Tackling health workforce challenges to universal health coverage: setting targets and measuring progress
Tackling health workforce challenges to universal health coverage: setting targets and measuring progress
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DOI：
10.2471/blt.13.118810
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发表时间：
2013-11-01
影响因子：
11.1
通讯作者：
Witter, Sophie
中科院分区：
文献类型：
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作者：
Cometto, Giorgio;Witter, Sophie
如果要实现全民健康覆盖，就必须加强卫生人力资源。现有的卫生人力基准只关注医生、护士和助产士的密度，制定这些基准的目的是实现熟练助产服务和与卫生千年发展目标相关的其他基本卫生服务的相对高覆盖率。然而，实现全民健康覆盖不仅取决于是否有足够数量的卫生工作者，还取决于现有卫生人力的分布、质量和绩效。此外，随着非传染性疾病的相对重要性日益增加，卫生工作者所需的投入也在发生变化。因此，需要制定新的、更广泛的卫生人力基准以及相应的监测框架，并将其纳入全民健康覆盖议程，以促进对卫生系统这一关键领域的关注和投资。新的基准需要反映卫生人力队伍的更多样化组成以及社区卫生工作者和中级卫生工作者的参与情况，还必须反映卫生保健发展的多面性和复杂性，包括可及性、性别构成和质量方面的公平性。
Human resources for health (HRH) will have to be strengthened if universal health coverage (UHC) is to be achieved. Existing health workforce benchmarks focus exclusively on the density of physicians, nurses and midwives and were developed with the objective of attaining relatively high coverage of skilled birth attendance and other essential health services of relevance to the health Millennium Development Goals (MDGs). However, the attainment of UHC will depend not only on the availability of adequate numbers of health workers, but also on the distribution, quality and performance of the available health workforce. In addition, as noncommunicable diseases grow in relative importance, the inputs required from health workers are changing. New, broader health-workforce benchmarks - and a corresponding monitoring framework - therefore need to be developed and included in the agenda for UHC to catalyse attention and investment in this critical area of health systems. The new benchmarks need to reflect the more diverse composition of the health workforce and the participation of community health workers and mid-level health workers, and they must capture the multifaceted nature and complexities of HRH development, including equity in accessibility, sex composition and quality.