Diallo Khassoum, Zurn Pascal, Gupta Neeru, Dal Poz Mario
Department of Health Service Provision, World Health Organization, Geneva, Switzerland.
Hum Resour Health. 2003 Apr 14;1(1):3. doi: 10.1186/1478-4491-1-3.
Despite the undoubted importance of human resources to the functions of health systems, there is little consistency between countries in how human resource strategies are monitored and evaluated. This paper presents an integrated approach for developing an evidence base on human resources for health (HRH) to support decision-making, drawing on a framework for health systems performance assessment. METHODS: Conceptual and methodological issues for selecting indicators for HRH monitoring and evaluation are discussed, and a range of primary and secondary data sources that might be used to generate indicators are reviewed. Descriptive analyses are conducted drawing primarily on one type of source, namely routinely reported data on the numbers of health personnel and medical schools as covered by national reporting systems and compiled by the World Health Organization. Regression techniques are used to triangulate a given HRH indicator calculated from different data sources across multiple countries. RESULTS: Major variations in the supply of health personnel and training opportunities are found to occur by region. However, certain discrepancies are also observed in measuring the same indicator from different sources, possibly related to the occupational classification or to the sources' representation. CONCLUSION: Evidence-based information is needed to better understand trends in HRH. Although a range of sources exist that can potentially be used for HRH assessment, the information that can be derived from many of these individual sources precludes refined analysis. A variety of data sources and analytical approaches, each with its own strengths and limitations, is required to reflect the complexity of HRH issues. In order to enhance cross-national comparability, data collection efforts should be processed through the use of internationally standardized classifications (in particular, for occupation, industry and education) at the greatest level of detail possible.
尽管人力资源对卫生系统的功能至关重要，但各国在人力资源战略的监测和评估方式上缺乏一致性。本文借鉴卫生系统绩效评估框架，提出一种综合方法，以建立卫生人力资源（HRH）的证据基础，支持决策制定。方法：讨论了选择卫生人力资源监测和评估指标的概念和方法问题，并审查了一系列可能用于生成指标的主要和次要数据来源。主要利用一种数据来源进行描述性分析，即国家报告系统涵盖并由世界卫生组织汇编的关于卫生人员数量和医学院校的常规报告数据。使用回归技术对多个国家不同数据来源计算出的特定卫生人力资源指标进行三角测量。结果：发现卫生人员供应和培训机会在区域间存在重大差异。然而，从不同来源测量同一指标时也观察到某些差异，这可能与职业分类或来源的代表性有关。结论：需要基于证据的信息来更好地了解卫生人力资源的趋势。尽管存在一系列可能用于卫生人力资源评估的来源，但从许多这些单个来源获得的信息难以进行精细分析。需要各种数据来源和分析方法，每种方法都有其自身的优势和局限性，以反映卫生人力资源问题的复杂性。为了提高跨国可比性，应尽可能详细地通过使用国际标准化分类（特别是职业、行业和教育分类）来进行数据收集工作。
