Making Pregnancy Safer, World Health Organization, Geneva, Switzerland.
Hum Resour Health. 2011 Jun 24;9:16. doi: 10.1186/1478-4491-9-16.
There is increasing attention, globally and in countries, to monitoring and addressing the health systems and human resources inputs, processes and outputs that impede or facilitate progress towards achieving the Millennium Development Goals for maternal and child health. We reviewed the situation of human resources for health (HRH) in 68 low- and middle-income countries that together account for over 95% of all maternal and child deaths.
We collected and analysed cross-nationally comparable data on HRH availability, distribution, roles and functions from new and existing sources, and information from country reviews of HRH interventions that are associated with positive impacts on health services delivery and population health outcomes.
Findings from 68 countries demonstrate availability of doctors, nurses and midwives is positively correlated with coverage of skilled birth attendance. Most (78%) of the target countries face acute shortages of highly skilled health personnel, and large variations persist within and across countries in workforce distribution, skills mix and skills utilization. Too few countries appropriately plan for, authorize and support nurses, midwives and community health workers to deliver essential maternal, newborn and child health-care interventions that could save lives.
Despite certain limitations of the data and findings, we identify some key areas where governments, international partners and other stakeholders can target efforts to ensure a sufficient, equitably distributed and efficiently utilized health workforce to achieve MDGs 4 and 5.
全球各国越来越关注监测和解决妨碍或促进实现孕产妇和儿童健康千年发展目标的卫生系统和人力资源投入、过程和产出。我们审查了在占所有孕产妇和儿童死亡人数 95%以上的 68 个中低收入国家的卫生人力资源状况。
我们从新的和现有的来源收集和分析了有关人力资源供应、分布、角色和职能的具有跨国可比性的数据，以及与改善卫生服务提供和人口健康结果相关的人力资源干预措施的国家审查信息。
来自 68 个国家的结果表明，医生、护士和助产士的供应与熟练接生覆盖率呈正相关。大多数（78%）目标国家面临高度熟练卫生人员的严重短缺，而且劳动力分布、技能组合和技能利用在国家内部和国家之间存在很大差异。只有少数国家适当规划、授权和支持护士、助产士和社区卫生工作者提供基本的孕产妇、新生儿和儿童保健干预措施，这些措施可以拯救生命。
尽管数据和结果存在一定的局限性，但我们确定了一些关键领域，政府、国际伙伴和其他利益攸关方可以集中精力确保有足够、公平分配和有效利用的卫生人力来实现千年发展目标 4 和 5。
