Liverpool School of Tropical Medicine (LSTM), Liverpool, UK.
European Observatory on Health Systems and Policies, Brussels, Belgium.
Int J Health Plann Manage. 2024 May;39(3):757-780. doi: 10.1002/hpm.3773. Epub 2024 Feb 6.
Inadequate numbers, maldistribution, attrition, and inadequate skill-mix are widespread health and care workforce (HCWF) challenges. Intersectoral-inclusive of different government sectors, non-state actors, and the private sector-collaboration and action are foundational to the development of a responsive and sustainable HCWF. This review presents evidence on how to work across sectors to educate, recruit, and retain a sustainable HCWF, highlighting examples of the benefits and challenges of intersectoral collaboration. We carried out a scoping review of scientific and grey literature with inclusion criteria around intersectoral governance and mechanisms for the HCWF. A framework analysis to identify and collate factors linked to the education, recruitment, and retention of the HCWF was carried out. Fifty-six documents were included. We identified a wide array of recommendations for intersectoral activity to support the education, recruitment, and retention of the HCWF. For HCWF education: formalise intersectoral decision-making bodies; align HCWF education with population health needs; expand training capacity; engage and regulate private sector training; seek international training opportunities and support; and innovate in training by leveraging digital technologies. For HCWF recruitment: ensure there is intersectoral clarity and cooperation; ensure bilateral agreements are ethical; carry out data-informed recruitment; and learn from COVID-19 about mobilising the domestic workforce. For HCWF retention: innovate around available staff, especially where staff are scarce; improve working and employment conditions; and engage the private sector. Political will and commensurate investment must underscore any intersectoral collaboration for the HCWF.
卫生和医疗保健工作者队伍(HCWF)数量不足、分布不均、人员流失以及技能组合不恰当,这些都是普遍存在的问题。跨部门合作——包括不同政府部门、非国家行为体和私营部门——对于 HCWF 的发展具有基础性作用,有助于 HCWF 的响应能力和可持续性。本综述介绍了如何跨部门协作来教育、招聘和留住可持续的 HCWF 的证据,强调了跨部门合作的好处和挑战。我们对围绕 HCWF 跨部门治理和机制的科学和灰色文献进行了范围界定审查。采用框架分析方法,以确定和整理与 HCWF 的教育、招聘和留用相关的因素。共纳入了 56 份文件。我们为支持 HCWF 的教育、招聘和留用确定了一系列跨部门活动的建议。对于 HCWF 教育:使跨部门决策机构正式化;使 HCWF 教育与人口健康需求保持一致;扩大培训能力;参与并规范私营部门培训;寻求国际培训机会和支持;利用数字技术创新培训。对于 HCWF 招聘:确保跨部门有明确的分工和合作;确保双边协议符合道德规范;开展基于数据的招聘;并从 COVID-19 中吸取经验,动员国内劳动力。对于 HCWF 留用:在现有员工的基础上进行创新,特别是在人员短缺的情况下;改善工作和就业条件;并吸引私营部门参与。任何 HCWF 的跨部门合作都必须以政治意愿和相应的投资为后盾。