Addressing the human resources crisis: a case study of the Namibian health service.
Addressing the human resources crisis: a case study of the Namibian health service.
复制标题
DOI：
10.1186/1478-4491-5-1
复制
发表时间：
2007-01-15
影响因子：
4.5
通讯作者：
Awases, Magda
中科院分区：
文献类型：
--
作者：
McCourt, Willy;Awases, Magda
背景：本文解决了员工管理的一个重要的实际挑战。 2000 年，联合国致力于实现千年发展目标 (MDG) 中包含的雄心勃勃的目标。仅仅五年后，很明显贫穷国家还没有走上实现这些目标的轨道。同样显而易见的是，只有具备适当的人力资源（HR），才有可能实现八个千年发展目标中涉及健康的三个目标。 方法：我们使用基于半结构化访谈数据的案例研究来探讨纳米比亚这个面临艾滋病感染率高得惊人的严重健康问题的国家在管理其卫生工作者方面所采取的步骤。 结果：独立十五年来，纳米比亚耐心地建立了一个相对较好的卫生政策战略框架。政府政策作为一个整体，包括对各级卫生人员的强有力的培训安排，并通过国家艾滋病毒/艾滋病战略计划将艾滋病毒/艾滋病置于战略保护之下。它的主要弱点是它没有跟上艾滋病毒/艾滋病和结核病感染的增长步伐：社区咨询服务在本研究时仍处于试点阶段，是唯一的具体应对措施。这就造成了战略背景下的长期能力建设与应对艾滋病和结核病危机的短期需求之间的紧张关系，这反过来又影响了人力资源部门为改善健康结果做出贡献的能力。结论：建议像纳米比亚这样的国家需要一种新的卫生服务人员配置模式。在现有战略框架的基础上，应以“中层干部”培养为目标。上级干部要发挥好中层干部的支持和监督作用。为此，他们需要管理培训和用于员工支持和监控的绩效管理框架。
BACKGROUND: This paper addresses an important practical challenge to staff management. In 2000 the United Nations committed themselves to the ambitious targets embodied in the Millennium Development Goals (MDGs). Only five years later, it was clear that poor countries were not on track to achieve them. It was also clear that achieving the three out of the eight MDGs that concern health would only be possible if the appropriate human resources (HR) were in place.METHODS: We use a case study based on semi-structured interview data to explore the steps that Namibia, a country facing severe health problems that include an alarmingly high AIDS infection rate, has taken to manage its health workers.RESULTS: In the fifteen years since independence, Namibia has patiently built up a relatively good strategic framework for health policy in the context of government policy as a whole, including strong training arrangements at every level of health staffing, and it has brought HIV/AIDS under the strategic umbrella through its National Strategic Plan for HIV/AIDS. Its major weakness is that it has not kept pace with the rise in HIV/AIDS and TB infection: the community counselling service, still at the pilot stage at the time of this study, was the only specific response. That has created a tension between building long-term capacity in a strategic context and responding to the short-term demands of the AIDS and TB crisis, which in turn affects the ability of HR to contribute to improving health outcomes.CONCLUSION: It is suggested that countries like Namibia need a new paradigm for staffing their health services. Building on the existing strategic framework, it should target the training of 'mid-level cadres'. Higher-level cadres should take on the role of supporting and monitoring the mid-level cadres. To do that, they will need management training and a performance management framework for staff support and monitoring.