Pilot-testing service-based planning for health care in rural Zambia
| Autor: | Gail Tomblin Murphy, Selestine Nzala, Fastone Goma, Adrian MacKenzie, Janet Rigby, Clara Mbwili-Muleya, Miriam Libetwa, Amy Gough |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty compétences planification planification fondée sur les services human resources for health Population Zambia Pilot Projects Population health Health informatics Health administration ressources humaines en santé 03 medical and health sciences 0302 clinical medicine Nursing Surveys and Questionnaires Environmental health Health care Humans Medicine 030212 general & internal medicine education competencies Health Services Needs and Demand education.field_of_study business.industry Research 030503 health policy & services Health Policy Public health 1. No poverty Health services research politiques Focus Groups 3. Good health Health Planning service-based planning Zambie Community health Female Health Services Research Rural Health Services planning 0305 other medical science business policy |
| Zdroj: | BMC Health Services Research |
| ISSN: | 1472-6963 |
| DOI: | 10.1186/1472-6963-14-s1-s7 |
| Popis: | Background Human resources for health (HRH) planning in Zambia, as in other countries, is often done by comparing current HRH numbers with established posts, without considering whether population health needs are being met. Service-based HRH planning compares the number and type of services required by populations, given their needs, with the capacity of existing HRH to perform those services. The objective of the study was to demonstrate the effectiveness of service-based HRH planning through its adaptation in two rural Zambian districts, Gwembe and Chibombo. Methods The health conditions causing the greatest mortality and morbidity in each district were identified using administrative data and consultations with community health committees and health workers. The number and type of health care services required to address these conditions were estimated based on their population sizes, incidence and prevalence of each condition, and desired levels of service. The capacity of each district’s health workers to provide these services was estimated using a survey of health workers (n=44) that assessed the availability of their specific competencies. Results The primary health conditions identified in the two districts were HIV/AIDS in Gwembe and malaria in Chibombo. Although the competencies of the existing health workforces in these two mostly aligned with these conditions, some substantial gaps were found between the services the workforce can provide and the services their populations need. The largest gaps identified in both districts were: performing laboratory testing and interpreting results, performing diagnostic imaging and interpreting results, taking and interpreting a patient’s medical history, performing a physical examination, identifying and diagnosing the illness in question, and assessing eligibility for antiretroviral treatment. Conclusions Although active, productive, and competent, health workers in these districts are too few to meet the leading health care needs of their populations. Given the specific competencies most lacking, on-site training of existing health workers to develop these competencies may be the best approach to addressing the identified gaps. Continued use of the service-based approach in Zambia will enhance the country’s ability to align the training, management, and deployment of its health workforce to meet the needs of its people. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink