Human resources for health and universal health coverage: fostering equity and effective coverage.

Abstract:

:Achieving universal health coverage (UHC) involves distributing resources, especially human resources for health (HRH), to match population needs. This paper explores the policy lessons on HRH from four countries that have achieved sustained improvements in UHC: Brazil, Ghana, Mexico and Thailand. Its purpose is to inform global policy and financial commitments on HRH in support of UHC. The paper reports on country experiences using an analytical framework that examines effective coverage in relation to the availability, accessibility, acceptability and quality (AAAQ) of HRH. The AAAQ dimensions make it possible to perform tracing analysis on HRH policy actions since 1990 in the four countries of interest in relation to national trends in workforce numbers and population mortality rates. The findings inform key principles for evidence-based decision-making on HRH in support of UHC. First, HRH are critical to the expansion of health service coverage and the package of benefits; second, HRH strategies in each of the AAAQ dimensions collectively support achievements in effective coverage; and third, success is achieved through partnerships involving health and non-health actors. Facing the unprecedented health and development challenges that affect all countries and transforming HRH evidence into policy and practice must be at the heart of UHC and the post-2015 development agenda. It is a political imperative requiring national commitment and leadership to maximize the impact of available financial and human resources, and improve healthy life expectancy, with the recognition that improvements in health care are enabled by a health workforce that is fit for purpose. :Parvenir à la couverture sanitaire universelle (CSU) implique la répartition des ressources, et en particulier des ressources humaines pour la santé (RHS), afin de répondre aux besoins de la population. Cet article étudie les leçons politiques sur les RHS de quatre pays ayant accompli des progrès durables en matière de CSU: le Brésil, le Ghana, le Mexique et la Thaïlande. Son but est d'informer sur les politiques globales et les engagements financiers dans les RHS visant à promouvoir la CSU.L'article décrit les expériences des pays à l'aide d'un cadre analytique examinant la couverture efficace par rapport à la disponibilité, l'accessibilité, l'acceptabilité et la qualité (DAAQ) des RHS. Les dimensions DAAQ permettent de réaliser une analyse de traçage des actions politiques en RHS depuis 1990 dans les quatre pays étudiés, par rapport aux tendances nationales des statistiques de main-d'oeuvre et des taux de mortalité de la population. Les résultats indiquent quels sont les principes clés pour la prise de décisions basées sur les faits sur les RHS visant à promouvoir la CSU. Premièrement, les RHS sont essentielles à l'expansion de la couverture des services de santé et de l'ensemble des avantages; deuxièmement, des stratégies RHS pour chacune des dimensions DAAQ favorisent collectivement les progrès vers une couverture efficace; et troisièmement, le succès est atteint à travers des partenariats impliquant des acteurs tant médicaux que non médicaux.Répondre aux défis sans précédent dans les domaines de la santé et du développement, qui concernent tous les pays, et transformer les faits RHS en politiques et en pratiques doivent être à la base du programme de CSU et de l'agenda de développement post-2015. C'est un impératif politique qui exige un engagement et un leadership nationaux pour optimiser l'impact des ressources financières et humaines disponibles et accroître l'espérance de vie en bonne santé, avec la reconnaissance que les progrès dans le domaine des soins de santé ne sont possibles qu'avec une main-d'oeuvre de santé adéquate. :Lograr una cobertura sanitaria universal implica una distribución de los recursos, en particular, de los recursos humanos para la salud (RHS), a fin de satisfacer las necesidades de la población. Este documento examina las lecciones sobre políticas relacionadas con los RHS de cuatro países que han conseguido avances ininterrumpidos en materia de cobertura sanitaria universal: Brasil, Ghana, México y Tailandia. Su objetivo consiste en exponer la política mundial y los compromisos financieros sobre RHS como ayuda para una cobertura sanitaria universal.El documento explica las experiencias de los países mencionados por medio de un marco de trabajo analítico que examina la eficacia de una cobertura en función de la disponibilidad, accesibilidad, aceptabilidad y calidad (DAAC) de los RHS. Los aspectos DAAC permiten llevar a cabo análisis de seguimiento sobre las acciones políticas relativas a los RHS desde 1990 en los cuatro países de interés en relación con las tendencias nacionales en el número de trabajadores y las tasas de mortalidad de la población.Los resultados muestran los principios fundamentales para la toma de decisiones basadas en pruebas científicas sobre los RHS como apoyo a una cobertura sanitaria universal. En primer lugar, los RHS son esenciales para expandir la cobertura de los servicios sanitarios y el conjunto de prestaciones. En segundo lugar, las estrategias RHS en cada uno de los aspectos DAAC respaldan de forma colectiva los logros en la eficacia de la cobertura y, en tercer lugar, los buenos resultados solo pueden conseguirse a través de la asociación de actores sanitarios y no sanitarios.Hacer frente a los desafíos sanitarios y de desarrollo sin precedentes que afectan a todos los países y traducir las pruebas científicas sobre RHS en políticas y prácticas deben convertirse en los puntos centrales de la cobertura sanitaria universal y de la agenda de desarrollo a partir del año 2015. Se trata de un imperativo político que requiere un compromiso y liderazgo nacionales para potenciar el impacto de los recursos financieros y humanos disponibles, y así mejorar la esperanza de vida saludable, sin olvidar que las mejoras en materia de asistencia sanitaria son posibles gracias a un personal sanitario apto para tal propósito. :يتضمن تحقيق التغطية الصحية الشاملة توزيع الموارد، لاسيما الموارد البشرية الصحية، لتلبية احتياجات السكان. وتستكشف هذه الورقة الدروس السياسية المعنية بالموارد البشرية الصحية المستفادة من أربعة بلدان حققت تحسينات مستدامة في التغطية الصحية الشاملة، هي: البرازيل وغانا والمكسيك وتايلند. وتهدف هذه الورقة إلى توفير المعلومات اللازمة للسياسة العالمية والالتزامات المالية للموارد البشرية الصحية دعماً للتغطية الصحية الشاملة. تقدم هذه الورقة تقارير عن خبرات البلدان باستخدام إطار تحليلي يدرس التغطية الفعالة فيما يتصل بتوافر وإتاحة ومقبولية وجودة الموارد البشرية الصحية. وتتيح أبعاد التوافر والإتاحة والمقبولية والجودة تنفيذ تتبع التحليل المعني بإجراءات سياسة الموارد البشرية الصحية منذ عام 1990 في البلدان الأربع محل الاهتمام فيما يتصل بالاتجاهات الوطنية في أعداد القوى العاملة ومعدلات وفيات السكان. توفر النتائج المعلومات اللازمة حول المبادئ الرئيسية لاتخاذ القرار المستند على البيّنات المعني بالموارد البشرية الصحية دعماً للتغطية الصحية الشاملة. أولاً، الموارد البشرية الصحية بالغة الأهمية في توسيع تغطية الخدمات الصحية وحزمة المزايا؛ ثانياً، تدعم استراتيجيات الموارد البشرية الصحية في كل بعد من أبعاد التوافر والإتاحة والمقبولية والجودة في مجموعها الإنجازات في التغطية الفعالة؛ ثالثاً، يتحقق النجاح من خلال الشراكات التي تضم جهات فاعلة في المجال الصحي وغير الصحي. يجب أن تكون مواجهة التحديات الصحية والإنمائية غير المسبوقة التي تؤثر على كل البلدان وتحويل بينّات الموارد البشرية الصحية إلى سياسة وممارسة محور التغطية الصحية الشاملة وجدول أعمال التنمية بعد عام 2015. وتمثل زيادة أثر الموارد المالية والبشرية المتاحة إلى أقصى قدر ممكن، وتحسين متوسط العمر المأمول لدى الأصحاء مع الإقرار بتمكين القوى العاملة الصحية المناسبة للغرض من إدخال تحسينات في الرعاية الصحية واجباً سياسياً يتطلب التزاماً وقيادة على الصعيد الوطني. :实现全民医保(UHC)涉及满足人们需求的资源分配,尤其是卫生人力资源(HRH)的分配。文本探讨了巴西、加纳、墨西哥和泰国四国HRH相关政策的经验教训,这四个国家在UHC方面取得了持续改进。本文旨在为HRH的相关全球政策和财务规划提供信息,用以支持UHC。本文使用考查HRH可用性、可及性、可接受性和质量(AAAQ)相关有效覆盖的分析框架来报告国家经验。采用AAAQ维度可以对四个受关注国家执行1990 年以来有关劳动力数量和人口死亡率国家趋势的HRH政策行为跟踪分析。研究结果可以为基于证据的相关HRH决策的基本原则提供参考信息,对UHC加以支持。首先,HRH对于扩大卫生服务覆盖和福利制度非常关键;其次,每个AAAQ维度中的HRH战略对实现有效覆盖共同起支持作用;第三,成功通过合作关系实现,这种合作关系涉及卫生工作者,也牵涉到非卫生行动者。面对影响所有国家的前所未有的卫生和发展挑战,将HRH证据转化为政策和实践必须居于UHC和2015 年后发展议程的核心。一个需要国家承诺和领导的政治要务就是,通过认识到专业对口的卫生劳动力能实现医疗卫生事业的改善,将可用财政和人力资源的效力最大化,并改善健康预期寿命。 :Достижение всеобщего охвата медико-санитарной помощью (ВОМСП) подразумевает распределение ресурсов, особенно кадровых ресурсов здравоохранения (КРЗ), в соответствии с потребностями населения. В данной статье исследуются результаты проведения политики в области КРЗ в четырех странах, добившихся устойчивых улучшений в области ВОМСП: Бразилии, Ганы, Мексики и Таиланда. Целью статьи является информирование о глобальной политике и финансовых обязательствах по КРЗ в целях обеспечения ВОМСП.В статье сообщается об опыте стран с применением аналитической основы, когда эффективность охвата медицинскими услугами рассматривается на основе таких параметров КРЗ, как наличие, доступность, приемлемость и качество (НДПК). Использование параметров НДПК дало возможность выполнить исторический анализ политики КРЗ в этих четырех странах с 1990 года с учетом национальных тенденций численности рабочей силы и смертности населения.В результате были выделены основные принципы научно обоснованных решений по КРЗ для поддержки ВОМСП. Во-первых, КРЗ имеет решающее значение для расширения охвата медицинским обслуживанием и связанных с ним комплексных улучшений; во-вторых, стратегии КРЗ по каждому параметру НДПК совместно обеспечивают более эффективный охват услугами; и в-третьих, успех достигается благодаря партнерским отношениям с организациями, как связанными со здравоохранением, так и работающими вне этой области.Эффективное преодоление беспрецедентных трудностей в области здравоохранения и развития, затрагивающих все страны, и воплощение результатов, полученных в ходе исследования КРЗ, в политику и практику, должно стать основой стратегии ВОМСП и сформировать повестку дня в целях развития после 2015 года. Политическим императивом сегодня является национальная заинтересованность и обеспечение руководства развитием здравоохранения, что позволит оптимально использовать имеющиеся финансовые и людские ресурсы и увеличить ожидаемую продолжительность здоровой жизни. При этом необходимо признание того, что улучшения в области медицинского обслуживания возможны только при наличии кадров работников здравоохранения, соответствующих данным целям.

authors

Campbell J,Buchan J,Cometto G,David B,Dussault G,Fogstad H,Fronteira I,Lozano R,Nyonator F,Pablos-Méndez A,Quain EE,Starrs A,Tangcharoensathien V

doi

10.2471/BLT.13.118729

subject

Has Abstract

pub_date

2013-11-01 00:00:00

pages

853-63

issue

11

eissn

0042-9686

issn

1564-0604

pii

BLT.13.118729

journal_volume

91

pub_type

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  • Incidence of influenza-like illness and severe acute respiratory infection during three influenza seasons in Bangladesh, 2008-2010.

    abstract:OBJECTIVE:To determine how much influenza contributes to severe acute respiratory illness (SARI), a leading cause of death in children, among people of all ages in Bangladesh. METHODS:Physicians obtained nasal and throat swabs to test for influenza virus from patients who were hospitalized within 7 days of the onset o...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章

    doi:10.2471/BLT.11.090209

    authors: Azziz-Baumgartner E,Alamgir AS,Rahman M,Homaira N,Sohel BM,Sharker MA,Zaman RU,Dee J,Gurley ES,Al Mamun A,Mah-E-Muneer S,Fry AM,Widdowson MA,Bresee J,Lindstrom S,Azim T,Brooks A,Podder G,Hossain MJ,Rahman M,Luby S

    更新日期:2012-01-01 00:00:00

  • Three basic convictions: a recipe for preventing child injuries.

    abstract::This paper represents a personal reflection on what is needed worldwide to prevent child injuries. It repeats messages that have been frequently delivered in the past. The main points are: first, the need for everyone to accept the view that, ultimately, injuries are a health problem and health departments must view t...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章

    doi:10.2471/blt.08.058024

    authors: Pless IB

    更新日期:2009-05-01 00:00:00

  • The effect of metrifonate on Brugia pahangi infections in domestic cats.

    abstract::Metrifonate, an organophosphorus compound, caused a decline in the number of microfilariae in domestic cats experimentally infected with Brugia pahangi. It was found that the drug was active against both microfilariae and macrofilariae, but probably its greatest effect was on the macrofilarial stages. It is suggested ...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章

    doi:

    authors: Denham DA,Ponnudurai T,Nelson GS,Guy F,Rogers R

    更新日期:1971-01-01 00:00:00

  • [Direct cost of the ambulatory management of diabetes at the outpatient clinic of the National Social Security Fund of Sfax (Tunisia)].

    abstract::The direct costs were determined by conducting a retrospective study on the files of 100 diabetics (selected at random) who had attended the clinic at least once in 1991. Another study was conducted simultaneously under the same conditions on 100 non-diabetic patients. Diabetic patients attend on average 8 times a yea...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章

    doi:

    authors: Rekik M,Abid M,Hachicha J,Abbes R,Moujahed M,Jarraya A

    更新日期:1994-01-01 00:00:00

  • Göran Tomson: scientists can help achieve sustainable development.

    abstract::Countries signed up to the 2030 Agenda for Sustainable Development face the challenge of achieving economic progress without damaging the environment or depleting natural resources. Göran Tomson tells Fiona Fleck how scientists can help. ...

    journal_title:Bulletin of the World Health Organization

    pub_type: 新闻

    doi:10.2471/BLT.18.030918

    authors:

    更新日期:2018-09-01 00:00:00

  • Health sector reform and reproductive health in Latin America and the Caribbean: strengthening the links.

    abstract::Many countries in Latin America and the Caribbean (LAC) are currently reforming their national health sectors and also implementing a comprehensive approach to reproductive health care. Three regional workshops to explore how health sector reform could improve reproductive health services have revealed the inherently ...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章,评审

    doi:

    authors: Langer A,Nigenda G,Catino J

    更新日期:2000-01-01 00:00:00

  • Observations on the physiology of adult anophelines in Asia.

    abstract::Some recent physiological observations made in Afghanistan, Ceylon and Burma on adults of Anopheles culicifacies and A. aconitus are described. The specimens from Ceylon and Burma, in particular, showed a peculiar physiological process in which, at the beginning of the dry season, the coagulated, dark red, and almost ...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章

    doi:

    authors: Büttiker W

    更新日期:1958-01-01 00:00:00

  • OBSERVATIONS ON THE SPREAD OF CHOLERA IN HONG KONG, 1961-1963.

    abstract::Cholera, which had been spreading throughout the south-west Pacific in 1961, broke out in Hong Kong in August of that year. The outbreak lasted about six weeks, and recurred in 1962 and 1963; but whereas the 1961 outbreak resembled classical cholera, in the succeeding years the pattern changed. The disease, though sti...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章

    doi:

    authors: VANDELINDE PA

    更新日期:1965-01-01 00:00:00

  • Protein-deficient diet and DDT toxicity.

    abstract::The objective of the study reported was to investigate the hypothesis that a diet low in protein would affect ability to detoxify pesticides. If this were so, the results would have application to use of pesticides in areas of the world where the diet is normally low in protein. To test the hypothesis, weanling albino...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章

    doi:

    authors: Boyd EM,de Castro ES

    更新日期:1968-01-01 00:00:00