School of Public Health, University of the Western Cape, Private Bag x17, Bellville, Cape Town, 7535, South Africa.
Health Workforce, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland.
Hum Resour Health. 2018 Aug 14;16(1):35. doi: 10.1186/s12960-018-0302-z.
Health workers are central to people-centred health systems, resilient economies and sustainable development. Given the rising importance of the health workforce, changing human resource for health (HRH) policy and practice and recent health policy and systems research (HPSR) advances, it is critical to reassess and reinvigorate the science behind HRH as part of health systems strengthening and social development more broadly. Building on the recently published Health Policy and Systems Research Reader on Human Resources for Health (the Reader), this commentary reflects on the added value of HPSR underpinning HRH. HPSR does so by strengthening the multi-disciplinary base and rigour of HRH research by (1) valuing diverse research inferences and (2) deepening research enquiry and quality. It also anchors the relevance of HRH research for HRH policy and practice by (3) broadening conceptual boundaries and (4) strengthening policy engagement. Most importantly, HPSR enables us to transform HRH from being faceless numbers or units of health producers to the heart and soul of health systems and vital change agents in our communities and societies. Health workers' identities and motivation, daily routines and negotiations, and training and working environments are at the centre of successes and failures of health interventions, health system functioning and broader social development. Further, in an increasingly complex globalised economy, the expansion of the health sector as an arena for employment and the liberalisation of labour markets has contributed to the unprecedented movement of health workers, many or most of whom are women, not only between public and private health sectors, but also across borders. Yet, these political, human development and labour market realities are often set aside or elided altogether. Health workers' lives and livelihoods, their contributions and commitments, and their individual and collective agency are ignored. The science of HRH, offering new discoveries and deeper understanding of how universal health coverage and the Sustainable Development Goals are dependent on millions of health workers globally, has the potential to overcome this outdated and ineffective orthodoxy.
卫生工作者是以人为本的卫生系统、有弹性的经济和可持续发展的核心。鉴于卫生人力的重要性不断上升，人力资源开发政策和实践不断变化，以及最近在卫生政策和系统研究方面取得进展，必须重新评估和振兴人力资源开发背后的科学，将其作为更广泛的卫生系统加强和社会发展的一部分。本评论以最近出版的《卫生政策和系统研究读本：卫生人力资源》（读本）为基础，探讨了卫生政策和系统研究对人力资源开发的增值作用。卫生政策和系统研究通过以下方式增强了人力资源开发研究的多学科基础和严谨性：（1）重视各种研究推论；（2）深化研究探究和质量。它还通过以下方式为人力资源开发政策和实践确定了人力资源开发研究的相关性：（3）扩大概念边界；（4）加强政策参与。最重要的是，卫生政策和系统研究使我们能够将人力资源开发从无足轻重的数字或卫生生产单位转变为卫生系统的核心和灵魂，以及我们社区和社会中重要的变革推动者。卫生工作者的身份和动机、日常工作和谈判、培训和工作环境是卫生干预措施、卫生系统运作和更广泛社会发展成败的核心。此外，在日益复杂的全球化经济中，卫生部门作为就业领域的扩大以及劳动力市场的自由化，导致卫生工作者空前流动，其中许多或大多数是妇女，不仅在公共和私营卫生部门之间流动，而且还跨越国界。然而，这些政治、人类发展和劳动力市场现实往往被搁置或完全忽略。卫生工作者的生活和生计、他们的贡献和承诺，以及他们的个人和集体能动性都被忽视了。人力资源开发科学提供了新的发现和更深入的理解，即全民健康覆盖和可持续发展目标依赖于全球数以百万计的卫生工作者，它有可能克服这种过时和无效的传统观念。
