Alliance for Health Policy and Systems Research, World Health Organization, 20 avenue Appia, 1211 Geneva 27, Switzerland.
Bull World Health Organ. 2010 Jun;88(6):435-43. doi: 10.2471/BLT.09.066290.
To identify the human resources for health (HRH) policy concerns and research priorities of key stakeholders in low- and middle-income countries; to assess the extent to which existing HRH research addresses these concerns and priorities; and to develop a prioritized list of core research questions requiring immediate attention to facilitate policy development and implementation.
The study involved interviews with key informants, including health policy-makers, researchers and community and civil society representatives, in 24 low- and middle-income countries in four regions, a literature search for relevant reviews of research completed to date, and the assessment of interview and literature search findings at a consultative multinational workshop, during which research questions were prioritized.
Twenty-one research questions emerged from the key informant interviews, many of which had received little or no attention in the reviewed literature. The questions ranked as most important at the consultative workshop were: (i) To what extent do incentives work in attracting and retaining qualified health workers in underserviced areas? (ii) What is the impact of dual practice and multiple employment? and (iii) How can incentives be used to optimize efficiency and the quality of health care?
There was a clear consensus about the type of HRH policy problems faced by different countries and the nature of evidence needed to tackle them. Coordinated action to support and implement research into the highest priority questions identified here could have a major impact on health worker policies and, ultimately, on the health of the poor.
确定中低收入国家关键利益攸关方对卫生人力资源(HRH)政策的关注和研究重点;评估现有 HRH 研究在多大程度上解决了这些问题和重点;并制定一份需要立即关注的核心研究问题的优先清单,以促进政策的制定和实施。
该研究涉及对 24 个中低收入国家的关键信息员(包括卫生政策制定者、研究人员以及社区和民间社会代表)进行访谈,对迄今为止完成的研究进行文献检索,在一次多国协商性研讨会上评估访谈和文献检索结果,在研讨会上对研究问题进行了优先排序。
从关键信息员访谈中得出了 21 个研究问题,其中许多问题在已审查的文献中很少或没有得到关注。在协商性研讨会上被列为最重要的问题是:(i)激励措施在吸引和留住服务不足地区合格卫生工作者方面的效果如何?(ii)双重执业和多重就业的影响是什么?以及(iii)如何利用激励措施来优化医疗保健的效率和质量?
不同国家面临的 HRH 政策问题类型以及解决这些问题所需证据的性质存在明确的共识。协调行动,支持和实施对这里确定的优先问题的研究,可能会对卫生工作者政策产生重大影响,并最终影响贫困人口的健康。