基于WHO卫生人力战略目标的我国农村卫生人才政策研究

文章以农村卫生人才建设的公共政策属性和对农村卫生人才建设的障碍分析为基础,基于世界卫生组织卫生人力战略目标建立理论框架,从思路、模式、行动、措施4个维度,提出建立和完善农村卫生人才管理政策、规制政策、医学教育政策和卫生人才支持政策的建议.     

基于WHO卫生人力战略目标的我国农村卫生人才建设障碍分析

农村卫生人才政策开发的前提是对农村卫生人才建设障碍的深入分析.文章基于世界卫生组织卫生人力战略目标建立理论框架,从城乡二元结构、卫生管理体制、卫生财政政策和医学教育政策4个维度对我国农村卫生人才建设所存在的障碍进行了深入分析.     

Accessibility of primary health care workforce in rural china

This study aims to develop an accessibility index to illustrate the status of the accessibility of primary health care workers in remote and rural areas in China. Relevant county-level data were used to analyze the number and distribution of primary health care workforce in rural China, and relevant provincial-level data were used to analyze the accessibility index. The study found that the development of rural primary health care workers is suboptimal. The rural Primary Health Care Worker Accessibility index shows that the accessibility to primary health care workers in western rural areas is poor. The correlation between PHCWA index and maternal mortality rate is more significant than that between primary health care workers density and maternal mortality rate. In addition to increasing the number of primary health care workers, strategies addressing the challenge of distance are also required.     

The local public health workforce in rural communities.

This work describes the public health workforce and training needs of rural local public health agencies (LPHAs) in comparison with suburban and metropolitan LPHA jurisdictions. A survey was sent to 1,100 LPHAs nationwide. The rural urban commuting area codes (RUCAs) defined LPHAs as rural or urban, and the Standard Occupational Classification system enumerated the workforce. Most occupational classifications had significantly fewer staff in rural LPHAs. Public health nurses ranked as the most needed staff and serve in various important capacities in rural LPHAs. In terms of training, job-specific or programmatic continuing education was identified as the most important training need. Developing leadership and public health workforce capacity within rural public health is an essential agenda item for rural America. Decision makers may need to consider different organizational structures while balancing the need for local input and control. Regionalization and collaborative approaches to difficult workforce issues may present potential solutions to workforce challenges.     

Oral health workforce in rural and remote Western Australia: practice perceptions

OBJECTIVE: In this study an analysis was undertaken to determine: (i) the major factors that influence oral health professionals to practise in rural areas and determine practice location; (ii) what assists the professional oral health workforce to remain in rural practice; and (iii) what the main reasons are for leaving rural practice. DESIGN: A postal survey was undertaken among all registered oral health professionals in Western Australia. SETTING: Rural and remote Western Australia. PARTICIPANTS: Registered dental therapists, dental hygienists and dentists in rural and remote Western Australia. RESULTS: Results indicated that there are various factors that attract people to rural and remote areas, other than financial incentives. Incentives to remain in rural practice include the need for professional development. The most common reason for leaving rural practice was to access children's educational facilities. CONCLUSIONS: This study emphasises that many factors contribute to recruitment and retention of dental professionals in rural practice. A broad integrated retention strategy is needed to address oral health workforce shortage issues in rural and remote Western Australia.     

Mapping the public health workforce I: a tool for classifying the public health workforce

We aimed to develop a tool to identify members of the public health workforce and classify them using categories developed for the Chief Medical Officer's project to strengthen the public health function. The tool was developed to gain a picture of London's public health workforce, and needed to be reliable and easy to use in many settings inside and outside the health service. We needed to be able to classify posts from brief information without interrogation of postholders, so that the entire workforces of large organisations could be classified from information provided by only a few key informants. Key questions and decision rules were defined by presenting interviewees in public health with brief information on nine jobs and discussing with them the process by which they determined whether each post was in the public health workforce, and if so, in which category. The questions and decision rules were refined into a classification tool which was presented as a flow diagram and a questionnaire. Application of the tool revealed that it was understood by key informants and resulted in classifications which were accepted by the researchers. The tool has now been applied extensively in London and yielded useful results. Many other applications in public health workforce planning and development are anticipated.     

Harnessing a university to address rural health workforce shortages in Australia

OBJECTIVE: To describe the efforts of health faculties at the University of Sydney to contribute to the recruitment and retention of rural health professionals and examine for opportunities that would benefit from an institutional-led response. DESIGN: Cross-sectional survey. SETTING: The University of Sydney as a leading institution for health science education in New South Wales, which produces approximately 40% of all health science graduates in the state each year. PARTICIPANTS: Staff responsible for course coordination within the faculties of Dentistry, Medicine, Nursing and Midwifery, and Pharmacy; and eight disciplines of the Faculty of Health Sciences. RESULTS: Of the two educational strategies associated with future rural employment, more progress has been made with rural placements, which were offered by all but one of the health courses. Efforts aimed at the other key strategy of attracting and supporting rural origin students were not well developed. Dentistry, Medicine, Pharmacy and only one Faculty of Health Sciences programs had more than 0.2 full-time equivalent staff to support rural initiatives. CONCLUSION: Despite the significant government investment in rural health education, the University of Sydney experience demonstrates that this does not necessarily translate into adequate internal resources available for every course or program to optimise performance for rural health workforce outcomes. In an environment of competing priorities, benefits are likely to accrue from strategies that draw on the existing resource base and operate through greater collaborative action, coordinated at the institutional level.     

Incentives to attract and retain the health workforce in rural areas of Peru: a qualitative study

The study aimed to identify the main incentives for attracting and retaining health workers in rural and remote health facilities in Ayacucho, Peru. In-depth interviews were performed with 80 physicians, obstetricians, nurses, and nurse technicians in the poorest areas (20 per group), plus 11 health managers. Ayacucho lacks systematic policies for attracting and retaining human resources. The main incentives, in order of relevance, were higher wages, opportunities for further training, longer/permanent contracts, better infrastructure and medical equipment, and more staff. Interviewees also mentioned improved housing conditions and food, the opportunity to be closer to family, and recognition by the health system. Health workers and policymakers share perceptions on key incentives to encourage work in rural areas. However, there are also singularities to be considered when designing specific strategies. Public initiatives thus need to be monitored and evaluated closely in order to ensure the intended impact.     

State of emergency preparedness of Kentucky's rural public health workforce: assessing its ability to identify community health problems

OBJECTIVE: The author examined the emergency preparedness readiness of all workgroups within Kentucky's rural public health departments as it related to the 10 Essential Public Health Services. This article describes the results related to the three emergency preparedness competencies for the first Essential Public Health Service: the ability to monitor health status to identify community health problems. METHODS: Onsite surveys were conducted in one urban and 93 rural Kentucky public health agencies during 2005 and 2006. Categorical data were analyzed using univariate and multivariate analysis techniques. The author compared responses to the level of confidence (LOC) and need for training (NFT) among the seven workgroup classifications. RESULTS: One thousand nine hundred ninety-four public health workers completed the surveys. Of these, 1,813 workers represented 55% of the state's rural local public health workforce. Kentucky's rural public health workforce can be described as predominantly Caucasian, female, and not planning to retire within the next five years. There were significant differences among workgroups for LOC and NFT for each competency examined. Across all workgroups, there was a mean LOC (58%) in the ability to describe the actions to take and procedures to follow in an emergency. There was a correspondingly higher mean perceived NFT (73%) for this competency. CONCLUSION: This study raises the question of whether we are adequately prepared to monitor our communities' health status. Further research that minimizes the limitations of self-reports and, instead, requires the worker to demonstrate the competency may provide a more accurate assessment of emergency preparedness.