scholarly journals Feminisation of the health workforce and wage conditions of health professions: an exploratory analysis

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Geordan Shannon ◽  
Nicole Minckas ◽  
Des Tan ◽  
Hassan Haghparast-Bidgoli ◽  
Neha Batura ◽  
...  
Keyword(s):  
Global Health ◽  
Health Workforce ◽  
Gender Wage Gap ◽  
Wage Gap ◽  
Health Professions ◽  
Gender Analysis ◽  
Middle Income ◽  
Health Occupations ◽  
Middle Income Countries ◽  
Over Time

Abstract Background The feminisation of the global health workforce presents a unique challenge for human resource policy and health sector reform which requires an explicit gender focus. Relatively little is known about changes in the gender composition of the health workforce and its impact on drivers of global health workforce dynamics such as wage conditions. In this article, we use a gender analysis to explore if the feminisation of the global health workforce leads to a deterioration of wage conditions in health. Methods We performed an exploratory, time series analysis of gender disaggregated WageIndicator data. We explored global gender trends, wage gaps and wage conditions over time in selected health occupations. We analysed a sample of 25 countries over 9 years between 2006 and 2014, containing data from 970,894 individuals, with 79,633 participants working in health occupations (48,282 of which reported wage data). We reported by year, country income level and health occupation grouping. Results The health workforce is feminising, particularly in lower- and upper-middle-income countries. This was associated with a wage gap for women of 26 to 36% less than men, which increased over time. In lower- and upper-middle-income countries, an increasing proportion of women in the health workforce was associated with an increasing gender wage gap and decreasing wage conditions. The gender wage gap was pronounced in both clinical and allied health professions and over lower-middle-, upper-middle- and high-income countries, although the largest gender wage gaps were seen in allied healthcare occupations in lower-middle-income countries. Conclusion These results, if a true reflection of the global health workforce, have significant implications for health policy and planning and highlight tensions between current, purely economic, framing of health workforce dynamics and the need for more extensive gender analysis. They also highlight the value of a more nuanced approach to health workforce planning that is gender sensitive, specific to countries’ levels of development, and considers specific health occupations.

scholarly journals Opening up ‘fever’, closing down medicines

2019 ◽  
Vol 6 (4) ◽  
Author(s):  
Clare Chandler ◽  
Justin Dixon
Keyword(s):  
Antimicrobial Resistance ◽  
Global Health ◽  
Integrated Management ◽  
Childhood Illness ◽  
High Tech ◽  
Middle Income ◽  
Middle Income Countries ◽  
Opening Up ◽  
Over Time ◽  
Global Algorithm

Rising concerns about antimicrobial resistance have sparked a renewed push to rationalise and ration the use of medicines. This article explores the case of the Integrated Management of Childhood Illness (IMCI) guideline, a periodically updated ‘global’ algorithm that shapes and normalises the centrality of medicines to care in low- and middle-income countries and, increasingly, the imperative to ration them. Using ‘classification work’ as analytic frame, we firstly consider the IMCI algorithm as a blueprint for global health that classifies illnesses, patients, and care in particular ways relative to available medicines. Zooming in on this blueprint, we then offer a classificatory reading of ‘fever’ over time, tracing ‘nonmalarial fever’ from being malaria’s residual ‘other’ category to becoming increasingly legible through attention to diagnostics and antibiotic (over)use. Our reading suggests that an apparent refinement of the ‘fever’ category may concurrently entail the closing down of medicine options. This raises the possibility that an increasingly high-tech but ‘empty’ form of pharmaceuticalised care is being incidentally worked into the infrastructure of weak health systems.

scholarly journals How global is global health research? A large-scale analysis of trends in authorship

2021 ◽  
Vol 6 (1) ◽  
pp. e003758
Author(s):  
Michelle C Dimitris ◽  
Matthew Gittings ◽  
Nicholas B King
Keyword(s):  
Global Health ◽  
Low Income ◽  
Health Research ◽  
Large Scale ◽  
Health Science ◽  
Global Health Research ◽  
Middle Income ◽  
Middle Income Countries ◽  
Income Status ◽  
Over Time

Many have called for greater inclusion of researchers from low- and middle-income countries (LMICs) in the conduct of global health research, yet the extent to which this occurs is unclear. Prior studies are journal-, subject-, or region-specific, largely rely on manual review, and yield varying estimates not amenable to broad evaluation of the literature. We conducted a large-scale investigation of the contribution of LMIC-affiliated researchers to published global health research and examined whether this contribution differed over time. We searched titles, abstracts, and keywords for the names of countries ever classified as low-, lower middle-, or upper middle-income by the World Bank, and limited our search to items published from 2000 to 2017 in health science-related journals. Publication metadata were obtained from Elsevier/Scopus and analysed in statistical software. We calculated proportions of publications with any, first, and last authors affiliated with any LMIC as well as the same LMIC(s) identified in the title/abstract/keywords, and stratified analyses by year, country, and countries’ most common income status. We analysed 786 779 publications and found that 86.0% included at least one LMIC-affiliated author, while 77.2% and 71.2% had an LMIC-affiliated first or last author, respectively; however, analagous proportions were only 58.7%, 36.8%, and 29.1% among 100 687 publications about low-income countries. Proportions of publications with LMIC-affiliated authors increased over time, yet this observation was driven by high research activity and representation among upper middle-income countries. Between-country variation in representation was observed, even within income status categories. We invite comment regarding these findings, particularly from voices underrepresented in this field.

Gender wage gap in selected developing upper-middle income countries

2018 ◽  
Vol 17 (2) ◽  
pp. 142-156
Author(s):  
Maryam Almasifard
Keyword(s):  
International Trade ◽  
Labor Force ◽  
Gender Wage Gap ◽  
Wage Gap ◽  
Random Effect ◽  
Panel Regression ◽  
Middle Income ◽  
Productivity Level ◽  
Content Type ◽  
Middle Income Countries

Purpose The purpose of this paper is to examine the relationship between gender wage gap, productivity level of labor force and international trade for a sample of 13 developing upper-middle income countries over the period 2001 to 2015. Design/methodology/approach According to different statistical tests such as F-Limer test, the proper method for estimating this model is panel regression analysis. The Hausman test was handled to realize the fixed or random effect characteristics of this data. The final result of this test shows that the data follow some kind of random behavior which makes the panel regression model, random effect a suitable method for estimating this data. Findings The regression results showed that women’s (and men’s) employment in this sample has a positive relationship with their wages. Results showed that labor force’s productivity level affects their wage, and therefore, productivity difference between women and men is impressive on the gender wage gap. The significant finding is about international trade. While international trade has a positive effect on the wage rate of both genders, this effect is stronger for the female labor force. As a result of a stronger effect of international trade on the female labor force, a negative effect of international trade on the gender wage gap is observed. Research limitations/implications Productivity variables are not available for this sample countries, so the author creates a new variable which is going to be used as a proxy for productivity. The author divides value added in each section (Agriculture, Manufacture, Industry, Service) by the total number of employees in that section; then for calculating the productivity rate of women, the author multiplies the result by the percentage of the employed women in that sector; for the productivity of men in that sector, the author multiplies the result by the percentage of men employed in that sector. Originality/value This paper contributes to the available studies by selecting a new sample of developing countries with upper-middle income level and also by introducing a new variable which is useful for measuring labor force productivity level.

Doctor Retention in Ireland - What it may mean for the Global Health Workforce Reform Agenda Comment on "Doctor Retention: A Cross-sectional Study of How Ireland Has Been Losing the Battle"

2020 ◽  
Author(s):  
Bernard Hope Taderera
Keyword(s):  
Global Health ◽  
Health Workforce ◽  
Cross Sectional Study ◽  
Early Career ◽  
Healthcare Personnel ◽  
Health Coverage ◽  
Cross Sectional ◽  
Middle Income ◽  
Reform Agenda ◽  
Medical Graduates

The study of healthcare personnel migration in Ireland reports that most medical graduates plan to leave the country’s health system. It may be possible to address this challenge by understanding and addressing the reasons why young doctors plan to leave. Future studies should contribute to the retention of early career doctors in highincome countries such as Ireland. This will help reduce the migration of doctors from low- and middle-income countries in order to address the global health workforce crisis and its impact on the attainment of universal health coverage in all health systems.

scholarly journals Maternal mortality in six low and lower-middle income countries from 2010 to 2018: risk factors and trends

2020 ◽  
Vol 17 (S3) ◽  
Author(s):  
Melissa Bauserman ◽  
Vanessa R. Thorsten ◽  
Tracy L. Nolen ◽  
Jackie Patterson ◽  
Adrien Lokangaka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Maternal Mortality ◽  
Maternal Deaths ◽  
Middle Income ◽  
Maternal Risk ◽  
Live Births ◽  
Middle Income Countries ◽  
Risk Of Death ◽  
Increased Risk ◽  
Over Time

Abstract Background Maternal mortality is a public health problem that disproportionately affects low and lower-middle income countries (LMICs). Appropriate data sources are lacking to effectively track maternal mortality and monitor changes in this health indicator over time. Methods We analyzed data from women enrolled in the NICHD Global Network for Women’s and Children’s Health Research Maternal Newborn Health Registry (MNHR) from 2010 through 2018. Women delivering within research sites in the Democratic Republic of Congo, Guatemala, India (Nagpur and Belagavi), Kenya, Pakistan, and Zambia are included. We evaluated maternal and delivery characteristics using log-binomial models and multivariable models to obtain relative risk estimates for mortality. We used running averages to track maternal mortality ratio (MMR, maternal deaths per 100,000 live births) over time. Results We evaluated 571,321 pregnancies and 842 maternal deaths. We observed an MMR of 157 / 100,000 live births (95% CI 147, 167) across all sites, with a range of MMRs from 97 (76, 118) in the Guatemala site to 327 (293, 361) in the Pakistan site. When adjusted for maternal risk factors, risks of maternal mortality were higher with maternal age > 35 (RR 1.43 (1.06, 1.92)), no maternal education (RR 3.40 (2.08, 5.55)), lower education (RR 2.46 (1.54, 3.94)), nulliparity (RR 1.24 (1.01, 1.52)) and parity > 2 (RR 1.48 (1.15, 1.89)). Increased risk of maternal mortality was also associated with occurrence of obstructed labor (RR 1.58 (1.14, 2.19)), severe antepartum hemorrhage (RR 2.59 (1.83, 3.66)) and hypertensive disorders (RR 6.87 (5.05, 9.34)). Before and after adjusting for other characteristics, physician attendance at delivery, delivery in hospital and Caesarean delivery were associated with increased risk. We observed variable changes over time in the MMR within sites. Conclusions The MNHR is a useful tool for tracking MMRs in these LMICs. We identified maternal and delivery characteristics associated with increased risk of death, some might be confounded by indication. Despite declines in MMR in some sites, all sites had an MMR higher than the Sustainable Development Goals target of below 70 per 100,000 live births by 2030. Trial registration The MNHR is registered at NCT01073475.

scholarly journals Global health in low-income and middle-income countries: a framework for action

2021 ◽  
Vol 9 (7) ◽  
pp. e899-e900
Author(s):  
Isaac Olufadewa ◽  
Miracle Adesina ◽  
Toluwase Ayorinde
Keyword(s):  
Global Health ◽  
Low Income ◽  
Middle Income ◽  
Middle Income Countries

scholarly journals The burgeoning role of global health diplomacy to alleviate suffering of cancer patients in low- and middle-income countries

2020 ◽  
Vol 12 (3) ◽  
pp. 231-233
Author(s):  
Melissa Adomako ◽  
Alaei Kamiar ◽  
Abdulla Alshaikh ◽  
Lyndsay S Baines ◽  
Desiree Benson ◽  
...  
Keyword(s):  
Global Health ◽  
Evidence Base ◽  
International Affairs ◽  
Global Health Diplomacy ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Diplomacy ◽  
Health Practitioners ◽  
And Control ◽  
Low And Middle Income

Abstract The science of global health diplomacy (GHD) consists of cross-disciplinary, multistakeholder credentials comprised of national security, public health, international affairs, management, law, economics and trade policy. GHD is well placed to bring about better and improved multilateral stakeholder leverage and outcomes in the prevention and control of cancer. It is important to create an evidence base that provides clear and specific guidance for health practitioners in low- and middle-income countries (LMICs) through involvement of all stakeholders. GHD can assist LMICs to negotiate across multilateral stakeholders to integrate prevention, treatment and palliative care of cancer into their commercial and trade policies.

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