Martineau Tim, Willetts Annie
Liverpool School of Tropical Medicine, International Health Research Group, Liverpool L3 5QA, UK.
Health Policy. 2006 Feb;75(3):358-67. doi: 10.1016/j.healthpol.2005.04.012. Epub 2005 Jun 20.
Many countries are using the strategy of international recruitment to make up for shortages of health professionals to the detriment of health systems in the poorest parts of the world. This study reviewed the potential impact of eight national level and international codes of practice or similar instruments that are being introduced to encourage ethical recruitment in order to protect these countries. Whilst effective dissemination of the instruments is generally in place, support systems, incentives and sanctions and monitoring systems necessary for effective implementation and sustainability are currently weak or have not been planned. If such codes or instruments are to be used to protect developing country health systems, lessons should be learnt from the early adopters; the focus of protecting developing country health systems needs to be emphasised in instruments with multiple objectives; the process of implementing the instruments strengthened; and internal and external pressure needs to be increased to ensure the codes and instruments lead to ethical recruitment and help to protect developing country health systems.
许多国家正在采用国际招聘策略来弥补卫生专业人员短缺的问题，这对世界最贫困地区的卫生系统造成了损害。本研究回顾了八项国家级和国际执业规范或类似文书的潜在影响，这些规范或文书旨在鼓励道德招聘以保护这些国家。虽然这些文书的有效传播总体上已经到位，但有效实施和可持续性所需的支持系统、激励措施、制裁措施和监测系统目前较为薄弱或尚未规划。如果要利用此类规范或文书来保护发展中国家的卫生系统，就应从早期采用者身上吸取经验教训；在具有多个目标的文书中应强调保护发展中国家卫生系统这一重点；加强文书的实施过程；并加大内部和外部压力，以确保这些规范和文书能带来道德招聘并有助于保护发展中国家的卫生系统。
