Cochrane Nigeria, Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria.
Department of Internal Medicine, University of Calabar, Calabar, Nigeria.
J Public Health (Oxf). 2021 Apr 13;43(Suppl 1):i67-i85. doi: 10.1093/pubmed/fdaa264.
Many low- and middle-income countries (LMICs) are facing a crisis of human resources for health (HRH) attributed to poor governance and leadership that characterizes the health sector in this setting. It is unclear which specific strategies are effective in ameliorating the crisis.
Selected electronic databases were searched up until 30 May 2020. Two authors screened studies independently and extracted data from included studies. Quality assessment was done using the Mixed Methods Appraisal Tool. Thematic analysis of the outcomes was done.
We included 18 studies of variable designs across Africa, Asia, South America and the Pacific islands. Most were case-based studies and were of moderate to high quality. Several governance strategies with a positive impact on the health workforce and health outcomes identified included decentralization, central coordination and facilitation process, posting and transfer policies as well as the setting up of human resource units.
Governance and leadership strategies targeting the HRH crises in LMIC are variable, interdependent and complex. While some show benefits in improving health workforce outcomes, only a few have an impact on population health outcomes.
许多中低收入国家（LMICs）正面临着卫生人力资源（HRH）危机，这归因于该环境中卫生部门的治理和领导力不佳。目前尚不清楚哪些具体策略可以有效缓解危机。
截至 2020 年 5 月 30 日，我们检索了选定的电子数据库。两位作者独立筛选研究并从纳入的研究中提取数据。使用混合方法评估工具进行质量评估。对结果进行主题分析。
我们纳入了来自非洲、亚洲、南美洲和太平洋岛屿的 18 项不同设计的研究。大多数是基于案例的研究，质量为中等到高度。确定了一些对卫生人力和卫生结果有积极影响的治理策略，包括权力下放、中央协调和促进进程、职位和调任政策以及人力资源单位的设立。
针对中低收入国家卫生人力资源危机的治理和领导策略是多样的、相互依存的和复杂的。虽然一些策略在改善卫生人力成果方面显示出益处，但只有少数策略对人口健康结果有影响。
