Office of Global Health, University of Maryland School of Nursing, Baltimore, MD, USA.
University of Washington Department of Global Health, Seattle, WA, USA.
Glob Health Sci Pract. 2021 Mar 31;9(1):160-176. doi: 10.9745/GHSP-D-20-00362.
A critical shortage of health workers with needed maternal and newborn competencies remains a major challenge for the provision of quality care for mothers and newborns, particularly in low- and middle-income countries. Supply-side challenges related to human resources for health (HRH) worsen shortages and can negatively affect health worker performance and quality of care. This review scoped country-focused sources to identify and map evidence on HRH-related challenges to quality facility-based newborn care provision by nurses and midwives.
Evidence for this review was collected iteratively, beginning with pertinent World Health Organization documents and extending to articles identified via database and manual reference searches and country reports. Evidence from country-focused sources from 2000 onward was extracted using a data extraction tool that was designed iteratively; thematic analysis was used to map the 10 categories of HRH challenges.
A total of 332 peer-reviewed articles were screened, of which 22 met inclusion criteria. Fourteen additional sources were added from manual reference search and gray literature sources. Evidence has been mapped into 10 categories of HRH-related challenges: (1) lack of health worker data and monitoring; (2) poor health worker preservice education; (3) lack of HW access to evidence-based practice guidelines, continuing education, and continuing professional development; (4) insufficient and inequitable distribution of health workers and heavy workload; (5) poor retention, absenteeism, and rotation of experienced staff; (6) poor work environment, including low salary; (7) limited and poor supervision; (8) low morale, motivation, and attitude, and job dissatisfaction; (9) weaknesses of policy, regulations, management, leadership, governance, and funding; and (10) structural and contextual barriers.
The mapping provides needed insight that informed new World Health Organization strategies and supporting efforts to address the challenges identified and strengthen human resources for neonatal care, with the ultimate goal of improving newborn care and outcomes.
在提供优质母婴保健服务方面，拥有必要的孕产妇和新生儿护理能力的卫生工作者严重短缺，这仍是一个重大挑战，尤其是在中低收入国家。与卫生人力资源相关的供应方挑战加剧了卫生工作者的短缺，并可能对卫生工作者的绩效和护理质量产生负面影响。本研究通过对以国家为重点的资源进行分析，旨在确定并绘制与护士和助产士提供优质机构内新生儿护理相关的人力资源挑战的证据。
本研究通过迭代方式收集证据，从世界卫生组织的相关文件开始，扩展到通过数据库和手动参考文献搜索以及国家报告确定的文章。从 2000 年以来以国家为重点的资源中提取证据，使用的是一个迭代设计的数据提取工具；采用主题分析方法对 10 个人力资源挑战类别进行了映射。
共筛选了 332 篇同行评议文章，其中 22 篇符合纳入标准。从手动参考文献搜索和灰色文献来源中增加了另外 14 个来源。证据已映射到 10 个人力资源相关挑战类别中：（1）缺乏卫生工作者数据和监测；（2）卫生工作者职前教育质量差；（3）卫生工作者获取循证实践指南、继续教育和持续专业发展的机会有限；（4）卫生工作者分布不均且数量不足，工作量过大；（5）经验丰富的员工保留率低、缺勤率高且轮调频繁；（6）工作环境差，包括工资低；（7）监督有限且质量差；（8）士气低落、动力不足、态度不佳和工作满意度低；（9）政策、法规、管理、领导、治理和供资薄弱；（10）结构性和背景性障碍。
这种映射提供了必要的见解，为新的世界卫生组织战略提供了信息，并为解决所确定的挑战和加强新生儿保健人力资源提供了支持，最终目标是改善新生儿护理和结果。
