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发展中国家技术熟练的医护人员移民:基于团队的医疗实践能否填补孕产妇、新生儿和儿童医疗服务的缺口?

Emigration of skilled healthcare workers from developing countries: can team-based healthcare practice fill the gaps in maternal, newborn and child healthcare delivery?

作者信息

Owusu Yaw, Medakkar Prerana, Akinnawo Elizabeth M, Stewart-Pyne Althea, Ashu Eta E

机构信息

Registered Nurses' Association of Ontario, 158 Pearl St., Toronto, Ontario, CANADA M5H-1L3.

York University, 158 St. George Street, Toronto, ON, M5S 2V8 CANADA.

出版信息

Int J MCH AIDS. 2017;6(2):121-129. doi: 10.21106/ijma.204.

Abstract

BACKGROUND AND INTRODUCTION

Emigration of healthcare workers from developing countries is on the rise and there is an urgent need for policies that increase access to and continuity of healthcare. In this commentary, we highlight some of the negative impacts of emigration on maternal and child health and discuss whether team-based healthcare delivery could possibly mitigate the shortfall of maternal and child health professionals in developing countries.

METHODOLOGY

We cross-examine the availability of supporting structures to implement team-based maternal and child healthcare delivery in developing countries. We briefly discuss three key supporting structures: culture of sharing, telecommunication, and inter-professional education. Supporting structures are examined at system, organizational and individual levels. We argue that the culture of sharing, limited barriers to inter-professional education and increasing access to telecommunication will be advantageous to implementing team-based healthcare delivery in developing countries.

CONCLUSION AND GLOBAL HEALTH IMPLICATIONS

Although most developing countries may have notable supporting structures to implement team-based healthcare delivery, the effectiveness of such models in terms of cost, time and infrastructure in resource limited settings is still to be evaluated. Hence, we call on usual stakeholders, government, regulatory colleges and professional associations in countries with longstanding emigration of maternal and child healthcare workers to invest in establishing comprehensive models needed to guide the development, implementation and evaluation of team-based maternal and child healthcare delivery.

摘要

背景与引言

发展中国家医护人员的移民现象日益增多,迫切需要制定政策以增加医疗服务的可及性和连续性。在本评论中,我们强调了移民对孕产妇和儿童健康的一些负面影响,并讨论了基于团队的医疗服务提供方式是否有可能缓解发展中国家孕产妇和儿童健康专业人员短缺的问题。

方法

我们审视了在发展中国家实施基于团队的孕产妇和儿童医疗服务提供所需支持结构的可得性。我们简要讨论了三个关键支持结构:共享文化、电信和跨专业教育。从系统、组织和个人层面审视支持结构。我们认为,共享文化、跨专业教育的有限障碍以及电信接入的增加将有利于在发展中国家实施基于团队的医疗服务提供。

结论与全球健康影响

尽管大多数发展中国家可能有显著的支持结构来实施基于团队的医疗服务提供,但在资源有限的环境中,此类模式在成本、时间和基础设施方面的有效性仍有待评估。因此,我们呼吁在孕产妇和儿童医护人员长期移民的国家中,包括政府、监管机构和专业协会等相关利益方,投资建立全面的模式,以指导基于团队的孕产妇和儿童医疗服务提供的发展、实施和评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c16/5777387/2cbe2d36fc32/IJMA-6-121-g001.jpg

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