Zhu Lin, Lu Hui, Li Wenting, Chang Jingru, Ma Guoliang
Nanjing Municipal Center for Disease Control & Prevention, No.3, Zizhulin Road, Gulou District, Nanjing, Jiangsu, 210013, China.
School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.
BMC Public Health. 2025 Apr 17;25(1):1442. doi: 10.1186/s12889-025-22567-w.
Strengthening health systems and ensuring equity and access to human resources can significantly reduce maternal and child mortality and improve maternal and child health outcomes. This mixed-methods study aimed at the quantity, quality, and equity of the allocation of human resources for health (HRH) in Chinese maternal and child healthcare institutions from 2002 to 2021 while providing a reference for optimally allocating HRH in the new era.
Relying on health-related data obtained from statistical yearbooks in 2003-2022, the study analysed the allocation status using descriptive statistics, examined the allocation equity with the Gini coefficient and the Health resource agglomeration degree/Health resource population agglomeration degree (HRAD/HRPAD). Finally, the study predicted the future allocation trend by compiling a grey prediction model GM (1,1).
HRH quantity in Chinese maternal and child healthcare institutions experienced steady growth. However, the composition of educational background and professional titles was unreasonable. The quality structure needs to be further optimized. The equity of demographic allocation (Gini < 0.2) was superior to the geographic allocation (Gini = 0.631-0.678), with significant regional differences. The HRAD values of HRH in different regions were as follows: eastern region (3.50-3.70) > central region (1.69-1.92) > western region (0.36-0.44); HRPAD (2021): western region (1.150) > central region (0.991) > eastern region (0.912). The equity of sparsely populated regions was superior to that of densely populated regions. The HRH future allocation trend is positive.
Emphasis should be placed on the status quo of unreasonable allocation and unbalanced distribution. Careful consideration must be given to factors like service population, service radius, economic development, and population mobility while considering demographic and geographic equity to promote the reasonable allocation and full utilisation of HRH.
加强卫生系统建设并确保公平性以及人力资源可及性，能够显著降低孕产妇和儿童死亡率，并改善孕产妇和儿童健康状况。这项混合方法研究旨在探讨2002年至2021年中国妇幼保健机构卫生人力资源（HRH）分配的数量、质量和公平性，同时为新时代优化卫生人力资源分配提供参考。
该研究依托2003年至2022年统计年鉴中的卫生相关数据，运用描述性统计分析分配现状，采用基尼系数以及卫生资源集聚度/卫生资源人口集聚度（HRAD/HRPAD）检验分配公平性。最后，通过编制灰色预测模型GM（1,1）预测未来分配趋势。
中国妇幼保健机构的卫生人力资源数量稳步增长。然而，学历和职称构成不合理，质量结构有待进一步优化。人口分配公平性（基尼系数<0.2）优于地理分配公平性（基尼系数=0.631 - 0.678），存在显著的区域差异。不同地区卫生人力资源的HRAD值如下：东部地区（3.50 - 3.70）>中部地区（1.69 - 1.92）>西部地区（0.36 - 0.44）；HRPAD（2021年）：西部地区（1.150）>中部地区（0.991）>东部地区（0.9I2）。人口稀少地区的公平性优于人口密集地区。卫生人力资源未来分配趋势呈正向。
应重视分配不合理和分布不均衡的现状。在考虑人口和地理公平性时，必须仔细考量服务人口、服务半径、经济发展和人口流动等因素，以促进卫生人力资源的合理分配和充分利用。
