributed to failure by some employers to recruit the required health workers and retain them (Chomitz et al, 1998;WHO, 1998;Dambisya, 2002;Serneels et al, 2007;).…”

Section: Introductionmentioning

confidence: 99%

Comprehensive health workforce planning: re-consideration of the primary health care approach as a tool for addressing the human resource for health crisis in low and middle income countries

Munga

Mwangu

2013

Tanzania J Hlth Res

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Although the Human Resources for Health (HRH) crisis is apparently not new in the public health agenda of many countries, not many low and middle income countries are using Primary Health Care (PHC) as a tool for planning and addressing the crisis in a comprehensive manner. The aim of this paper is to appraise the inadequacies of the existing planning approaches in addressing the growing HRH crisis in resource limited settings. A descriptive literature review of selected case studies in middle and low income countries reinforced with the evidence from Tanzania was used. Consultations with experts in the field were also made. In this review, we propose a conceptual framework that describes planning may only be effective if it is structured to embrace the fundamental principles of PHC. We place the core principles of PHC at the centre of HRH planning as we acknowledge its major perspective that the effectiveness of any public health policy depends on the degree to which it envisages to address public health problems multidimensionally and comprehensively. The proponents of PHC approach in planning have identified intersectoral action and collaboration and comprehensive approach as the two basic principles that policies and plans should accentuate in order to make them effective in realizing their pre-determined goals. Two conclusions are made: Firstly, comprehensive health workforce planning is not widely known and thus not frequently used in HRH planning or analysis of health workforce issues; Secondly, comprehensiveness in HRH planning is important but not sufficient in ensuring that all the ingredients of HRH crisis are eliminated. In order to be effective and sustainable, the approach need to evoke three basic values namely effectiveness, efficiency and equity.

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Workforce analysis using data mining and linear regression to understand HIV/AIDS prevalence patterns

Cited by 14 publications

References 11 publications

Analysis of the association between millennium development goals 4 & 5 and the physician workforce across international economic strata

Analysis of the association between millennium development goals 4 & 5 and the physician workforce across international economic strata

Measuring inequalities in the distribution of health workers: the case of Tanzania

Comprehensive health workforce planning: re-consideration of the primary health care approach as a tool for addressing the human resource for health crisis in low and middle income countries

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