Health and care workforce policy

  • 文章类型: Journal Article
    背景:国际关注的突发公共卫生事件(PHEIC),如COVID-19大流行以及自2000年代初以来发生的其他事件,给医疗保健系统带来了巨大压力。由于额外的工作量,这是卫生和护理人员(HCW)抗议的背景,工作条件和对身心健康的影响。在本文中,我们打算分析与工业行动相关的HCWs的需求,抗议,在COVID-19大流行和其他PHEIC期间发生的罢工和停工(IAPSL);确定这些不满的影响;并描述解决这些IAPSL的相关干预措施。
    方法:我们纳入了2000年1月至2022年3月在PubMed上发表的研究,Embase,Scopus,BVS/LILACS,世界卫生组织的COVID-19研究数据库,ILO,OECD,HSRM,和谷歌灰色文学学者。合格标准是HCWs作为参与者,IAPSL是在COVID-19和其他PHEIC的背景下发生的感兴趣的现象。GRADECERQual用于评估偏倚风险和证据可信度。
    结果:检索了1656条记录,并选择91人进行全文筛选。我们包括18种出版物。全系统的方法,而不是对罢工机构采取有限的方法,使人们有可能了解罢工对医疗保健服务的全部影响。PHEIC倾向于加剧已经不利的HCWs的工作条件,充当HCWs罢工的司机,导致人员短缺,和财务问题,在北方和全球南方,在亚洲和非洲尤其明显。此外,与卫生部门领导和治理不足以及医疗产品和技术缺乏相关的问题(例如,缺乏个人防护设备)是罢工的主要驱动因素,每个人占确定的总司机的25%。
    结论:有必要将重点放在卫生保健系统的准备工作上,以充分应对PHEIC,这包括为HCWs\'IAPSL做准备,在COVID-19大流行的背景下谈了很多。在IAPSL期间,协助决策者制定充分应对人口健康和护理需求的战略的证据至关重要。罢工的主要影响是对医疗保健服务供应的中断。性别不平等是HCWs中的一个主要问题,只有将性别视角与系统方法相结合,才能正确理解罢工对医疗保健服务的全面影响,而不是仅限于罢工机构的无性别区分方法。
    BACKGROUND: Public health emergencies of international concern (PHEICs) as the COVID-19 pandemic and others that have occurred since the early 2000s put enormous pressure on health and care systems. This is being a context for protests by health and care workers (HCWs) because of additional workload, working conditions and effects on mental and physical health. In this paper, we intended to analyze the demands of HCWs associated with industrial actions, protests, strikes and lockouts (IAPSLs) which occurred during COVID-19 pandemic and other PHEICs; to identify the impact of these grievances; and describe the relevant interventions to address these IAPSLs.
    METHODS: We included studies published between January 2000 and March 2022 in PubMed, Embase, Scopus, BVS/LILACS, WHO\'s COVID-19 Research Database, ILO, OECD, HSRM, and Google Scholar for grey literature. Eligibility criteria were HCWs as participants, IAPSLs as phenomenon of interest occurring in the context of COVID-19 and other PHEICs. GRADE CERQual was used to assess risk of bias and confidence of evidence.
    RESULTS: 1656 records were retrieved, and 91 were selected for full-text screening. We included 18 publications. A system-wide approach, rather than a limited approach to institutions on strike, makes it possible to understand the full impact of the strike on health and care services. PHEICs tend to aggravate already adverse working conditions of HCWs, acting as drivers for HCWs strikes, leading to staff shortages, and financial issues, both in the North and in the Global South, particularly evident in Asia and Africa. In addition, issues related to deficiencies in leadership and governance in heath sector and lack of medical products and technologies (e.g., lack of personal protective equipment) were the main drivers of strikes, each contributing 25% of the total drivers identified.
    CONCLUSIONS: It is necessary to focus on the preparedness of health and care systems to respond adequately to PHEICs, and this includes being prepared for HCWs\' IAPSLs, talked much in the context of COVID-19 pandemic. Evidence to assist policymakers in defining strategies to respond adequately to the health and care needs of the population during IAPSLs is crucial. The main impact of strikes is on the disruption of health care services\' provision. Gender inequality being a major issue among HCWs, a proper understanding of the full impact of the strike on health and care services will only be possible if gender lens is combined with a systemic approach, rather than gender-undifferentiated approaches limited to the institutions on strike.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Systematic Review
    背景:COVID-19大流行突显了医疗保健系统和服务中先前存在的弱点以及医疗保健工作者(HCWs)的短缺。因此,政策制定者需要采取措施提高卫生和护理劳动力(HCWF)的能力。本审查旨在确定各国为提高医护人员应对COVID-19大流行的能力而实施的政策和管理干预措施的范围,综合他们关于有效性的证据,找出证据中的漏洞。
    方法:在PubMed,Embase,Scopus,LILACS-BVS,世界卫生组织的COVID-19研究数据库和国际劳工组织,经合组织和HSRM网站提供2020年1月至2022年3月期间发布的文献和文件。资格标准是HCWs作为参与者,以及旨在提高HCWF应对COVID-19大流行应对能力的政策和管理干预措施。使用JoannaBriggs研究所(JBI)关键评估工具(CAT)评估偏倚风险,并以GRADE给出结果的证据确定性。
    结果:搜索检索到3378个文档。共包括69个,但只有8人提出了实施干预措施的结果.大多数选定的文件描述了各国在组织环境一级实施的至少一项干预措施,以提高HCWF应对大流行的灵活性和能力,其次是在安全和体面的工作环境中吸引和留住HCW的干预措施。缺乏关于社会保护的研究,卫生信息系统人力资源,以及社区卫生工作者和其他社区提供者的作用。关于偏见的风险,大多数文件被评为中等或高质量(JBI的CAT),而提供的干预措施结局的证据被归类为主要低确定性证据(GRADE).
    结论:各国实施了各种干预措施,一些创新,为了应对大流行,其他人的进程开始得更早,并因大流行而加速。关于各国在大流行期间使用的策略的影响和效力的证据仍需要进一步研究。
    The COVID-19 pandemic highlighted pre-existing weaknesses in health and care systems and services and shortages of health and care workers (HCWs). As a result, policymakers needed to adopt measures to improve the health and care workforce (HCWF) capacity. This review aims to identify countries\' range of policies and management interventions implemented to improve HCWs\' capacity to address the COVID-19 pandemic response, synthesize their evidence on effectiveness, and identify gaps in the evidence.
    The literature was searched in PubMed, Embase, Scopus, LILACS-BVS, WHO\'s COVID-19 Research Database and the ILO, OECD and HSRM websites for literature and documents published between January 2020 and March 2022. Eligibility criteria were HCWs as participants and policy and management interventions aiming to improve HCWF capacity to address the COVID-19 pandemic response. Risk of bias was assessed with Joanna Briggs Institute (JBI) Critical Appraisal Tools (CAT) and certainty of the evidence in presented outcomes with GRADE.
    The searches retrieved 3378 documents. A total of 69 were included, but only 8 presented outcomes of interventions implemented. Most of the selected documents described at least one intervention implemented by countries at the organizational environment level to increase the flexibility and capacity of the HCWF to respond to the pandemic, followed by interventions to attract and retain HCWs in safe and decent working environments. There was a lack of studies addressing social protection, human resources for health information systems, and regarding the role of community health workers and other community-based providers. Regarding the risk of bias, most of documents were rated as medium or high quality (JBI\'s CAT), while the evidence presented for the outcomes of interventions was classified as mostly low-certainty evidence (GRADE).
    Countries have implemented various interventions, some innovative, in response to the pandemic, and others had their processes started earlier and accelerated by the pandemic. The evidence regarding the impact and efficacy of the strategies used by countries during the pandemic still requires further research.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:国家和卫生系统必须做出具有挑战性的资源分配和能力建设决定,以促进适当的患者护理并确保卫生和护理人员的安全和福祉,这样他们就可以有效地解决目前的COVID-19大流行以及即将到来的公共卫生问题和自然灾害。随着创新已经到位,每天都有最新的证据发表,需要更多的信息来告知政策和干预措施的制定和实施,以提高卫生和护理工作人员的能力,以应对COVID-19大流行的应对措施。
    目的:本方案审查的目的是确定各国在政策和管理干预措施方面的一系列经验,以提高卫生和护理人员应对COVID-19大流行的能力,并综合干预措施有效性的证据。
    方法:我们将对定量,定性,以及以英语出版的混合方法研究和灰色文献(技术和政治文献),法语,印地语,葡萄牙语,意大利语,2000年1月1日至2022年3月1日之间的西班牙语。要搜索的数据库是MEDLINE(PubMed),Embase,Scopus,和拉丁美洲和加勒比健康科学文献。此外,世界卫生组织的COVID-19研究数据库和国际组织网站(国际劳工组织,经济合作与发展,和卫生系统反应监测器)将搜索未发表的研究和灰色文献。将使用JoannaBriggsInstitute定量和定性数据提取工具改编的电子表格从选定的文档中提取数据。将使用融合的综合和集成方法。偏差的风险将通过乔安娜·布里格斯研究所的关键评估工具进行评估,所呈现结果中证据的确定性将通过建议分级来评估,评估,发展和评价。
    结果:数据库和灰色文献检索检索到3378篇文献。2名独立审核员正在分析数据。该研究预计将于2023年底在同行评审的期刊上发表。
    结论:这次审查将使我们能够确定和描述各国实施的政策和战略及其有效性,以及找出证据中的漏洞。
    背景:PROSPEROCRD42022327041;https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=327041。
    RR1-10.2196/50306。
    Countries and health systems have had to make challenging resource allocation and capacity-building decisions to promote proper patient care and ensure health and care workers\' safety and well-being, so that they can effectively address the present COVID-19 pandemic as well as upcoming public health problems and natural catastrophes. As innovations are already in place and updated evidence is published daily, more information is required to inform the development and implementation of policies and interventions to improve health and care workforce capacity to address the COVID-19 pandemic response.
    The objective of this protocol review is to identify countries\' range of experiences with policies and management interventions that can improve health and care workers\' capacity to address the COVID-19 pandemic response and synthesize evidence on the effectiveness of the interventions.
    We will conduct a living systematic review of quantitative, qualitative, and mixed methods studies and gray literature (technical and political documents) published in English, French, Hindi, Portuguese, Italian, and Spanish between January 1, 2000, and March 1, 2022. The databases to be searched are MEDLINE (PubMed), Embase, SCOPUS, and Latin American and Caribbean Health Sciences Literature. In addition, the World Health Organization\'s COVID-19 Research Database and the websites of international organizations (International Labour Organization, Economic Co-operation and Development, and The Health System Response Monitor) will be searched for unpublished studies and gray literature. Data will be extracted from the selected documents using an electronic form adapted from the Joanna Briggs Institute quantitative and qualitative tools for data extraction. A convergent integrated approach to synthesis and integration will be used. The risk of bias will be assessed with Joanna Briggs Institute critical appraisal tools, and the certainty of the evidence in the presented outcomes will be assessed with the Grading of Recommendations, Assessment, Development and Evaluation.
    The database and gray literature search retrieved 3378 documents. Data are being analyzed by 2 independent reviewers. The study is expected to be published by the end of 2023 in a peer-reviewed journal.
    This review will allow us to identify and describe the policies and strategies implemented by countries and their effectiveness, as well as identify gaps in the evidence.
    PROSPERO CRD42022327041; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=327041.
    RR1-10.2196/50306.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号