Health workforce issues and the Global Fund to fight AIDS, Tuberculosis and Malaria: an analytical review.
Health workforce issues and the Global Fund to fight AIDS, Tuberculosis and Malaria: an analytical review.
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DOI：
10.1186/1478-4491-4-23
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发表时间：
2006-08-24
影响因子：
4.5
通讯作者：
Dal Poz MR
中科院分区：
文献类型：
--
作者：
Dräger S;Gedik G;Dal Poz MR
最近的研究表明，卫生工作者人数与健康结果之间存在直接和积极的因果关系。若干研究已经确定，充足的卫生人力是实现更好的健康结果的关键因素之一。全球卫生行动面临人力资源问题，这是全系统的主要制约因素。本文探讨了全球基金如何应对卫生人力瓶颈对成功实施重点疾病规划的挑战。审查了全球基金政策文件和准则中对人力资源进行投资的可能性。接下来是对来自埃塞俄比亚、加纳、肯尼亚、马拉维和坦桑尼亚五个非洲国家的35项全球基金提案进行深入研究。讨论提出了可以在提案中找到的具体人力资源干预措施。最后，审查了对全球基金技术审查小组人力资源干预措施和卫生人力资源预算分配的意见。全球基金的政策文件和指导方针鼓励考虑到受援国的人力资源限制和解决这些限制的干预措施。但是，对实际建议的审查清楚地表明，各国往往没有利用它们的机会，而主要集中于其人力资源部分的短期在职培训。技术审查小组对拟议的加强卫生系统干预措施的评论表明，全球基金一方面要实现与三种目标疾病作斗争的目标，另一方面需要加强卫生系统作为成功的先决条件。在利用全球基金为人力资源干预提供的机会时，各国应超越短期目标，将其活动与卫生人力资源的长期发展联系起来。
Recent studies have shown evidence of a direct and positive causal link between the number of health workers and health outcomes. Several studies have identified an adequate health workforce as one of the key ingredients to achieving improved health outcomes. Global health initiatives are faced with human resources issues as a major, system-wide constraint. This article explores how the Global Fund addresses the challenges of a health workforce bottleneck to the successful implementation of priority disease programmes. Possibilities for investment in human resources in the Global Fund's policy documents and guidelines are reviewed. This is followed by an in-depth study of 35 Global Fund proposals from five African countries: Ethiopia, Ghana, Kenya, Malawi and Tanzania. The discussion presents specific human resources interventions that can be found in proposals. Finally, the comments on human resources interventions in the Global Fund's Technical Review Panel and the budget allocation for human resources for health were examined. Policy documents and guidelines of the Global Fund foster taking account of human resources constraints in recipient countries and interventions to address them. However, the review of actual proposals clearly shows that countries do not often take advantage of their opportunities and focus mainly on short-term, in-service training in their human resources components. The comments of the Technical Review Panel on proposed health system-strengthening interventions reveal a struggle between the Global Fund's goal to fight the three targeted diseases, on the one hand, and the need to strengthen health systems as a prerequisite for success, on the other. In realizing the opportunities the Global Fund provides for human resources interventions, countries should go beyond short-term objectives and link their activities to a long-term development of their human resources for health.