Centre for Health Professions Education, Faculty of Health Sciences, North-West University, Potchefstroom Campus, Building PC-G16, Office 101,11 Hoffman St., Potchefstroom 2520, South Africa.
Intercountry Support Team for Eastern and Southern Africa, Health Workforce Unit, Regional Office for Africa, World Health Organisation, 82-86 Cnr Enterprise/Glenara Roads, Harare CY 348, Zimbabwe.
Int J Environ Res Public Health. 2021 Feb 22;18(4):2113. doi: 10.3390/ijerph18042113.
Although the conceptual underpinnings of needs-based health workforce planning have developed over the last two decades, lingering gaps in empirical models and lack of open access tools have partly constrained its uptake in health workforce planning processes in countries. This paper presents an advanced empirical framework for the need-based approach to health workforce planning with an open-access simulation tool in Microsoft Excel to facilitate real-life health workforce planning in countries. Two fundamental mathematical models are used to quantify the supply of, and need for, health professionals, respectively. The supply-side model is based on a stock-and-flow process, and the need-side model extents a previously published analytical frameworks using the population health needs-based approach. We integrate the supply and need analyses by comparing them to establish the gaps in both absolute and relative terms, and then explore their cost implications for health workforce policy and strategy. To illustrate its use, the model was used to simulate a real-life example using midwives and obstetricians/gynaecologists in the context of maternal and new-born care in Ghana. Sensitivity analysis showed that if a constant level of health was assumed (as in previous works), the need for health professionals could have been underestimated in the long-term. Towards universal health coverage, the findings reveal a need to adopt the need-based approach for HWF planning and to adjust HWF supply in line with population health needs.
尽管基于需求的卫生人力规划的概念在过去二十年中已经发展起来，但实证模型中仍然存在差距，并且缺乏开放获取工具，这在一定程度上限制了其在各国卫生人力规划过程中的应用。本文提出了一个基于需求的卫生人力规划的高级实证框架，并提供了一个在 Microsoft Excel 中使用的开放获取模拟工具，以促进各国的实际卫生人力规划。两个基本的数学模型分别用于量化卫生专业人员的供应和需求。供应方模型基于存量和流量过程，需求方模型扩展了以前使用基于人口健康需求的分析框架的方法。我们通过比较供应和需求分析来整合它们，以确定绝对和相对差距，并探讨它们对卫生人力政策和战略的成本影响。为了说明其用途，我们使用该模型模拟了加纳母婴保健背景下的助产士和妇产科医生的实际案例。敏感性分析表明，如果假设健康水平保持不变（如以前的工作中那样），则从长期来看，对卫生专业人员的需求可能被低估了。为了实现全民健康覆盖，研究结果表明需要采用基于需求的方法进行卫生人力规划，并根据人口健康需求调整卫生人力供应。
