Mowafi Hani, Nowak Kristin, Hein Karen
Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts 02138, USA.
Prehosp Disaster Med. 2007 Sep-Oct;22(5):351-9.
The human resources crisis in humanitarian health care parallels that seen in the broader area of health care. This crisis is exacerbated by the lack of resources in areas in which humanitarian action is needed--difficult environments that often are remote and insecure--and the requirement of specific skill sets is not routinely gained during traditional medical training. While there is ample data to suggest that health outcomes improve when worker density is increased, this remains an area of critical under-investment in humanitarian health care. In addition to under-investment, other factors limit the availability of human resources for health (HRH) in humanitarian work including: (1) over-reliance on degrees as surrogates for specific competencies; (2) under-development and under-utilization of national staff and beneficiaries as humanitarian health workers; (3) lack of standardized training modules to ensure adequate preparation for work in complex emergencies; (4) and the draining of limited available HRH from countries with low prevalence and high need to wealthier, developed nations also facing HRH shortages. A working group of humanitarian health experts from implementing agencies, United Nations agencies, private and governmental financiers, and members of academia gathered at Hanover, New Hampshire for a conference to discuss elements of the HRH problem in humanitarian health care and how to solve them. Several key elements of successful solutions were highlighted, including: (1) the need to develop a set of standards of what would constitute "adequate training" for humanitarian health work; (2) increasing the utilization and professional development of national staff; (3) "training with a purpose" specific to humanitarian health work (not simply relying on professional degrees as surrogates); (4) and developing specific health task-based competencies thereby increasing the pool of potential workers. Such steps would accomplish several key goals, such as: (1) more confidently ensuring that individuals hired for a given post would have the capacity to function at a commonly understood level of training; (2) greatly increasing the potential number and types of workers available for humanitarian work; (3) increasing the efficiency of human resources utilization in humanitarian projects; and (4) recognition that humanitarian work is a multi-disciplinary endeavor: these goals will contribute to ensuring that humanitarian health workers have a minimum training in broader humanitarian action, making them more effective team members in the field. Efforts were made to highlight some promising pilot programs for human resource development in humanitarian work, to identify a future vision for humanitarian health as a profession, and to develop a human resources strategy for achieving that vision.
人道主义医疗保健领域的人力资源危机与更广泛的医疗保健领域所面临的危机类似。在需要开展人道主义行动的地区——往往地处偏远且不安全的艰苦环境中，资源匮乏，而传统医学培训通常无法培养出所需的特定技能，这加剧了这场危机。虽然有大量数据表明，增加工作人员密度可改善健康状况，但在人道主义医疗保健领域，这仍是一个关键的投资不足领域。除了投资不足外，其他因素也限制了人道主义工作中卫生人力资源的可得性，包括：（1）过度依赖学位作为特定能力的替代指标；（2）本国工作人员和受益人作为人道主义卫生工作者的发展不足和利用不足；（3）缺乏标准化培训模块，无法确保为应对复杂紧急情况做好充分准备；（4）有限的可用卫生人力资源从患病率低但需求高的国家流向同样面临卫生人力资源短缺的富裕发达国家。来自实施机构、联合国机构、私人和政府资助方以及学术界的人道主义卫生专家工作小组齐聚新罕布什尔州汉诺威参加一次会议，讨论人道主义医疗保健领域卫生人力资源问题的要素以及如何解决这些问题。会议强调了成功解决方案的几个关键要素，包括：（1）需要制定一套构成人道主义卫生工作“充分培训”的标准；（2）提高本国工作人员的利用率和专业发展；（3）针对人道主义卫生工作进行“有目的的培训”（而不是简单地依赖学位作为替代指标）；（4）制定基于特定卫生任务的能力标准，从而增加潜在工作人员的数量。这些举措将实现几个关键目标，例如：（1）更有信心地确保为特定岗位聘用的人员具备在普遍认可的培训水平上履行职责的能力；（2）大幅增加可用于人道主义工作的潜在工作人员数量和类型；（3）提高人道主义项目中人力资源的利用效率；（4）认识到人道主义工作是一项多学科的努力：这些目标将有助于确保人道主义卫生工作者在更广泛的人道主义行动方面接受最低限度的培训，使他们在实地成为更有效的团队成员。会议还努力强调了一些在人道主义工作中人力资源开发方面有前景的试点项目，确定了人道主义卫生作为一种职业的未来愿景，并制定了实现这一愿景的人力资源战略。
