Human resource challenges in health systems : evidence from 10 African countries
(2024) In Health Policy and Planning 39(7). p.693-709- Abstract
Sub-Saharan Africa has fewer medical workers per capita than any region of the world, and that shortage has been highlighted consistently as a critical constraint to improving health outcomes in the region. This paper draws on newly available, systematic, comparable data from 10 countries in the region to explore the dimensions of this shortage. We find wide variation in human resources performance metrics, both within and across countries. Many facilities are barely staffed, and effective staffing levels fall further when adjusted for health worker absences. However, caseloads—while also varying widely within and across countries—are also low in many settings, suggesting that even within countries, deployment rather than shortages,... (More)
Sub-Saharan Africa has fewer medical workers per capita than any region of the world, and that shortage has been highlighted consistently as a critical constraint to improving health outcomes in the region. This paper draws on newly available, systematic, comparable data from 10 countries in the region to explore the dimensions of this shortage. We find wide variation in human resources performance metrics, both within and across countries. Many facilities are barely staffed, and effective staffing levels fall further when adjusted for health worker absences. However, caseloads—while also varying widely within and across countries—are also low in many settings, suggesting that even within countries, deployment rather than shortages, together with barriers to demand, may be the principal challenges. Beyond raw numbers, we observe significant proportions of health workers with very low levels of clinical knowledge on standard maternal and child health conditions. This study highlights that countries may need to invest broadly in health workforce deployment, improvements in capacity and performance of the health workforce, and on addressing demand constraints, rather than focusing narrowly on increases in staffing numbers.
(Less)
- author
- organization
- publishing date
- 2024-08
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- developing countries, health systems research, Human resources, international health, knowledge, quality of care, staffing levels
- in
- Health Policy and Planning
- volume
- 39
- issue
- 7
- pages
- 17 pages
- publisher
- Oxford University Press
- external identifiers
-
- scopus:85201029691
- pmid:38722023
- ISSN
- 0268-1080
- DOI
- 10.1093/heapol/czae034
- language
- English
- LU publication?
- yes
- id
- 98db0b62-c413-4145-88b8-8667e042fac2
- date added to LUP
- 2024-09-10 14:34:10
- date last changed
- 2024-09-11 03:00:02
@article{98db0b62-c413-4145-88b8-8667e042fac2,
abstract = {{<p>Sub-Saharan Africa has fewer medical workers per capita than any region of the world, and that shortage has been highlighted consistently as a critical constraint to improving health outcomes in the region. This paper draws on newly available, systematic, comparable data from 10 countries in the region to explore the dimensions of this shortage. We find wide variation in human resources performance metrics, both within and across countries. Many facilities are barely staffed, and effective staffing levels fall further when adjusted for health worker absences. However, caseloads—while also varying widely within and across countries—are also low in many settings, suggesting that even within countries, deployment rather than shortages, together with barriers to demand, may be the principal challenges. Beyond raw numbers, we observe significant proportions of health workers with very low levels of clinical knowledge on standard maternal and child health conditions. This study highlights that countries may need to invest broadly in health workforce deployment, improvements in capacity and performance of the health workforce, and on addressing demand constraints, rather than focusing narrowly on increases in staffing numbers.</p>}},
author = {{Sheffel, Ashley and Andrews, Kathryn G. and Conner, Ruben and Di Giorgio, Laura and Evans, David K. and Gatti, Roberta and Lindelow, Magnus and Sharma, Jigyasa and Svensson, Jakob and Wane, Waly and Tärneberg, Anna Welander}},
issn = {{0268-1080}},
keywords = {{developing countries; health systems research; Human resources; international health; knowledge; quality of care; staffing levels}},
language = {{eng}},
number = {{7}},
pages = {{693--709}},
publisher = {{Oxford University Press}},
series = {{Health Policy and Planning}},
title = {{Human resource challenges in health systems : evidence from 10 African countries}},
url = {{http://dx.doi.org/10.1093/heapol/czae034}},
doi = {{10.1093/heapol/czae034}},
volume = {{39}},
year = {{2024}},
}