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Human resources for health (HRH) is a cornerstone in the medical system. This paper combined data envelopment analysis (DEA) with Tobit regression analysis to evaluate the efficiency of health care services in China over the years between 2007 and 2019. Efficiency was first estimated by using DEA with the choice of inputs and outputs being specific to health care services and residents’ health status. Malmquist index model was selected for estimating the changes in total factor productivity of provinces and exploring whether their performance had improved over the years. Tobit regression model was then employed in which the efficiency score obtained from the DEA computations used as the dependent variable, and HRH was chosen as the independent variables. The results showed that all kinds of health personnel had a significantly positive impact on the efficiency, and more importantly, pharmacists played a critical role in affecting both the provincial and national efficiency. Therefore, the health sector should pay more attention to optimizing allocation of HRH and focusing on professional training of clinical pharmacists.
Pharmacists play a fundamental role in healthcare systems and achieving Universal Health Coverage (UHC) through quality primary healthcare service provision. While the World Health Organization (WHO) forecasts a global shortage of health workforce by 2030, mainly affecting low- and middle-income nations (LMICs), limited published literature is found regarding pharmacy workforce capacity in LMICs, including Indonesia. This paper aims to analyse pharmacists’ capacity in Indonesia to identify emerging workforce planning gaps for future workforce planning and policies in Indonesia.Method
Several data sources were accessed, including a database from the National Pharmacy Committee and the professional leadership body in Indonesia. Descriptive (frequencies, percentages, and mean), correlational and time-series analysis using curve estimation were conducted. Secondary data on the number of programmes, pharmacy students, pharmacy workforce (pharmacists and pharmacy technicians) per province were obtained from the Ministry websites and reports.Result
There were a total of 77 191 registered pharmacists in Indonesia in 2019. The pharmacists’ pyramid showed a youth bulge as a general indication of market expansion in the education sector correlating to the pharmacy programme’s number and size. There was a variation in pharmacy workforce density and access to pharmacy programmes across islands, which also were strongly correlated. Forecasting estimates that by 2030, women will represent around 86% of pharmacists in Indonesia. More female pharmacists were found working in the hospital and primary healthcare (providing direct services to patients) than male pharmacists. Younger pharmacists worked in the industrial sector, while older pharmacists worked in governmental and educational institutions.Conclusion
This study signposted workforce planning gaps for policy development in Indonesia, including a need to develop structured training to support early career pharmacists in their practice. There is also a need for better access to professional development programmes designed to support female pharmacists return to the regulated workforce following career breaks. National policy to promote equitable distribution and retention of pharmacists is recommended.
Promoting Person-Centered Care for Health Baccalaureate Students: Piloting an Interprofessional Education Approach to Wound Management.
This review summarizes technology-based interventions for HIV in low- and middle-income countries (LMICs). We highlight potential benefits and challenges to using telehealth in LMICs and propose areas for future study.Recent findings
We identified several models for using telehealth to expand HIV health care access in LMICs, including telemedicine visits for pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) services, telementoring programs for providers, and virtual peer-support groups. Emerging data support the acceptability and feasibility of these strategies. However, further investigations are needed to determine whether these models are scalable and sustainable in the face of barriers related to cost, infrastructure, and regulatory approval.Summary
HIV telehealth interventions may be a valuable approach to addressing gaps along the HIV care cascade in LMICs. Future studies should focus on strategies for expanding existing programs to scale and for assessing long-term clinical outcomes.
A global overview of healthcare workers’ turnover intention amid COVID-19 pandemic: a systematic review with future directions
Globally, the health workforce has long suffered from labour shortages. This has been exacerbated by the workload increase caused by the COVID-19 pandemic. Major collapses in healthcare systems across the world during the peak of the pandemic led to calls for strategies to alleviate the increasing job attrition problem within the healthcare sector. This turnover may worsen given the overwhelming pressures experienced by the health workforce during the pandemic, and proactive measures should be taken to retain healthcare workers. This review aims to examine the factors affecting turnover intention among healthcare workers during the COVID-19 pandemic.Methods
A mixed studies systematic review was conducted. The PubMed, Embase, Scopus, CINAHL, Web of Science and PsycINFO databases were searched from January 2020 to March 2022. The Joanna Briggs Institute’s Critical Appraisal Tools and the Mixed Methods Appraisal Tool version 2018 were applied by two independent researchers to critically appraise the methodological quality. Findings were synthesised using a convergent integrated approach and categorised thematically.Results
Forty-three studies, including 39 quantitative, two qualitative and two mixed methods studies were included in this review. Eighteen were conducted in the Middle East, ten in the Americas, nine in the Asia–Pacific region and six in Europe. Nurses (n = 35) were included in the majority of the studies, while physicians (n = 13), allied health workers (n = 11) and healthcare administrative or management staff (n = 7) were included in a smaller proportion. Five themes emerged from the data synthesis: (1) fear of COVID-19 exposure, (2) psychological responses to stress, (3) socio-demographic characteristics, (4) adverse working conditions, and (5) organisational support.Conclusions
A wide range of factors influence healthcare workers’ turnover intention in times of pandemic. Future research should be more focused on specific factors, such as working conditions or burnout, and specific vulnerable groups, including migrant healthcare workers and healthcare profession minorities, to aid policymakers in adopting strategies to support and incentivise them to retain them in their healthcare jobs.
Comparison of simulation-based interprofessional education and video-enhanced interprofessional education in improving the learning outcomes of medical and nursing students: A quasi-experimental study.
Population health trends analysis and burden of disease profile observed in Sierra Leone from 1990 to 2017
Sierra Leone, in West Africa, is one of the poorest developing countries in the world. Sierra Leone has experienced several recent challenges namely, a civil war from 1991 to 2002, a massive Ebola outbreak from 2014 to 2016, followed by floods and landslides in 2017.In this study, we quantified the burden of disease in Sierra Leone over a 27-year period, from 1990 to 2017.Methodology
In this descriptive study, we analysed secondary data from the Institute of Health Metrics and Evaluation, Global Burden of Disease (GBD) study. We quantified patterns of burden of disease, injuries, and risk factors in Sierra Leone. We report GBD data and metrics including mortality rates, years of life lost and risk factors for all ages and both sexes from 1990 to 2017.Results
From 1990 to 2017, trends of mortality rates for all ages and sexes have declined in Sierra Leone although mortality rates remain some of the highest when compared to other developing countries. The burden of communicable, maternal, neonatal, and nutritional (CMNN) diseases are greater than the burden of non-communicable diseases (NCDs) due to the prevalence of endemic diseases in Sierra Leone. The most important CMNNs associated with premature mortality included respiratory infections, neglected tropical diseases, malaria, and HIV-Aids. Life expectancy has increased from 37 to 52 years.Conclusion
Sierra Leone’s health status is gradually improving following the civil war and Ebola outbreak. Sierra Leone has a double burden of disease with CMNNs leading and NCDs progressively increasing. Despite these challenges, Sierra Leone has promising initiatives and programs pursuing the Universal Health Coverage 2030 Sustainable Developmental Goals Agenda. There is need for accountability of available resources, clear rules and expected roles for non-governmental organisations to ensure a level playing field for all actors to rebuild the health system.
A comprehensive, accurate description of workforce capacity is important for health service planning, to ensure that health services meet local needs. In many low- to middle-income countries, the government’s service planning ability is barred by the lack of accurate and/or comprehensively-described workforce data. In these low-resource settings, lack of appropriate planning leads to limited or no access to rehabilitation services. Variability in the definitions and scope of rehabilitation professionals further complicates the understanding of rehabilitation services and how it should be planned and delivered. Another challenge to describing the primary rehabilitation workforce capacity, is the lack of standardised and agreed-upon global metrics. These inconsistencies highlight the need for a comprehensive understanding of current practices, which can offer guidance to countries wishing to describe their rehabilitation workforce. This study aimed to scope the range of descriptors and metrics used to describe the rehabilitation workforce and to compare the workforce across countries that used similar descriptors in published reports.Methods
A scoping review was conducted according to the five-step framework first developed by Arksey and O’Malley. The review included a broad search of literature regarding the rehabilitation workforce and how countries quantify and describe the rehabilitation workforce.Results
Nineteen studies on rehabilitation workforce capacity were identified. All but one (a cross-sectional study) were database reviews. The main descriptors and indicators used to describe the rehabilitation workforce capacity were profession type, age, gender, distributions between urban/rural, level of care, and private/public sectors, absolute count totals, and population-adjusted ratios.Conclusion
This scoping review provided an overview of descriptors and indicators used to describe the rehabilitation workforce capacity internationally. The study is a first step towards developing standardised descriptors and metrics to quantify the rehabilitation workforce capacity, that will allow for comparison between different settings.Trial registration
This scoping review protocol has been registered with the Open Science Framework (http://osf.10/7h6xz).
A Novel Interprofessional Education and Supervision Student Placement Model: Student and Clinical Educator Perspectives and Experiences.
Components of interprofessional education programs in neonatal medicine: A focused BEME review: BEME Guide No. 73.
The Development and Validation of a Professional Development Program for Health Professional Educators in Ethiopian Higher Education Context
Despite the presence of a common agreement on the importance of integrating professional development (PD) for instructors in higher education (HE), the level of progress made in that regard varies greatly across HE systems around the world. Part of the variation was due to the lack of comprehensive theories and guidelines that leverage efforts to integrate PD issues into HE system. Also, there is limited research regarding the development and revision of PD programs for instructors of health sciences in HE setting. The limited studies primarily lack a comprehensive or all-encompassing framework that capture the complexities of the program development and validation process. Rather, they are essentially impact evaluation studies, examining the short-term and long-term benefits of the programs under studies. This study offers a theoretical rationale and a three-step framework for PD program development and review in HE through presenting a case study of an innovative PD program in the Ethiopian public university context. A three-step approach that consists of curriculum development, an iterative research–based review, and collaborative revision and validation is recommended in this study, to promote a commitment to systematic planning and research-based review and revision in a PD of instructors in HE in Ethiopia and beyond.
The roles of physician associates and advanced nurse practitioners in the National Health Service in the UK: a scoping review and narrative synthesis
Mid-level practitioners (MLPs), including physician associates (PAs) and advanced nurse practitioners (ANPs), have emerged to address workforce shortages in the UK and perform specific roles in relation to population needs. This has resulted in new ways of working and changes to established professional hierarchies. We conducted a study to investigate the career development, competencies, effectiveness, perceptions, and regulation of PAs and ANPs, with the aim of understanding ways to effectively integrate MLPs into the NHS workforce.Methods
We conducted a systematic scoping review following PRISMA guidelines. Embase, Medline, the Cochrane database, Pubmed, and CINAHL databases were searched, using terms relating to PAs and ANPs in the UK. A total of 128 studies (60 on PAs and 68 on ANPs) were included in the final analysis. A narrative synthesis, guided by the pre-defined themes and emerging themes, was conducted to bring together the findings.Results
PAs are educated on a medical model with basic medical skills but lack formal professional regulation and do not have prescribing rights. ANPs are educated on a nurse model with enhanced skills that depend on roles within specific specialities, and their governance is mostly employer-led. PAs are primarily employed in secondary care. ANPs are employed widely in both primary and secondary care. No defined career progression exists for PAs. In contrast, becoming an ANP is a form of career progression within nursing. Both roles were regarded as cost-effective in comparison to doctors performing simple tasks. PAs were less understood compared to ANPs and received a mixed reception from colleagues, which sometimes undermined their professional identity, whereas ANPs were mostly welcomed by colleagues.Conclusions
Potential ways to better integrate PAs and ANPs into the NHS workforce include further initiatives by regulatory bodies and the NHS to create more awareness and clearer role definitions for MLPs, outline potential for career progression, offer transparency with regard to remuneration, and introduction of prescribing rights. Future research might include more cadres of MLPs and explore the international literature.
Delivery of interprofessional education through a co-curricular journal reviewing medical literature.
Incorporation of Child & Adolescent Mental Health Standardized Patient Simulations to Provide Interprofessional Education for Graduate Students.
Interdisciplinary interprofessional education using an online learning environment called values exchange: A qualitative investigation.
A qualitative exploration of Ugandan mental health care workers’ perspectives and experiences on sexual and reproductive health of people living with mental illness in Uganda
People with Mental Illness experience vast sexual and reproductive health challenges due to the affected mental health. Globally, prevalence of mental illness is on the rise with subsequent increase in the number of people with sexual and reproductive challenges warranting urgent public health intervention. However, information on the perceptions and experiences of mental health workers, the key health care providers for this population is generally lacking yet it’s essential for formulation of appropriate policies and public health interventions.Aim
To explore Ugandan mental health care worker’s perspectives and experiences on the sexual and reproductive health of people living with mental illness in Uganda in order to generate recommendations to the ministry of health on how it can be improved.Materials and methods
Qualitative study design was employed with utilization of phone call semi-structured in-depth interviews to collect data from 14 mental health workers from Uganda’s National mental referral hospital, Butabika. Purposive sampling and convenience recruitment was done and the collected data was analyzed using Thematic content analysis.Results
Four themes were generated which included people with Mental illness having normal sexual needs, mental illness effect on sexuality and relationships, practices for safeguarding sexuality of people with mental illness and the barriers encountered in the provision of sexual and reproductive health services at a mental hospital.Conclusion
People with mental illness experience a multitude of sexual and reproductive health challenges that need public health interventions. However, the integration of sexual and reproductive health services in a mental hospital are not yet successful making people with mental illness to remain with unaddressed health challenges. Policies should therefore be developed and implemented to ensure successful integration of sexual and reproductive health at all mental health service care provision points.