Human resources for health governance and leadership strategies for improving health outcomes in low- and middle-income countries: a narrative review.

Autor:	Effa E; 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., Arikpo D; Cochrane Nigeria, Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria., Oringanje C; Cochrane Nigeria, Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria., Udo E; Cochrane Nigeria, Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria., Esu E; Cochrane Nigeria, Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria.; Department of Public Health, College of Medical Sciences, University of Calabar, Calabar, Nigeria., Sam O; Inter-Country Support Team, World Health Organization, Ouagadougou, Burkina Faso., Okoroafor S; Health Systems Strengthening Cluster, World Health Organization Country Office, Abuja, Nigeria., Oyo-Ita A; Department of Community Medicine, University of Calabar, Calabar, Nigeria., Meremikwu M; Department of Paediatrics, University of Calabar, Calabar, Nigeria.
Jazyk:	angličtina
Zdroj:	Journal of public health (Oxford, England) [J Public Health (Oxf)] 2021 Apr 13; Vol. 43 (Suppl 1), pp. i67-i85.
DOI:	10.1093/pubmed/fdaa264
Abstrakt:	Background: 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. Methods: 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. Results: 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. Conclusions: 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. (© The Author(s) 2021. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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