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用 20/20 的眼光做好大流行病防范工作:将交叉公平视角应用于卫生人力规划。

Pandemic preparedness with 20/20 vision: Applying an intersectional equity lens to health workforce planning.

机构信息

School of Health and Social Care, University of Essex, Colchester, UK.

出版信息

Int J Health Plann Manage. 2023 Sep;38(5):1117-1126. doi: 10.1002/hpm.3677. Epub 2023 Jul 8.

Abstract

Human resource for health (HRH) is considered critical for achieving Universal Health Coverage, and the crisis surrounding HRH is now established as a global emergency. Their vital role has been central in the pandemic response. Yet, the discussions and deliberations on the recent pandemic treaty circumscribe HRH discussions to their capacities and protection, and address discrimination mainly in relation to gender. While this paper endorses the case for prioritisation of HRH in global pandemic preparedness planning, it re-frames the HRH crisis in relation to the institutional and structural factors driving HRH shortage, maldistribution and skills-needs misalignment. We critique the supply-and-demand framing of HRH crisis as one that obliviates the systematic inequalities within health systems that underpin health workforce motivations, distribution, satisfaction and performance. We propose an intersectional equity lens to redefine the HRH challenges, understand their underlying drivers and accordingly integrate in the global pandemic preparedness plans.

摘要

卫生人力资源(HRH)被认为对于实现全民健康覆盖至关重要,而围绕 HRH 的危机现已被确立为全球紧急情况。他们的重要作用在大流行应对中处于核心地位。然而,最近有关大流行条约的讨论和审议将 HRH 讨论限制在其能力和保护范围内,并主要解决与性别有关的歧视问题。虽然本文支持在全球大流行防范规划中优先考虑 HRH,但它重新构建了与导致 HRH 短缺、分配不均和技能需求错位的体制和结构因素有关的 HRH 危机。我们批评将 HRH 危机视为供求关系的框架,这种框架忽略了卫生系统内的系统性不平等,而这些不平等是支撑卫生人力的动机、分配、满意度和绩效的基础。我们提议采用交叉平等视角来重新定义 HRH 挑战,了解其根本驱动因素,并据此纳入全球大流行防范计划。

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