In low and middle-income countries like Ghana, private providers, particularly the grouping of faith-based non-profit health providers networked by the Christian Health Association of Ghana (CHAG), play a crucial role in maintaining service continuity during health worker strikes. Poor engagement with the private sector during such strikes could compromise care quality and impose financial hardships on populations, especially the impoverished. This study delves into the engagement between CHAG and the Government of Ghana (GoG) during health worker strikes from 2010 to 2016, employing a qualitative descriptive and exploratory case study approach. By analysing evidence from peer-reviewed literature, media archives, grey literature and interview transcripts from a related study using a qualitative thematic analysis approach, this study identifies health worker strikes as a persistent chronic stressor in Ghana. Findings highlight some system-level interactions between CHAG and GoG, fostering adaptive and absorptive resilience strategies, influenced by CHAG\'s non-striking ethos, unique secondment policy between the two actors and the presence of a National Health Insurance System. However, limited support from the government to CHAG member facilities during strikes and systemic challenges with the National Health Insurance System pose threats to CHAG\'s ability to provide quality, affordable care. This study underscores private providers\' pivotal role in enhancing health system resilience during strikes in Ghana, advocating for proactive governmental partnerships with private providers and joint efforts to address human-resource-related challenges ahead of strikes. It also recommends further research to devise and evaluate effective strategies for nations to respond to strikes, ensuring preparedness and sustained quality healthcare delivery during such crises.

As new graduates are crucial in providing healthcare services in rural areas, this study aimed to identify and describe the rural facility attributes that attract medical students to apply for rural internships. A literature review and focus groups informed a discrete choice experiment conducted amongst graduating medical students at one public university in South Africa. One main effect using a mixed logit model and another main effect plus interaction model was estimated. Females (130/66.33%) of urban origin (176/89.80%) with undergraduate exposure to rural facilities (110/56.12%) were the majority. The main effects only model showed advanced practical experience, hospital safety, correctly fitting personal protective equipment, and the availability of basic resources were the strongest predictors of rural internship uptake. Respondents were willing to forgo 66% of rural allowance (ZAR 2645.92, 95% CI: 1345.90; 3945.94) for a facility offering advanced practical experience. In contrast, increased rural allowance and housing provision were weak predictors of rural work uptake. Based on the interaction model, females and those not intending to specialise preferred hospital safety compared to advanced practical experience. To improve internship recruitment, rural facility managers should provide staff with supervision, safety, and protection from occupational exposure to contractible illnesses.

BACKGROUND: Healthcare organisations have undergone organisational change to respond to COVID-19. This pandemic has presented challenges for employee adjustment, with impacts on the availability and coordination of human resources in healthcare. This study aimed to characterise the organisational actions regarding the coordination of human resources in healthcare within Bogotá, Colombia, to respond to the COVID-19 pandemic.
METHODS: We followed a case study approach to understand the response to the emergency taking into account the narratives of managerial actors who have been directly involved in the planning of guidelines oriented to face the pandemic or in the implementation of health services for COVID-19. Twenty-two interviews with multiple health system organisations within Bogotá were conducted between May and September 2020 and analysed thematically.
RESULTS: Three themes emerged from the analysis of the interview data: to retain human resources, to implement actions to improve the mental and physical health of the healthcare workers, and to enhance healthcare workers knowledge, skills and availability to respond to COVID-19.
CONCLUSIONS: Organisational actions led by hospital managers to retain, protect, and train human health resources in the dynamic context of the COVID-19 pandemic were identified. Other system-wide organisations like scientific associations contributed to the coordination of human resources across hospitals to respond to COVID-19 in Bogotá, Colombia. The actions of hospital managers, and roles of system-wide intermediary organisations, in coordinating human resources need to be explored in other health system contexts facing COVID-19.

The situation of labour inclusion of people with disabilities in Spain is still too negative, in spite of the different efforts carried out by public and private sector. Previous research points to social discrimination as one of the main causes of the situation. Ilunion Hotels is one of the most important hotel companies in Spain focused on labour inclusion of people with disabilities. The objective of this paper is to explore the social inclusion case of Ilunion Hotels of the Costa del Sol, the actions that they have developed to improve the labour integration of this collective, based on a behavioral economics theoretical model (with a high relevance of the influence of social stigma, stress theories and coping to stress responses). We look into the specific situation of two of the three hotels developed as Special Employment Centres (sheltered employment contexts defined by Spanish legislation) and the possible impact of their Support Units for Professional Activity. Case study methodology is considered the most appropriate, according to the research objective, supported by semi-structured interviews with the hotel managers. The results show that, although Special Employment Centres are effective in improving labour integration in the short term and could contribute to change the long-term social perspectives about workers with disabilities, they could be also reinforcing the social stigma existing in the ordinary market.

Foot and mouth disease (FMD) is a highly contagious viral disease that affects domestic and wild artiodactyl animals and causes considerable economic losses related to outbreak management, production losses and trade impacts. In Tunisia, the last FMD outbreak took place in 2018-2019. The effectiveness of control measures implemented to control FMD depends, in particular, on the human resources used to implement them. Tunisia has the ultimate objective of obtaining OIE status as \'FMD-free with vaccination\'. The aim of this study was to determine and compare the necessary and available human resources to control FMD outbreaks in Tunisia using emergency vaccination and to assess the gaps that would play a role in the implementation of the strategy. We developed a resources-requirement grid of necessary human resources for the management of the emergency vaccination campaign launched after the identification of a FMD-infected premises in Tunisia. Field surveys, conducted in the 24 governorates of Tunisia, allowed quantifying the available human resources for several categories of skills considered in the resources-requirement grid. For each governorate, we then compared available and necessary human resources to implement vaccination according to eight scenarios mixing generalised or cattle-targeted vaccination and different levels of human resources. The resources-requirement grid included 11 tasks in three groups: management of FMD-infected premises, organisational tasks and vaccination implementation. The available human resources for vaccination-related tasks included veterinarians and technicians from the public sector and appointed private veterinarians. The comparison of available and necessary human resources showed vaccination-related tasks to be the most time-consuming in terms of managing a FMD outbreak. Increasing the available human resources using appointed private veterinarians allowed performing the emergency vaccination of animals in the governorate in due time, especially if vaccination was targeted on cattle. The overall approach was validated by comparing the predicted and observed durations of a vaccination campaign conducted under the same conditions as during the 2014 Tunisian outbreak. This study could provide support to the Tunisian Veterinary Services or to other countries to optimise the management of a FMD outbreak.

Public support of training in firms corresponds to the long-term importance of the quality of human capital in the competitiveness of firms and nations. Thus, the EU supports such training via the European Social Fund (ESF). The evaluation community evaluates the support by using either qualitative or quantitative methods. The simultaneous application of these two approaches is rare. The purpose of this paper is to combine quantitative (counterfactual impact evaluation) and qualitative (qualitative comparative analysis) methods in order to fill the methodological gap. Based on the combination of both approaches, it explores their strengths, complementarity and disadvantages to evaluate public support for employee training in the Czech Republic. The combination of methods makes it possible to identify not only the impacts but also their causes. Linking the ESF support to corporate competitiveness is crucial for demonstrating the effectiveness of public spending.

Antimicrobial stewardship programs (ASPs) have been shown to reduce inappropriate antimicrobial use and its consequences. However, these programs lack legislative requirements in many places and it can be difficult to determine what human resources are required for these programs and how to create a business case to present to hospital administrators for program funding. The objectives of the current paper were to review legislative requirements and outline human resource requirements for ASPs, and to create a base business case for ASPs.
A working group of antimicrobial stewardship experts from across Canada met to discuss the necessary components for creation of a business case for antimicrobial stewardship. A narrative review of the literature of the regulatory requirements and human resource recommendations for ASPs was conducted. Informed by the review and using a consensus decision-making process, the expert working group developed human resource recommendations based on a 1000 bed acute care health care facility in Canada. A spreadsheet based business case model for ASPs was also created.
Legislative and /or regulatory requirements for ASPs were found in 2 countries and one state jurisdiction. The literature review and consensus development process recommended the following minimum human resources complement: 1 physician, 3 pharmacists, 0.5 program administrative and coordination support, and 0.4 data analyst support as full time equivalents (FTEs) per 1000 acute care beds. Necessary components for the business case model, including the human resource requirements, were determined to create a spreadsheet based model.
There is evidence to support the negative outcomes of inappropriate antimicrobial use as well as the benefits of ASPs. Legislative and /or regulatory requirements for ASPs are not common. The available evidence for human resource recommendations for ASPs using a narrative review process was examined and a base business case modelling scenario was created. As regulatory requirements for ASPs increase, it will be necessary to create accurate business cases for ASPs in order to obtain the necessary funding to render these programs successful.

OBJECTIVE: Residency coordinators are valuable members of the education leadership administration. In General Surgery, program directors must devote time to both their clinical practice and as the leader of the education program for surgical residents. With the introduction of competencies and the Next Accreditation System, the responsibilities of training programs have increased, with much of the necessary day to day management being driven by the residency coordinator. The purpose of this study was to identify the current roles of a residency coordinator in surgery to determine appropriate language for a standardized job description that accurately describes the responsibilities of a program coordinator.
METHODS: A survey was created and distributed via email to 317 general surgery program coordinators in programs with continued, initial, or pre-accreditation status by the ACGME in October-December 2017. Questions were asked about coordinator demographics, ADS involvement, and communication with program director, recruitment, and professional development. 223 coordinators (70%) completed the survey.
RESULTS: Thirty-five percent of coordinators reported that their program director expects them to complete the annual ADS update in its entirety with a final review by the program director before submission, whereas 15% stated that the program director expects the program coordinator to input, update, and submit the annual ADS update without oversite from the program director. Fifty percent of program coordinators speak with their program director 2 to 4 days a week, whereas 38% speak with their program director daily. Eighty-nine percent of coordinators reported that their program directors trust them to make appropriate administrative decisions during scheduled or emergent absences. Sixty-nine percent of coordinators strongly agreed that they assist their program directors with collating and analyzing recruitment data post-recruitment season. Eighty-six percent of coordinators regularly participate in one or more professional development activities. Forty-six percent of coordinators stated that they oversee administrative staff in their office, division, or department.
CONCLUSIONS: Given the current makeup of today\'s residency coordinator in general surgery programs, the need for baseline qualifications and a standardized job description allowing for recruitment and retention of a coordinator capable of managing a residency along with a program director. The data from our survey indicate that most coordinators currently perform tasks and take on responsibilities of a manager, but they hold current job descriptions that do not adequately reflect the role. The current proposed ACGME revisions state that there must be a program coordinator for a residency program, citing the coordinator as an integral member of the residency leadership team. Therefore, human resource departments need a job description that identifies level of responsibility, contribution, leadership, and management required of a program coordinator.

In today\'s interconnected world, infectious diseases can spread rapidly within and between countries. The 2014-2016 Ebola epidemic in Guinea, Liberia, and Sierra Leone underscored the inability of countries with limited capacities and weak public health systems to respond effectively to outbreaks. To mitigate future health threats, nations and international organizations launched the Global Health Security Agenda (GHSA) to accelerate compliance with the WHO\'s International Health Regulations, so as to enhance global protection from infectious disease threats. To advance GHSA\'s mandate to build capacity to prevent, detect, and respond to infectious diseases, and thereby contain threats at their source, community engagement is needed. This article advocates for community engagement in GHSA implementation, using examples from 3 GHSA action packages. A country\'s ability to prevent a local disease outbreak from becoming an epidemic often rests with the level of knowledge about the situation and the actions taken at the community level.

In Mexico, the Modelo Nacional de Farmacia Hospitalaria (MNFH, or National Hospital Pharmacy Model), published in 2009, mainly aims to promote the provision of clinical pharmacy services in private and public hospitals. However, there is little scientific documentation about the quality of these services.
To explore healthcare professionals\' perceptions related to the quality of clinical pharmacy services provision.
A case-study based on a qualitative approach was performed at the pharmaceutical services unit at a public hospital located in Mexico City, which operates under the administrative control of the Ministry of Health. Donabedian\'s conceptual model was adapted to explore health care professionals\' perceptions of the quality of clinical pharmacy services provision. Semi-structured interviews were carried out with pharmacists, physicians and nurses and then transcribed and analyzed via discourse analysis and codification techniques, using the software package Atlas. ti.
Limitations in pharmaceutical human resources were identified as the main factor affecting coverage and quality in clinical pharmacy services provision. However, the development in pharmacy staff of technical competences and skills for clinical pharmacy service provision were recognized. Significant improvements in the rational use of medicines were associated with clinical pharmacy services provision.
The perception analysis performed in this study suggested that it is necessary to increase pharmacy staff in order to improve interprofessional relationships and the quality of clinical pharmacy services provision.