Contribution of health workforce to health outcomes: empirical evidence from Vietnam
Contribution of health workforce to health outcomes: empirical evidence from Vietnam
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DOI：
10.1186/s12960-016-0165-0
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发表时间：
2016-11-16
影响因子：
4.5
通讯作者：
Thi Minh Le
中科院分区：
文献类型：
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作者：
Mai Phuong Nguyen;Mirzoev, Tolib;Thi Minh Le
背景资料：在越南这个中低收入国家，虽然卫生工作者的整体技能和知识质量正在提高，但卫生工作者不成比例地分布在不同的经济区域。这些区域之间的健康结果似乎也有类似的趋势。然而，目前尚不清楚，在越南的背景下，卫生工作者的分布和卫生成果的实现之间是否有任何关系。本研究探讨了卫生工作者的可用性和健康结果之间的统计关系在不同的经济区域在Vietnam.Methods：我们构建了一个面板数据的6个经济区域，涵盖8年（2006-2013），并使用主成分分析回归估计卫生人力对健康结果的影响。代表结果的因变量包括出生时预期寿命、婴儿死亡率和五岁以下儿童死亡率。除了作为我们的目标解释变量的卫生人力，我们还控制了关键的人口因素，包括地区人均收入，贫困率，文盲率，人口density.Results：医生，护士，助产士，药剂师的数量一直在上升，在该国在过去的十年。然而，不同类别之间存在显著差异。例如，2006年至2013年期间，护士人数大幅增加，而药剂师人数在2011年至2013年期间略有下降。我们发现了统计学上的显着证据的密度的医生，护士，助产士，和药剂师对改善预期寿命和减少婴儿和5岁以下的死亡率的影响。结论：不同类别的卫生工作人员的可用性可以积极促进健康结果的改善，并最终延长人口的预期寿命。因此，增加对四个主要类别的卫生劳动力（医生，护士，助产士和药剂师）的更公平分配的投资可能是改善越南和其他类似情况下健康结果的重要战略。今后的干预措施还需要考虑采取综合办法，建立在健康与发展之间的联系之上。
Background: In Vietnam, a lower-middle income country, while the overall skill-and knowledge-based quality of health workforce is improving, health workers are disproportionately distributed across different economic regions. A similar trend appears to be in relation to health outcomes between those regions. It is unclear, however, whether there is any relationship between the distribution of health workers and the achievement of health outcomes in the context of Vietnam. This study examines the statistical relationship between the availability of health workers and health outcomes across the different economic regions in Vietnam.Methods: We constructed a panel data of six economic regions covering 8 years (2006-2013) and used principal components analysis regressions to estimate the impact of health workforce on health outcomes. The dependent variables representing the outcomes included life expectancy at birth, infant mortality, and under-five mortality rates. Besides the health workforce as our target explanatory variable, we also controlled for key demographic factors including regional income per capita, poverty rate, illiteracy rate, and population density.Results: The numbers of doctors, nurses, midwives, and pharmacists have been rising in the country over the last decade. However, there are notable differences across the different categories. For example, while the numbers of nurses increased considerably between 2006 and 2013, the number of pharmacists slightly decreased between 2011 and 2013. We found statistically significant evidence of the impact of density of doctors, nurses, midwives, and pharmacists on improvement to life expectancy and reduction of infant and under-five mortality rates.Conclusions: Availability of different categories of health workforce can positively contribute to improvements in health outcomes and ultimately extend the life expectancy of populations. Therefore, increasing investment into more equitable distribution of four main categories of health workforce (doctors, nurses, midwives, and pharmacists) can be an important strategy for improving health outcomes in Vietnam and other similar contexts. Future interventions will also need to consider an integrated approach, building on the link between the health and the development.