Human Resources for Health最新文献

Background: The shortage of healthcare professionals, particularly public health dentists, in Pakistan, hinders the achievement of Sustainable Development Goal 3, which emphasizes good health and well-being. Dental Public Health (DPH) focuses on population-based oral healthcare, but it remains an underrepresented career choice among dental students in Pakistan. Understanding the factors that influence students' specialty choices is crucial for addressing workforce gaps and improving oral health outcomes.

Methods: This sequential explanatory mixed-methods study was conducted from February to June 2023 in Karachi, Pakistan. The quantitative phase involved a cross-sectional survey of 350 third- and fourth-year dental students and house officers from six randomly selected dental schools, with a response rate of 52% (n = 185). An adapted and validated questionnaire assessed attitudes toward pursuing DPH as a career. The data were analyzed using SPSS version 21. The qualitative phase included in-depth semi-structured interviews with 20 purposively selected participants to explore the motivations behind their specialty choices. A thematic analysis was performed on the qualitative data.

Results: Only 17.5% of house officers expressed an interest in pursuing DPH, compared to 39.2% of third-year students and 20.8% of fourth-year students. The majority preferred clinical specialties such as oral surgery. Students from private institutions showed slightly higher interest in DPH (37.3%) than those from public institutions (18.6%). Key themes from the interviews revealed that clinical specialties are favored for better financial prospects and relevance to private practice. DPH was considered a fallback option if clinical specialty was unattainable. Several participants acknowledged DPH's role in community service, research opportunities, and job security but felt that these benefits were insufficient to choose it in clinical fields.

Conclusions: There is declining interest in DPH as students' progress in their dental education, with a strong preference for clinical specialties due to perceived financial and professional advantages. Strategies such as integrating public health principles into the curriculum, providing incentives, and raising awareness about the importance of DPH are recommended to address the shortage of public health dentists in Pakistan. Enhancing the appeal of DPH as a viable career option is essential to strengthen the public health workforce and improve oral health equity.

Effective human resource management (HRM) is a dominant topic of interest owing to its crucial role in both health production and service provision. Despite the recognition of the fundamental Strategic HRM (SHRM) practices, the intellectual structure and direction of research is yet to be fully developed, integrated and practically evolved in response to contemporary developments. Therefore, this study analyses the knowledge structure and evolution of HRM issues and practices in internal stakeholder management (ISM) within healthcare. In this study, we conduct a bibliometric analysis of 477 articles published in the Web of Science database from 2000 to 2024. The articles were synthesised through a qualitative analysis (citation network analysis and a concurrence network of key words). We synthesised 6 clusters that highlighted distinct themes and their respective references using VOS Viewer. Thereafter, a systematic analysis was conducted to identify gaps and synthesize findings. The findings revealed 6 major thematic clusters: (1) HRM Innovation and Work Engagement Practices; (2) Lean Management and Empowerment; (3) Cross-sectoral High Performance Work Systems (HPWS); (4) Work Environment and Patient Satisfaction Factors-high commitment work systems (HCWS); (5) Leadership and Employee Well-being; (6) HRM and Institutional Performance. The analysis confirmed employee well-being, leadership engagement, burn-out and the implementation of HPWS and HCWS as emerging issues in HRM practice. The findings evidence the evolution of HPWS towards a dual integrated model with employee well-being, centrally supported by leadership. We highlight the strategic framing significance of SDG 3 (Good Health and Well-being) and SDG 8 (Decent Work and Economic Growth), in the operationalisation and cascading of public and organisational HRM practices in healthcare. We argue out the managerial tension in managing efficiency and satisfaction based on the influential studies advancing performance and other dominant clusters revealing salience for human capital support. Therefore, the findings uphold the imperative of anchoring (SHRM) practices on engaging leadership, fair compensation practices, employee well-being, robust and responsive support systems. We contribute to enhanced ISM organisational performance and sustainable health-care delivery by bringing to the fore evidence-based insights that supports policy development and effective health-care management.

Background: In 2008, Kazakhstan introduced a structured ophthalmology residency program. Between 2008 and 2020, two parallel training pathways coexisted: a three-year residency program and short-term ophthalmology training courses lasting up to six months. After 2020, only the residency program remained in place. This study aims to examine the associations between these medical education reforms and the observed trends in the absolute numbers and per million population (PMP) rates of ophthalmologists in Kazakhstan from 1998 to 2022. Furthermore, it explores temporal patterns in cataract surgery performance by ophthalmologists across the country.

Methods: Interrupted Time Series (ITS) analysis using ARIMA models was conducted to examine the associations between medical education reforms and the number and PMP rates of ophthalmologists in Kazakhstan, as well as their performance in conducting cataract surgeries.

Results: Throughout the study period, the PMP rates of ophthalmologists ranged from 59.73 to 90.48, demonstrating an overall upward trend. The ITS model identified a statistically significant negative level change in both the number and PMP rates of rural ophthalmologists at the time of the residency program's introduction in 2008, whereas no statistically significant association was observed for urban ophthalmologists. The discontinuation of short-term training courses exerted a minor, statistically insignificant negative effect on the numbers and PMP rates of ophthalmologists. The number of cataract surgeries performed varied between 9,550 and 19,018, corresponding to a cataract surgical rate ranging from 639.72 to 1,067.88, with marked regional disparities.

Conclusion: This evaluation provides exploratory evidence on how medical education reforms may be associated with temporal changes in the ophthalmology workforce and cataract surgery performance, and can inform future policy discussions on ophthalmology training and service provision in Kazakhstan.

The persistent shortfall in medical staffing in the UK has drawn renewed focus since the government first published its NHS Long Term Workforce Plan, in which it pledged to double the capacity of UK medical schools in the context of significant bottlenecks in doctors' pathways to career progression. In this article, we challenge the viability of medical school expansion as a tool to combat the persistent workforce crisis in the NHS. Our critique contributes to the ongoing workforce planning debate, and highlights issues with clinical capacity, sustainability, and the preservation of educational standards. With an updated Long Term Workforce Plan forthcoming, we urge policymakers to implement an immediate moratorium on medical school expansion in the UK until these factors - and a viable future for the medical profession - can be guaranteed.

Background: This analytical cross-sectional study assessed job satisfaction, stress, and perceived social support among postgraduate dental students and identified contributing factors.

Methods: Sixty-four postgraduate dental students across 10 specialties at Mashhad Dental School participated between January and February 2024. A structured questionnaire included the Brayfield-Rothe Job Satisfaction Scale, a validated Persian Job Satisfaction Scale, the Multidimensional Scale of Perceived Social Support, and the Ryff Psychological Well-Being Scale. Demographic data were also collected. Statistical analyses examined relationships between variables, with a significance level of 0.05.

Results: The Brayfield-Rothe Scale indicated above-average job satisfaction (p < 0.05), while the Persian Job Satisfaction Scale showed below-average scores (p < 0.05). Perceived social support (p < 0.05) and psychological well-being (p < 0.05) were above average. Married students reported significantly higher satisfaction and social support (p = 0.002). Significant correlations were found between job satisfaction, perceived social support, and psychological well-being.

Conclusion: Postgraduate dental students reported high perceived social support and psychological well-being but elevated stress levels, with varying job satisfaction across scales. Married students demonstrated higher satisfaction and support. Enhancing support systems and stress-reduction strategies in dental education is recommended.

Introduction: The training of clinical specialists in Malaysia on completion of the undergraduate medical programme is long and expansive. In recent years, the training process has been plagued with issues of funding, recognition, insufficient training opportunities, and lack of uniformity in the delivery of the training. However, there is a dire shortage of clinical specialists across all specialties in Malaysia, especially with the increase in demand for healthcare services. An analysis of the intentions of Malaysian medical students to specialise and the factors that influence their decisions is currently lacking. This study aims to provide insights into specialty training and may inform the planning of human resources for health in the country.

Methods: This was a cross-sectional study involving 859 medical students from 21 medical schools in Malaysia. This study was part of the Malaysian Medical Students' Career Intentions (MMSCI) project. Data were collected via a self-administered online questionnaire.

Results: Majority of medical students expressed an interest to specialise (85%). The most favoured specialties were General Surgery, Paediatrics, and Obstetrics and Gynaecology. Medical students from private universities had a greater intention to specialise compared to public university students (p < 0.001). Male medical students were more likely to select a pure surgical specialty as compared to medical-based specialties (p = 0.037). Female medical students rated "Working Environment & Conditions" and "Work-Life Balance" as important factors for the choice of specialty training (p = 0.044 and p = 0.032, respectively).

Conclusion: Majority of Malaysian medical students expressed intentions to specialise. The preferences in specialty choices in our study reflect the global trends. Passion and interest were the top reasons for medical students when indicating their specialty of choice. Further studies are needed to explore the changing trends in specialty choices and the influencing factors.

Background: Tracking country-wide human resources for health (HRH) information is a milestone in the global strategy for HRH 2030, and digitalized HRH information systems have been recommended by the World Health Organization. However, the implementation status differs among countries, and most systematic reviews on this topic have been conducted in high-income countries. This scoping review aimed to identify (1) stages of implementation, (2) functional components, (3) facilitators and barriers, and (4) policy impacts or outcomes of digitalized HRH information systems in low- and middle-income countries (LMICs).

Methods: The methodological framework of the Johanna Briggs Institute was used in this scoping review. English articles in two databases (PubMed and Web of Science) with publication dates ranging from inception to August 2023 were gathered, followed by a gray literature search and a reference search. Two author pairs independently performed the study selection. Data were extracted, analyzed, and presented in tabular form alongside a narrative summary.

Results: Forty studies and gray literature from 26 LMICs in Asia and Africa were included in the scoping review. Thirty-three studies and gray literature covered different stages of digitalized HRH information systems' implementation, including development, pilot, rollout, and maintenance. The HRH registry was the most common, whereas finances and migration were the least common functional components. Thirty-two studies and gray literature reported barriers and facilitators, stratified into four factors and stages. Many barriers were identified in organizational and environmental factors, especially in governance. Interoperability among multiple HRH information systems within a country is the key facilitator, where development partners play a critical role. Sixteen studies and gray literature from nine countries reported positive policy impacts/outcomes. Political commitment, strong national and subnational leadership, and coordination mechanisms among national stakeholders and development partners were key to gaining policy impact.

Conclusions: Barriers and facilitators were common across the studies, and governance factors were particularly crucial at all stages of digitalization. Our stratified methodology for analyzing facilitators and barriers can serve as an analytical framework for evaluating HRH information systems in any country. Data on the private sector and migration could be further strengthened as system components.

Introduction: The Project Extension for Community Health Care Outcomes (Project ECHO) is a renowned collaborative model of medical education and care management. This model enhances the capabilities of primary care providers through telementoring, providing a promising and cost-effective approach to augmenting healthcare professionals' knowledge. Participation in weekly ECHO sessions often falls short of expectations despite its benefits. This study examined the personal factors that influence Tanzanian nurses' engagement with Project ECHO.

Methods: We conducted a cross-sectional study involving 450 nurses from 42 primary healthcare facilities in Dar es Salaam, Tanzania. A standardised questionnaire served as the data collection tool. Descriptive analysis was performed to calculate means, frequencies and percentages for socio-demographic variables and the level of participation of nurses. Bivariate and multivariate logistic regression were used to test the association between the level of participation of nurses in ECHO sessions and their socio-demographic factors.

Results: Only 36% (n = 162) of 450 nurses attended at least two ECHO sessions (median 2, IQR 1-2). Paediatric ECHO sessions had the highest attendance (43.8%, n = 71). Ease of computer use (AOR = 1.95, p = 0.015) and ICT self-motivation (AOR = 2.08, p = 0.003) significantly increased attendance. A majority (58%) lacked personal computers. Surprisingly, adequate ICT skills lowered the likelihood of attending at least two sessions (AOR = 0.37, p < 0.001).

Conclusion: The study found low participation of nurses in ECHO sessions, with paediatric ECHO sessions showing the highest engagement. Comfort with online format and ease of instructions motivated attendance, while computer proficiency and ICT motivation were positive predictors. Surprisingly, adequate ICT skills correlated with lower participation. Enhancing basic computer literacy and ICT motivation is crucial for improved engagement. Future research should explore reasons for lower participation among digitally skilled nurses and tailor session content accordingly.

Background: With the development of society and the economy, along with the aging population, the demand for primary health care services is growing. As the core providers of primary healthcare services, the job satisfaction of general practitioners (GPs) directly affects the quality of healthcare services and patient satisfaction, and it is one of the key indicators for assessing the effectiveness of relevant policy implementations. However, the heavy workload of Chinese primary care physicians, their low income levels, and their weak sense of professional identity may lead to an effort-reward imbalance (ERI). Therefore, analyzing the mechanisms behind ERI in relation to GPs' job satisfaction is crucial for advancing their professional growth. This is particularly relevant in less developed regions, as it can significantly boost the performance of healthcare services, elevate the standard of primary healthcare, and ultimately contribute to the realization of universal health coverage.

Methods: This study, conducted from December 2023 to March 2024, employed a cross-sectional analysis of primary care GPs in Gansu Province, China, based on social exchange theory, to investigate whether and how ERI affects job satisfaction among primary care GPs. An electronic questionnaire survey was distributed to resident doctors who had completed their training through standardized residency training bases to test the theoretical hypotheses.

Findings: This study found that the ERI among primary care GPs in China was relatively significant (3.57/5.00). The ERI negatively affected primary care GPs' job satisfaction (B = - 0.381, p < 0.01), explaining 23.6% of the variance in job satisfaction. Additionally, public service motivation (PSM) fully mediated the relationship between ERI and primary care GPs' job satisfaction (mediation effect of - 0.500, 95% bootstrap confidence interval [- 0.818 to - 0.156]). The study also revealed that GPs in primary hospitals had higher job satisfaction, while rural order-oriented GPs experienced lower job satisfaction.

Conclusion: This study examines the detrimental effects and underlying mechanisms of ERI on the job satisfaction of primary care GPs, thereby contributing to the body of research on the factors influencing their job satisfaction. The findings underscore the importance of considering PSM as a critical intermediary when addressing ERI among primary care GPs. The conclusions offer practical insights for enhancing the job satisfaction of GPs, which, in turn, may lead to improved medical service performance in underdeveloped regions of China.