Ethics of Human Resources Management in the Cameroonian Health System, Medical Nomadism and the Ineffectiveness of the Fight against High Blood Pressure

Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%.

Human resources allocation for aircraft maintenance with predefined sequence

There are always large-scale items in the maintenances schedule of aircraft system, many of which have been fixed to be done in predefined sequences, which leads the workflow to be sys-tematically complex and makes this kind of problem quite different from all sorts of existing job-selection modes. On the other hand, the human resources are always limited and men have different working capabilities on different items, which make the allocation operation of human resources be much roomy. However, the final total time span of maintenance is often required to be as short as possible in many practices, in order to suffer only the lowest cost of loss while the system is stopping. A new model for op-timizing the allocation if aircraft maintenance human resources with the constraint of predefined sequence is presented. The ge-netic algorithm is employed to find the optimal solution that holds the shortest total time span of maintenance. To generate the ul-timate maintenance work items and the human resource array, the sequences among all maintenance work items are considered firstly, the work item array is then generated through traversal with the constraint of maintenance sequence matrix, and the human resources are finally allocated according to the work item array with the constraint of the maintenance capability. An example is demonstrated to show that the model and algorithm behave a satisfying performance on finding the optimal solution as expected.

A Method for Assessing the Fairness of Health Resource Allocation Based on Geographical Grid

The assessment of the fairness of health resource allocation is an important part of the study for the fairness of social development.The data used in most of the existing assessment methods comes from statistical yearbooks or field survey sampling.These statistics are generally based on administrative areas and are difficult to support a fine-grained evaluation model.In response to these problems,the evaluation method proposed in this paper is based on the query statistics of the geographic grid of the target area,which are more accurate and efficient.Based on the query statistics of hot words in the geographic grids,this paper adopts the maximum likelihood estimation method to estimate the population in the grid region.Then,according to the statistical yearbook data of Hunan province,the estimated number and actual number of hospitals in each grid are analyzed and compared to measure the fairness of health resource allocation in the target region.Experiments show that the geographical grid population assessment based on hot words is more accurate and close to the actual value.The estimated average error is only about 17.8 percent.This method can assess the fairness of health resource allocation in any scale,and is innovative in data acquisition and evaluation methods.

Design and implementation of a survey of senior Canadian healthcare decision-makers: Organization-wide resource allocation processes

A three-year research project based in British Columbia, Canada, is attempting to develop a framework and tools to assist healthcare system decision-makers achieve “high performance” in resource allocation. In pursuit of this objective, a literature search was conducted and two phases of primary data collection are being undertaken: an online survey of senior healthcare decision-makers, and in-depth case studies of potential “high performing” organizations. This paper addresses the survey phase;our aim is to provide a practical example of the mechanics of survey design, of benefit to those who want to better understand our forthcoming results, but also as an aid to other researchers grappling with the hard choices and trade-offs involved in the survey development process. Survey content is described in light of the existing literature, with discussion of the choices made by the research team to decide what questions and items would be included and excluded. The target population for the survey was senior managers in Canadian regional health authorities (or the closest equivalent organizations) in each of the 10 provinces and 3 territories. The paper dis- cusses how this sample was obtained, and describes the survey implementation process.

Present situation and the countermeasures of health human resources in Guangxi general hospitals at the county - level

[目的] 了解广西县级综合医院卫生人力资源状况,为进一步推进县级医院改革提供建设性意见. [方法]通过问卷调查法、数理统计法等综合分析广西县级综合医院卫生人力资源现状.[结果]广西县级综合 医院在岗人员在编率为41.56%,医护比为1： 1.68, 67.12%的卫生技术人员职称为初级及以下,超七成拥有 大专及以上学历.[结论]广西县级综合医院卫生技术人员在编率较低,医护比、职称及学历结构不合理,整 体年龄偏低,需通过综合措施加以改善.

Smart Dynamic Resource Allocation Model for Patient-Driven Mobile Medical Information System Using C4.5 Algorithm

A mobile medical information system (MMIS) is an integrated application (app) of traditional hospital information systems (HIS) which comprise a picture archiving and communications system (PACS), laboratory information system (LIS), pharmaceutical management information system (PMIS), radiology information system (RIS), and nursing information system (NIS). A dynamic resource allocation table is critical for optimizing the performance to the mobile system, including the doctors, nurses, or other relevant health workers. We have designed a smart dynamic resource allocation model by using the C4.5 algorithm and cumulative distribution for optimizing the weight of resource allocated for the five major attributes in a cooperation communications system. Weka is used in this study. The class of concept is the performance of the app, optimal or suboptimal. Three generations of optimization of the weight in accordance with the optimizing rate are shown.

The Place of Human Resource Management in Lagos State Healthcare Delivery: A Statistical Overview

Background: Behind every great system is an organized team;this is especially true in the healthcare industry, where a dedicated human resources team can effectively recruit employees, train staff, and implement safety measures in the workplace. The importance of human resources in the healthcare industry cannot be overstated, with benefits ranging from providing an orderly and effectively run facility to equipping staff with the most accurate and up-to-date training. Proper human resources management is critical in providing high-quality health care. A refocus on human resources management in healthcare requires more research to develop new policies. Effective human resources management strategies are greatly needed to achieve better outcomes and access to health care worldwide. Methods: This study leveraged NOI Polls census data on Health Facility Assessment for Lagos State. One thousand two hundred fifty-six health care facilities were assessed in Lagos State;numbers of Health workers were documented alongside their area of specialization. Also, demographic characterizations of the facilities, such as LGA, Ownership type, Facility Level Care, and Category of the facility, were also documented. Descriptive statistics alongside cross tabulation was done to present the various area of specialization of the health workers. Multiple response analysis was done to understand the distribution of human resources across the health facilities. At the same time, Chi-square and correlation tests were conducted to test the independence of various categories recorded while understanding the relationships among selected specialties. Results: The study revealed that Nurses were the most common health specialist in the Lagos State health facilities. At the same time, Gynecologists and General surgeons are the two medical specialists mostly common in health facilities. Midwives are the second most common health specialist working full time, while Generalist medical doctors make up the top three health specialists working full time. Nurses and Midwives had the highest number in Lagos State, while Pulmonologists were currently the lowest human resource available in Lagos State health care system. It was also noted that health facility distribution across Lagos’s urban and rural areas was even. In contrast, distribution based on other factors such as ownership type, Facility level of care, and facility category was slightly skewed. Conclusion: The distribution of health workers in health facility across LGA in Lagos State depend on Ownership type, Facility level of care, and category of the facility.

Healthcare Worker-Related Factors Contributing to Tuberculosis Treatment Non-Adherence among Patients in Kisumu East Sub-County

Background: Treatment non-adherence poses significant risks to health outcomes and impedes the health system’s efficiency, hence curtailing progress towards the end Tuberculosis (TB) strategy under SDG 3.3. Despite interventions to address TB treatment non-adherence, Kenya still reports high TB treatment non-adherence rates of 35% and consequently poor treatment outcome rates. Health Care Workers (HCWs) play a critical role in linking the population to health services, yet little is known of their influence on patients’ TB treatment non-adherence in Kenya. Objective: To analyze HCW-related factors associated with TB treatment non-adherence among patients in Kisumu East Sub-County. Methods: Health facility-based analytical cross-sectional mixed-method study. A Semi-structured questionnaire on treatment adherence and patients’ perceptions of HCWs during the clinic visit was administered to 102 consenting adult (out of a total census of 107 adults) drug-susceptible TB patients. 12 purposively selected HCWs by rank from 6 health facilities participated in Key Informant Interview sessions. Medication adherence was measured using the Morisky Medication Adherence Scale and then expressed as a dichotomous variable. Quantitative analysis utilized STATA version 15.1 while qualitative deductive thematic analysis was done using NVIVO version 14. Results: TB treatment non-adherence rate of 26% (CI: 18% - 36%) was recorded. Overall, patients who felt supported in dealing with the illness were 8 times more likely to adhere to treatment compared to those who were not (aOR = 7.947, 95% CI: 2.214 - 28.527, p = 0.001). Key HCW related factors influencing adherence to treatment included: friendliness (cOR = 4.31, 95% CI: 1.514 - 12.284, p = 0.006), respect (cOR = 6.679, 95% CI: 2.239 - 19.923, p = 0.001) and non-discriminatory service (cOR = 0.1478, 95% CI: 0.047 - 0.464, p = 0.001), communication [adequacy of consultation time (cOR = 6.563, 95% CI: 2.467 - 17.458, p = 0.001) and patients’ involvement in their health decisions (cOR = 3.02 95% CI: 1.061 - 8.592, p = 0.038)] and education and counselling (cOR = 4.371, 95% CI: 1.725 - 11.075, p = 0.002). Conclusion: The study results underline importance of patient-centered consultation for TB patients and targeted education and counselling for improved treatment adherence.

Efficiency of resource allocation in the hospital sector after global budgeting under National Health Insurance

Background Taiwan has implemented a National Health Insurance （NHI） program to provide uniform comprehensive coverage since 1995. Forced by the severe financial deficit, global budgeting is introduced to replace the original payment system in Taiwan＇s NHI. Under global budgeting system, the total budget is distributed to six geographical regions in Taiwan. There is no pre-determined budget for each hospital. In order to investigate the longitudinal trend of how global budgeting influences health care resource, it is essential to estimate the efficiency of resource allocation in Taiwan＇s NHI. Methods Data Envelopment Analysis （DEA） and Malmquist index （MI） are used to investigate the 8-year panel data of 23 cities and counties which was collected from the annual report from the Department of Health, Taiwan, China. A value of MI greater than 1 indicates that total factor productivity progress has occurred, while a value of MI less than 1 indicates productivity loss. Results As a result, 37 of the 184 DMUs in the analysis were found to be relatively efficient during the period, in which 14 of 23 DMUs are efficient in 2002 right after adopting globe budgeting. A trend of MI declines between 2002 and 2009 implies the volume of health care services decrease after adopting global budgeting system. Production efficiency has been improved after global budgeting implies that behaviors of health providers control cost and avoid wasting resource at macro level. Conclusions The regressive MI indicates the hospitals redistribute health care resource to eliminate unnecessary treatment and to control the growth of service volume under global budgeting system. Hence, a trend of declining MI focuses on health care resource redistribution rather than efficiency improvement in this study.

Human resource allocation for multiple scientific research projects via improved pigeon-inspired optimization algorithm

Aiming at the complex and restrictive characteristics of human resource allocation in multiple scientific university research projects, an improved pigeon-inspired optimization(IPIO) algorithm is proposed wherein loss minimization and the shortest project delay time are considered as optimization goals. Firstly, mathematical modelling of the problem is carried out, and the multi-objective optimization problem is transformed into a single-objective optimization problem by means of a weighted solution. In the second step, the traditional pigeon-inspired optimization(PIO) algorithm is discretized, and an adaptive parameter strategy is adopted to improve the shortcomings of the algorithm itself. Finally, by comparing the simulation results with the original algorithm and the genetic algorithm in the optimization of human resource allocation in multiple projects, the feasibility and superiority of the proposed algorithm in the optimization of human resource allocation in multi-scientific research projects is verified.

The impacts of organizational culture and neoliberal ideology on the continued existence of incivility and bullying in healthcare institutions:A discussion paper

Countless research studies have demonstrated the detrimental effects of incivility and bullying in healthcare.Despite the abundance of proposed solutions to this issue,many healthcare leaders continue to fail in mitigating the existence of such negative behaviors in the workplace.Personality attributes of perpetrators and victims have received attention,but much less research has examined the organizational and neoliberal causations of incivility and bullying in healthcare.Being the largest occupational group in the health sector,nursing professionals have the greatest influence and are crucial in ending these behaviors.This discussion paper outlines the effects of incivility and bullying in healthcare and provides a critical analysis on how organizational culture and neoliberal ideology influence the pervasiveness and persistence of these negative behaviors.The analysis reveals that organizational cultures that misuse power,disregard equality,and facilitate oppression,foster the existence of incivility and bullying in the workplace.Such cultures permit perpetrators to misuse their authority to control resource allocation,ignorance to social inequalities,and the silence of victims.Furthermore,the neoliberal concept of deregulation,austerity,and individualism further these behaviors.The neoliberal reforms have led to underfunding of anti-bullying programs and policies,use of bullying behaviours as management strategies,and victim-blaming for profit maximization.Financial cutbacks have resulted in denial and acceptance of uncivil and bullying behaviours in healthcare institutions,which endangers the rights of healthcare providers to a safe workplace environment.To curtail these negative behaviors,robust anti-bullying policies and programs must be strictly enforced and sustained in practice.Further exploration on the association of organizational culture and neoliberal principles to incivility and bullying in healthcare is greatly warranted.

2012—2021年我国专业公共卫生机构人力资源配置状况及公平性分析

目的:分析我国专业公共卫生机构人才队伍建设情况,为加强我国公共卫生人才队伍建设提供参考。方法:基于《中国卫生健康统计年鉴》数据,采用描述性统计分析、基尼系数和卫生资源集聚度等方法,分析2012—2021年我国专业公共卫生机构人才数量、质量及不同地区人力资源配置公平性。结果:2012—2021年,全国专业公共卫生机构人员数年均增长率为4.10%,每千人口专业公共卫生机构人员数年均增长率为3.71%;2021年,我国专业公共卫生机构人力资源按人口配置的基尼系数为0.1002,按地理面积配置的基尼系数为0.6706,21个省份的卫生资源集聚度值大于1。结论:十年间我国专业公共卫生机构人力资源总量稳步增长,质量有较大提升,但与预期发展目标尚有差距,不同专业公共卫生机构人力资源发展不均衡,公共卫生人力资源配置中人口公平性优于地理公平性,且省际差异显著。

基于fsQCA组态视角的我国医疗资源配置效率提升路径分析

背景当前我国医疗资源配置区域失衡、公平性缺失问题仍然突出。党的“二十大”报告明确提出要“促进优质医疗资源扩容和区域均衡布局”。目的探究提升我国医疗资源配置效率的具体路径,为实现我国医疗资源合理且高效配置、促进基本公共服务均等化提供科学参考。方法于2022年9月—2023年2月开展研究,数据源于《2021中国统计年鉴》《2021中国卫生健康统计年鉴》。将医疗卫生机构数、卫生技术人员数、床位数作为投入指标,以诊疗人次和入院人数为产出指标,通过数据包络分析(DEA)方法对我国2020年31个省份医疗资源配置效率进行测度;以医疗资源配置效率为结果变量,以卫生技术人员占比、每千人口床位数、出院者平均住院日、人均国内生产总值(GDP)、居民可支配收入、财政收入分权和医疗卫生财政预算支出占比为条件变量,运用模糊集定性比较分析(fsQCA)方法从组态视角探究内外部要素对医疗资源配置效率的协同影响机制,剖析高或非高水平医疗资源配置效率的条件组态,明确医疗资源高效率和低效率配置的多重路径。结果2020年我国31个省份医疗资源配置效率整体水平较高,均值为0.852,但省际存在较大差异。组态分析结果可知,医疗资源配置效率的提升是多因素共同作用的结果,共存在3种医疗资源高效率配置的路径。路径1:政府主导型驱动路径,以广西壮族自治区为典型案例。路径2:内外协调型驱动路径,以云南省和甘肃省为代表案例。路径3:均衡型驱动路径,代表案例主要有广东省、福建省和湖北省。非高医疗资源配置效率的路径也存在3条。路径1:政府制约型路径。路径2:经济-政府双重制约型路径,代表案例有黑龙江省和吉林省。路径3:内外制约型路径,典型案例有山西省和西藏自治区。结论内外部各要素及要素间的协同在良性互动过程中共同影响着医疗资源配置效率水平,需优化内外部环境,并对关键资源要素进行有效整合,以形成合力,促进区域医疗资源合理配置。

我国康复医院卫生资源配置现状和利用效率分析

目的:分析我国康复医院卫生资源配置现状和利用效率,探讨存在问题并提出相应对策。方法:应用描述性统计方法分析康复医院卫生资源配置和服务利用情况,应用数据包络分析法评估2011~2021年康复医院投入产出效率,采取TOPSIS法综合评估2011~2021年床位利用效率。结果:2021年康复医院数为810家,2011~2021年平均增长率为10.41%,非公立康复医院占77.53%;2021年平均每家康复医院病床数为124张,病床使用率为66.0%;2011~2021年康复医院卫生人员总量不断增长,2021年床卫技比、床医比和床护比分别为1∶0.70、1∶0.19和1∶0.31;2011~2021年诊疗人次和住院人数年平均增长率分别为9.46%和15.17%。DEA评估结果显示,2019~2021年康复医院投入产出相对有效性为非DEA有效或弱有效。TOPSIS评估结果显示,2019~2021年康复医院病床利用效率显著下降。结论:合理规划康复医疗机构,进一步增加二级及以上康复医院数量。加强康复医学人才培养,缓解人员配置不足局面。拓展康养结合服务内容,提升康复医院卫生资源利用效率。

江苏省卫生资源配置与新型城镇化水平耦合协调及关联性分析

[目的]基于卫生资源配置现状,探究江苏省卫生资源配置与新型城镇化发展进程中的耦合协调及相互作用关系。[方法]构建江苏省卫生资源配置及新型城镇化水平评价指标体系,利用耦合协调度模型及灰色关联分析,对两者间的耦合协调度和关联度进行探究。[结果]2012-2021年,江苏省卫生资源配置水平均值为0.506,新型城镇化水平均值为0.517,卫生资源配置低于城镇化水平。耦合协调度呈现增长趋势,由0.1增长至0.995,均值为0.681。卫生资源配置水平与新型城镇化中外商投资总额关联度最高,其次是医疗保险社会综合覆盖率、人均GDP和城镇居民人均可支配收入;新型城镇化水平与卫生总费用的关联度最高,其次是卫生技术人员和床位数。[结论]江苏省卫生资源配置与新型城镇化的耦合协调度呈现快速增长、波动增长和基本稳定增长的阶段性特征。新型城镇化水平与卫生总费用、卫生人员及床位数密切相关,而卫生资源配置的合理性离不开经济发展和社会保障程度。

人口老龄化趋势下卫生资源配置结构性失衡与社会福利损失

一国医疗资源的配置结构直接影响这些资源向医疗卫生服务转化的效率,我国卫生资源配置结构性失衡问题不仅影响着公众健康,同时也制约着公众社会福利。不仅如此,我国人口老龄化程度的加深导致医疗卫生服务需求井喷式增长,与卫生资源配置结构性失衡下的碎片式服务供给体系形成巨大反差,导致供求矛盾日益突出,将引发更大的经济社会代价。在此背景下,本文结合理论分析、数值模拟和实证检验,剖析卫生资源配置结构性失衡影响社会福利的内在机理以及人口老龄化对两者关系的调节作用。结果表明:存在最优化的卫生资源配置结构,在该结构下公众社会福利实现最大化;与这种最优化资源配置结构相比,卫生资源配置结构性失衡会引发社会福利损失。与此同时,人口老龄化加剧卫生资源配置结构性失衡带来的社会福利损失。异质性分析表明,建设信息基础设施和提高医疗卫生机构密度能够减少卫生资源配置结构性失衡带来的社会福利损失,但城乡收入差距的扩大会增加其福利损失。本文研究结论对于缓解卫生资源配置结构性失衡问题、推进健康中国建设具有重要的启示意义。

Advances in the Health Training Process Quality:Links between Education,Service and Community

This study proposes to discuss the experience lived by Pró-Saúde and PET-Saúde team of FACISA/ UFRN together with the Municipal Health Department of Santa Cruz/RN from a critical-reflexive perspective about the interaction between education, service and community as well as advances in approach and the strengthening between the school and Primary Health Care. This is an exploratory study with an experience report approach of the Pró-Saúde and PET-Saúde team from 2012 to 2014. The integration of these programs in experimental scenarios of the Unified Health System and the strengthening of the proposed training of human resources capable of the current healthcare system were observed. Thus, contributions in health in undergraduate courses and practices of health services are important, since the approach to the reality of the population and their social needs contribute to the vocational training quality.

基层医疗资源配置与经济高质量发展的耦合协调及其预测分析

背景精准识别制约基层医疗资源配置与经济高质量耦合协调发展的因素,对于有针对性地推动两系统耦合协调共进至关重要。然而,当前鲜有研究深入探讨阻碍两者耦合协调发展的关键因素。目的 对比分析“十二五”和“十三五”时期我国基层医疗资源配置与经济高质量发展的耦合协调水平,识别障碍因子,并预测“十四五”时期两系统的耦合协调趋势。方法 于2022年7月—2023年5月,从基层医疗资源配置系统选取卫生设施、卫生人员数、卫生经费3个维度,从经济高质量发展系统选取创新、协调、开放、共享、绿色5个维度,最终选取17项指标建立评价指标体系,指标数据源于2012—2021年的《中国统计年鉴》和相应卫生健康统计年鉴。借助熵值法与综合评价函数测算“十二五”与“十三五”时期基层医疗资源配置与经济高质量发展的综合评价值,通过构建耦合协调度模型测算其耦合协调水平,建立障碍函数诊断与识别影响耦合协调发展的障碍因子,引用灰色模型预测“十四五”期间两系统的耦合协调趋势。结果 “十二五”和“十三五”期间我国基层医疗资源配置与经济高质量发展耦合协调度由0.15上升到0.68,整体呈逐年上升的态势,虽增速较快但层次较低。卫生设施、卫生人员数、经济共享与绿色发展是制约“十二五”与“十三五”时期基层医疗资源配置与经济高质量发展二元复合系统耦合协调水平的主要障碍因子。借助修正GM(1,1)预测模型预测可知,“十四五”时期基层医疗系统与经济发展水平系统的耦合度在1.00左右微浮动,整体处于高耦合阶段,耦合协调度由0.73上升至1.12,总体呈上升态势,相对发展度>1.20,处于过度供给状态。结论为赋能基层医疗卫生体系的可持续发展,建议秉承绿色、共享的发展理念,从促进系统协调发展、完善基层医疗设施条件和打通基层医疗人才输送路径等方面着手,推动两系统和谐发展。

Applying the workload indicators of staffing needs method in determining frontline health workforce staffing for primary level facilities in Rivers state Nigeria

Background:Nigeria faces health workforce challenges and poor population health indices resulting from disparities in health worker densities by geographical locations and levels of health care delivery.Nigeria is constantly reforming its health system with the primary aim of having the right number of health workers in the right place at the right time to meet the population’s health needs.The majority of primary health facilities in the country are staffed using perceived needs.The Workload Indicators of Staffing Need(WISN)tool developed by the World Health Organization is used to determine staffing requirements for facilities.Methods:The WISN tool was used in assessing the staffing requirements for nurses/midwives and community health practitioners in 26 primary health facilities in Port Harcourt City Local Government Area(PHALGA)and Obio Akpor Local Government Area(OBALGA).Documents were reviewed to obtain information on working conditions and staffing,and interviews conducted with key informants in 12 randomly selected facilities.We supported an expert working group that comprised of nurses/midwives and community health practitioners to identify workload components and activity standards and validate both.We also retrieved workload data from January 1-December 31,2015 from the national district health information system.Results:Findings showed varying degrees of shortages and inequitable distribution of health workers.Health facilities in PHALGA had a WISN ratio of 0.63 and a shortage of 31 nurses/midwives.There was also a shortage of 12 community health practitioners with a WISN ratio of 0.85.OBALGA had a shortage of 50 nurses/midwives and 24 community health practitioners;and WISN ratios of 0.60 and 0.79 for nurses/midwives and community health practitioners respectively.Conclusion:Our findings provide evidence for policies that will help Nigeria improve the population’s access to quality health services and reduce inequities in distribution of the health workforce.Evidence-based health workforce planning and redistribution using WISN should be institutionalized.Review of scopes of practice of health workforce should be conducted periodically to ensure that the scope of practice matches the training received by the specific cadres and those skills are used to deliver quality services.

基于三维分析框架的我国护理人力资源配置政策研究

目的归纳总结我国护理人力资源配置政策,梳理其发展特点及影响因素,为完善我国护理人力资源配置政策提供新思路。方法采用内容分析法,基于政策工具-政策过程-发展历程构建三维分析框架,对国家层面印发的护理人力资源配置相关政策进行分析。结果共纳入25份政策文本,获取142条政策文本编码。最早的1份政策于1978年印发,2010年及以后共印发19份。从发文部门来看,国务院印发5份,国家卫生健康委员会印发15份,其中5份由2个及以上部门联合印发。在政策工具维度,供给型、需求型和环境型政策工具占比分别为22.54%、4.22%和73.24%。在政策发展维度,政策规划、政策实施、政策监督、政策评价分别占36.62%、50.00%、7.04%和6.34%。结论护理人力资源配置政策应加强需求型政策工具的使用,进一步协调政策工具的内部结构;加强政策过程中的监督和评价功能,加强各方协作,保障护理人力资源合理配置。