Health workers' strikes in low-income countries: the available evidence
Health workers' strikes in low-income countries: the available evidence
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DOI：
10.2471/blt.18.225755
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发表时间：
2019-07-01
影响因子：
11.1
通讯作者：
Campbell, James
中科院分区：
文献类型：
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作者：
Russo, Giuliano;Xu, Lihui;Campbell, James
目的分析低收入国家卫生工作者罢工的特征、频率、驱动因素、结果和利益相关者。方法我们回顾了2009年至2018年在线来源的已发表和灰色文献。我们使用了四种搜索策略：㈠探索主要的卫生和社会科学数据库; ㈡使用关于卫生和发展人力资源的专门网站; ㈢定制的谷歌搜索; ㈣与专家协商，以验证调查结果。要分析个人的罢工事件，预先存在的条件和影响演员，我们开发了一个概念框架从literature.Results我们确定了116个记录报告70个独特的卫生工作者的罢工在23个低收入国家在此期间，占875天的罢工。2018年的事件数量最多（17起），相当于损失了170个工作日。涉及一个以上专业类别的罢工是最常见的罢工形式（32起事件），其次是仅由医生发动的罢工（22起事件）。报告最多的原因是对薪酬的投诉（63起事件），其次是对该部门治理或政策的抗议（25起事件）和对工作条件安全的抗议（10起事件）。当集体谈判机构和更高级别的政府参与到谈判中时，积极的解决方案更经常地实现。结论在低收入国家，卫生部门罢工的发生和参与此类事件的行为者似乎存在一些共同的特点。今后的研究应侧重于个别事件和区域模式，为预防和解决罢工的机制奠定证据基础。
Objective To analyse the characteristics, frequency, drivers, outcomes and stakeholders of health workers' strikes in low-income countries.Methods We reviewed the published and grey literature from online sources for the years 2009 to 2018. We used four search strategies: (i) exploration of main health and social sciences databases; (ii) use of specialized websites on human resources for health and development; (iii) customized Google search; and (iv) consultation with experts to validate findings. To analyse individual strike episodes, pre-existing conditions and influencing actors, we developed a conceptual framework from the literature.Results We identified 116 records reporting on 70 unique health workers' strikes in 23 low-income countries during the period, accounting for 875 days of strike. Year 2018 had the highest number of events (17), corresponding to 170 work days lost. Strikes involving more than one professional category was the frequent strike modality (32 events), followed by strikes by physicians only (22 events). The most commonly reported cause was complaints about remuneration (63 events), followed by protest against the sector's governance or policies (25 events) and safety of working conditions (10 events). Positive resolution was achieved more often when collective bargaining institutions and higher levels of government were involved in the negotiations.Conclusion In low-income countries, some common features appear to exist in health sector strikes' occurrence and actors involved in such events. Future research should focus on both individual events and regional patterns, to form an evidence base for mechanisms to prevent and resolve strikes.