Human Resources for Health最新文献

Background: Nurses are crucial for high-quality healthcare, but there's a growing shortage. Wage inequality is a significant problem among nurses, affecting both nurses and patient care. This study investigates the wage gap among nurses in Iran.

Methods: This study examined wage inequality among 595 nurses using wage quartiles, Lorenz curves, and a Gini coefficient (GC) decomposition. The decomposition method was used to analyze the contributions of within, between, and overlap subgroups to the overall wage inequality, along with the population share, wage share, and GC for each subgroup of nurses.

Results: The findings revealed that nurses in the top quartile earn 2.03 times more than nurses in the bottom quartile, with respective wage rates of $9.31 and $4.58. The total GC for nurses' wages was 0.16, indicating a moderate wage gap. Among nurses, those in specialized roles had the highest wage at $9.10 based on Purchasing Power Parity (PPP). This was followed by nurses aged over 40 years ($8.30), nurses with over 15 years of work experience ($8.15), and those working in psychiatric centers ($8.08). Conversely, the lowest wage rates among nurses were observed in those working in non-provincial hospitals ($5.51), followed by nurses in the private sector ($5.73), and nurses working in general hospitals ($5.76). The GC analysis revealed that the highest wage inequality was among nurses working in hospitals specializing in Ophthalmology and ENT (GC = 0.23), the private sector (GC = 0.18), and emergency departments (GC = 0.18). Conversely, the lowest wage inequality was observed in nurses working at the surgery department (GC = 0.10) and cardiology hospitals (GC = 0.11).

Conclusions: The wage gap among Iranian nursing staff was moderate. Work experience, employment type, age, number of children, hospital specialty, workplace sector, and department significantly affected wage inequality among nurses, while gender and academic qualifications had no significant impact on the wage gap. Considering the importance of the wage gap for nurses' motivation and function, policymakers should consider these key determinants and develop targeted strategies to mitigate the wage gap among nurses.

Background: Hospital pharmacists play a pivotal role in ensuring the safe and effective use of medications, thereby supporting the quality of care and the resilience of health systems. Identifying the factors influencing turnover intention among hospital pharmacists and implementing strategies to maintain an appropriate talent pool can contribute to strengthening public health and improving patient outcomes. This study aimed to identify the factors influencing turnover intention among hospital pharmacists in South Korea and provide implications for strategies to support pharmacist retention.

Methods: A cross-sectional survey was conducted in July 2024 with 592 full-time pharmacists employed in tertiary and general hospitals using proportional stratified sampling by hospital type and region, representing 16.0% of the pharmacists working in these hospitals. The questionnaire incorporated items from Mitchell's Job Embeddedness theory, the Korean Occupational Stress Scale, and Singh's turnover intention scale, and underwent expert content validation and exploratory factor analysis. Multivariable linear and logistic regression analyses were performed to determine the factors associated with turnover intention after adjusting for key demographic and institutional characteristics.

Results: Among the 592 respondents, 255 (43.1%) had high turnover intention, with shorter employment durations associated with higher turnover intention scores. Within job embeddedness, factors significantly reducing turnover intention included fit to organization_task, organization-related sacrifice_direct, link to organization_task, and link to community_transverse. Within job stress, the factors that significantly increased turnover intention were lack of rewards, job demand_density, and organizational system_fairness. The identified associations were consistent across both linear and logistic regression models, supporting the robustness of the findings.

Conclusions: To retain skilled professionals, hospitals should improve their reward structures, foster a culture of fairness, and provide targeted support to junior pharmacists. Improving role fit in task assignments may help reduce turnover risk and enhance workforce stability.

Background: The health workforce (HW) plays an important role in patient care, and in rural Australia its distribution varies substantially. This paper explores trends in Australia's HW full-time equivalent (HW-FTE) rates and estimates the risk of HW attrition phenomena using data from local government areas (LGAs) during 2013-2021.

Methods: Trends and spatial analyses were used to understand HW-FTE rates for allied health professionals, medical practitioners, and nurses and midwives in four major types of Australian Statistical Geography Standard (ASGS) remoteness areas. The time-to-event modelling was used to identify HW retention times and probability of HW attrition, by remoteness areas and major states in Australia.

Results: On average the HW-FTE rate at the granular geo-spatial LGA level exhibits variation in trends between States, rurality, LGA and health professional groups over the study period. The increase in the HW-FTE rate over time for medical practitioners and allied health professionals is lower for outer regional, remote, and very remote Australia compared to inner regional Australia. The HW-FTE rate is also consistently lower for rural Australia compared to major cities irrespective of HW professions. The average HW retention time estimated for allied health was highest in major cities (5 years), and lowest in outer regional areas (3 years). States such as NSW and QLD had more than 4 years of HW retention time for medical practitioners. For nurses and midwives, the average retention time was less than 3 years for all states in Australia. There is variation in trends in HW-FTE rate between LGAs within and between States, including markedly contrasting trends between geographically adjacent LGAs.

Conclusions: Our results provide new insight into variation in HW availability, and trends in availability, between major health professional groupings between States, degrees of rurality and local government areas across Australia. This presents new opportunities for understanding and addressing factors that underly the variation in trends for the purpose of refining policy and programs that aim to address the persistent maldistribution and shortages in health worker availability between major cities and regional and remote parts of Australia.

Background: In Ethiopia, non-physician surgeons, such as Integrated Emergency Surgical Officers (IESOs) and MSc Clinical Midwives, provide critical comprehensive emergency obstetric and surgical care in areas, where physician shortages persist. Although task shifting has improved access to maternal healthcare services in many low-resource settings, maternal and newborn mortality remain high, particularly in the conflict-affected Tigray region. This study aimed to assess the impact of a comprehensive training program on safe cesarean delivery, essential newborn care, and obstetric anesthesia on IESOs' knowledge.

Methods: An embedded mixed-methods design was employed. Quantitative data included a pre-post-test on safe cesarean delivery, early neonatal care, and obstetric anesthesia, as well as a before-and-after training assessment of seven core domains (historical background of cesarean delivery, indications for and safe prevention of cesarean delivery, preoperative preparation, surgical technique, difficult cesarean delivery, early neonatal care, and obstetric anesthesia). Fifty-nine IESOs in Tigray were enrolled. Qualitative data were obtained from two focus group discussions and five in-depth interviews that explored training adequacy and professional competency. Quantitative data were analyzed using R (version 4.6.2), and qualitative data were thematically analyzed using ATLAS.ti (version 7).

Results: A total of 59 participants took part in the quantitative component, 94.9% of whom were male. The mean pre-training knowledge test score on safe cesarean delivery, early neonatal care, and obstetric anesthesia was 60.1 (± 8.7). This increased to 75.7 (± 10.58) on post-training test (mean difference 15.6, 95% CI 13.31-17.9, p < 0.001). The self-reported understanding of the seven domains improved from 17.1 (± 4.2) to 21.5 (± 4.3) (p < 0.001). Qualitative findings confirmed high appreciation of the training's relevance and possible practical application but also highlighted concerns about long-term support, career and skills advancement, and resource constraints in the post-conflict environment.

Conclusions: Comprehensive and context-specific training significantly enhanced the knowledge of non-physician surgeons in safe cesarean delivery, early neonatal care, and obstetric anestehsia in Tigray. Ongoing mentorship, career development opportunities, and system-level support are crucial for sustaining these gains and rebuilding maternal and newborn health services in conflict-affected and other resource-limited settings.

Background: A sense of calling-defined as viewing work as a meaningful contribution to society-has been linked to job satisfaction and overall well-being. In medicine, this intrinsic motivation may interact with systemic challenges and influence physicians' career trajectories, including their desire to work abroad.

Aim: To examine the relationship between medical students' sense of calling and their willingness to work abroad, comparing first- and final-year students.

Methods: This cross-sectional study was conducted at a Turkish medical school in 2024. A total of 278 students (140 first-year, 138 final-year) completed a structured online questionnaire. The survey included socio-demographic characteristics, perceptions of the medical profession, intention to work abroad, and the Turkish version of the Calling and Vocation Questionnaire (CVQ). Descriptive and comparative statistical analyses were conducted, with statistical significance set at p < 0.05.

Results: More than half (56.8%) of students expressed a desire to work abroad, primarily citing a higher quality of life and income. First-year students reported significantly higher interest in working abroad and marginally higher "presence of calling" scores than final-year students. Dissatisfaction with the healthcare system and anticipated income were significantly associated with the intention to migrate. The presence of calling was slightly, though not significantly, higher among students intending to relocate.

Conclusion: Medical students' vocational ideals decline over time, influenced by systemic dissatisfaction and perceived limitations within the national healthcare system. Addressing structural barriers in medical education and professional practice is essential to preserving professional motivation and mitigating physician migration.

Background: Job satisfaction is closely related to health service quality and patients' outcomes, including safety and continuity of care. With the transformation of Saudi Arabia's healthcare system driven by Vision 2030, determining the factors influencing job satisfaction among healthcare workers has become critical.

Objective: To identify the sociodemographic determinants and their association with healthcare workers' job satisfaction in public hospitals in Jeddah, Saudi Arabia.

Methods: Through a cross-sectional design, healthcare workers from 13 public hospitals were invited to respond to a self-administered questionnaire based on Spector's Job Satisfaction Survey. Data were collected via an electronic online survey (Google Form). Chi-square, ANOVA, independent t-tests, and multiple linear regression analysis were used.

Results: Nine hundred and thirty-two healthcare workers responded. There were significantly more females than males among nurses, midwives, and those with bachelor's qualifications. Conversely, there were significantly more males than females in administrative jobs. Males reported significantly higher income, were more likely to be married, and perform non-clinical work. Higher satisfaction scores were reported among males, non-Saudis, those 50 years or above, holding a diploma education, married, working in a tertiary hospital, and working the day shift. The regression model showed that being female, working in a night or rotating shift were negatively associated with job satisfaction. Being non-Saudi and working part-time were positively associated with job satisfaction.

Conclusions: Job satisfaction was higher among non-Saudis and those working part-time. It was lower among females and those working at night or rotating shift.

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.