全球范围内,许多国家正在采用基于证据的劳动力规划,以促进在实现生殖可持续发展目标方面取得进展,母婴健康。我们使用五个国家的人员需求工作量指标,审查了初级保健设施中生殖孕产妇新生儿健康服务的劳动力规划案例研究。
使用可用的工作量指标,提供孟加拉国的人员配备需求报告,加纳,肯尼亚,阿曼苏丹国和巴布亚新几内亚,我们生成了描述性统计数据,以探索可比的工作量组成部分和活动标准,卫生服务提供模式,重点是初级保健水平和提供与生殖孕产妇相关的干预措施的具体卫生职业,新生儿和儿童保健服务。
各个国家的卫生服务提供模式各不相同。结果显示各国存在差异,在每个机构的工作量组成部分和活动标准中,无论所涉及的设施级别或职业群体如何。所有国家都分散了卫生服务,重点是全面的初级保健。生殖,孕产妇和新生儿保健服务包括产前保健,产后,免疫接种,计划生育,婴儿健康诊所,综合儿童轻微疾病的交付和管理。只有阿曼苏丹国在初级保健中提供生育服务。肯尼亚扩大了对家庭和社区的干预。
由于医疗保健服务模式,卫生服务提供环境和医护人员团队因国家而异,因此,研究得出的结论是,尽管工作量构成相似,但活动标准不能从一个国家采用或改编到另一个国家。基于证据的劳动力规划必须针对具体情况,因此,每个国家都需要制定自己的工作量组成部分和活动标准,以适应当地情况。
Globally, many countries are adopting evidence-based workforce planning that facilitates progress towards achieving sustainable development goals for reproductive, maternal newborn and child health. We reviewed case studies on workforce planning for reproductive maternal newborn child health services at primary care level facilities using workload indicators of staffing need in five countries.
Using available workload indicators for staffing need reports from Bangladesh, Ghana, Kenya, Sultanate of Oman and Papua New Guinea, we generated descriptive statistics to explore comparable workload components and activity standards, health service delivery models with an emphasis on the primary care levels and the specific health occupations offering interventions associated with reproductive maternal, newborn and child health services.
The health services delivery models vary from one country to another. The results showed variability in the countries, in the workload components and activity standards of each regardless of facility level or occupational groups involved. All the countries have decentralized health services with emphasis on comprehensive primary care. Reproductive, maternal and new-born child health care services include antenatal, postnatal, immunization, family planning, baby wellness clinics, delivery and management of integrated minor childhood illnesses. Only Sultanate of Oman offers fertility services at primary care. Kenya has expanded interventions in the households and communities.
Since the health care services models, health services delivery contexts and the health care worker teams vary from one country to another, the study therefore concludes that activity standards cannot be adopted or adapted from one country to another despite having similar workload components. Evidence based workforce planning must be context-specific, and therefore requires that each country develop its own workload components and activity standards aligned to their local contexts.