scholarly journals Do health policies address the availability, accessibility, acceptability, and quality of human resources for health? Analysis over three decades of National Health Policy of India

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Sweta Dubey ◽  
Jeel Vasa ◽  
Siddhesh Zadey
Keyword(s):  
Human Resources ◽  
National Health ◽  
Human Resources For Health ◽  
World Health Organisation ◽  
Health Policies ◽  
World Health ◽  
The Status ◽  
Policy Priority ◽  
Almost All ◽  
National Health Policies

Abstract Background Human Resources for Health (HRH) are crucial for improving health services coverage and population health outcomes. The World Health Organisation (WHO) promotes countries to formulate holistic policies that focus on four HRH dimensions—availability, accessibility, acceptability, and quality (AAAQ). The status of these dimensions and their incorporation in the National Health Policies of India (NHPIs) are not well known. Methods We created a multilevel framework of strategies and actions directed to improve AAAQ HRH dimensions. HRH-related recommendations of NHPI—1983, 2002, and 2017 were classified according to targeted dimensions and cadres using the framework. We identified the dimensions and cadres focussed by NHPIs using the number of mentions. Furthermore, we introduce a family of dimensionwise deficit indices formulated to assess situational HRH deficiencies for census years (1981, 2001, and 2011) and over-year trends. Finally, we evaluated whether or not the HRH recommendations in NHPIs addressed the deficient cadres and dimensions of the pre-NHPI census years. Results NHPIs focused more on HRH availability and quality compared to accessibility and acceptability. Doctors were prioritized over auxiliary nurses-midwives and pharmacists in terms of total recommendations. AAAQ indices showed deficits in all dimensions for almost all HRH cadres over the years. All deficit indices show a general decreasing trend from 1981 to 2011 except for the accessibility deficit. The recommendations in NHPIs did not correspond to the situational deficits in many instances indicating a policy priority mismatch. Conclusion India needs to incorporate AAAQ dimensions in its policies and monitor their progress. The framework and indices-based approach can help identify the gaps between targeted and needed dimensions and cadres for effective HRH strengthening. At the global level, the application of framework and indices will allow a comparison of the strengths and weaknesses of HRH-related policies of various nations.

scholarly journals Do health policies address the availability, accessibility, acceptability, and quality of human resources for health?: Analysis of three decades of National Health Policy of India

2020 ◽  
Author(s):  
Sweta Dubey ◽  
Jeel Vasa ◽  
Siddhesh Zadey
Keyword(s):  
Health Policy ◽  
Human Resources ◽  
National Health ◽  
Human Resources For Health ◽  
World Health Organisation ◽  
World Health ◽  
National Health Policy ◽  
Four Dimensions ◽  
Almost All

Abstract Background: Human Resources for Health (HRH) are crucial to improve health services coverage and population health outcomes. The World Health Organisation (WHO) promotes four dimensions - availability, accessibility, acceptability, and quality (AAAQ) for HRH strengthening. Integrating AAAQ dimensions in policymaking is essential to reduce the critical shortage of HRH in India. Methods: We created a multilevel framework to evaluate the incorporation of AAAQ dimensions along with strategies and actions that can improve them in HRH-related policies. HRH-related recommendations of all versions of the National Health Policy of India (NHPI) were classified according to targeted dimensions and cadres. We evaluated the extent to which NHPIs incorporated AAAQ dimensions over three decades. Furthermore, dimension-wise normalized indices were formulated to calculate HRH deficits for pre-NHPI years to assess situational deficiencies. Finally, we evaluated whether or not the HRH recommendations of NHPIs addressed the deficient cadres and dimensions for the corresponding year. Results: We observed that HRH availability and quality were focused more in NHPI compared to accessibility and acceptability. Doctors were prioritized over auxiliary nurses-midwives and health assistants. AAAQ indices showed deficits in all dimensions in almost all cadres over the years. The cadres focused by NHPI recommendations did not completely correspond to the deficient cadres. Conclusion: The framework and indices based method can help identify the gaps between targeted and needed dimensions and cadres for effective HRH strengthening in countries. At the global level, the application of framework and indices will allow a comparison of strengths and weaknesses of HRH-related policies of various nations.

scholarly journals Do health policies address the availability, accessibility, acceptability, and quality of human resources for health?: Analysis of three decades of National Health Policy of India

2021 ◽  
Author(s):  
Sweta Dubey ◽  
Jeel Vasa ◽  
Siddhesh Zadey
Keyword(s):  
Health Policy ◽  
Human Resources ◽  
National Health ◽  
Human Resources For Health ◽  
World Health Organisation ◽  
World Health ◽  
National Health Policy ◽  
Four Dimensions ◽  
Almost All

Abstract Background Human Resources for Health (HRH) are crucial to improve health services coverage and population health outcomes. The World Health Organisation (WHO) promotes four dimensions - availability, accessibility, acceptability, and quality (AAAQ) for HRH strengthening. Integrating AAAQ dimensions in policymaking is essential to reduce the critical shortage of HRH in India.Methods We created a multilevel framework to evaluate the incorporation of AAAQ dimensions along with strategies and actions that can improve them in HRH-related policies. HRH-related recommendations of all versions of the National Health Policy of India (NHPI) were classified according to targeted dimensions and cadres. We evaluated the extent to which NHPIs incorporated AAAQ dimensions over three decades. Furthermore, dimension-wise normalized indices were formulated to calculate HRH deficits for pre-NHPI years to assess situational deficiencies. Finally, we evaluated whether or not the HRH recommendations of NHPIs addressed the deficient cadres and dimensions for the corresponding year.Results We observed that HRH availability and quality were focused more in NHPI compared to accessibility and acceptability. Doctors were prioritized over auxiliary nurses-midwives and health assistants. AAAQ indices showed deficits in all dimensions in almost all cadres over the years. The cadres focused by NHPI recommendations did not completely correspond to the deficient cadres.Conclusion The framework and indices based method can help identify the gaps between targeted and needed dimensions and cadres for effective HRH strengthening in countries. At the global level, the application of framework and indices will allow a comparison of strengths and weaknesses of HRH-related policies of various nations.

scholarly journals Synthesis and Application of Assessment Framework for Human Resources for Health Policy Implementation: Gaps in India’s National Health Policy

2020 ◽  
Author(s):  
Sweta Dubey ◽  
Jeel Vasa ◽  
siddhesh zadey
Keyword(s):  
Health Policy ◽  
Human Resources ◽  
National Health ◽  
Human Resources For Health ◽  
Implementation Strategies ◽  
World Health ◽  
National Health Policy ◽  
Four Dimensions ◽  
Health Organization ◽  
Almost All

Abstract Background: Human Resources for Health (HRH) are crucial to improve health services coverage and population health outcomes. The World Health Organization (WHO) promotes four dimensions - availability, accessibility, acceptability, and quality (AAAQ) for HRH strengthening. Integrating AAAQ dimensions in policymaking is essential to reduce the critical shortage of HRH in India. Methods: We created a multilevel framework consisting of implementable strategies and actions that can improve AAAQ dimensions. We assessed and monitored the incorporation of dimensions in HRH-related recommendations of all versions of the National Health Policy of India (NHPI) policies using this framework. Recommendations were coded using this framework and classified according to targeted dimensions and cadres. We formulated dimension-wise normalized indices to calculate HRH deficits for pre-NHPI years and assess situational deficiencies. Finally, we evaluated whether or not the HRH recommendations of NHPIs addressed the deficient cadres and dimensions for the corresponding year. Results: We observed that HRH availability and quality were focused more in NHPI compared to accessibility and acceptability. Doctors were prioritized over auxiliary nurses-midwives and health assistants. AAAQ indices showed deficits in all dimensions in almost all cadres over the years. The cadres focused by NHPI recommendations did not completely correspond to the deficient cadres. Conclusion: The framework and indices based method can help identify the gaps between targeted and needed dimensions and cadres for effective HRH strengthening in countries. At the global level, the application of framework and indices will allow a comparison of the strengths and weaknesses of HRH-related policies and indicate implementation strategies and actions.

scholarly journals Establishing an international laboratory network for neglected tropical diseases: Understanding existing capacity in five WHO regions

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1464
Author(s):  
Laura Dean ◽  
Janet Njelesani ◽  
Charles Mulamba ◽  
Russell Dacombe ◽  
Pamela S. Mbabazi ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Neglected Tropical Diseases ◽  
Eastern Mediterranean ◽  
World Health Organisation ◽  
International Standards ◽  
World Health ◽  
Reference Laboratory ◽  
Tropical Diseases ◽  
Snowball Sampling ◽  
The Status

Background. Limited laboratory capacity is a significant bottleneck in meeting global targets for the control and elimination of neglected tropical diseases (NTD). Laboratories are essential for providing clinical data and monitoring data about the status and changes in NTD prevalence, and for detecting early drug resistance. Currently NTD laboratory networks are informal and specialist laboratory expertise is not well publicised, making it difficult to share global expertise and provide training, supervision, and quality assurance for NTD diagnosis and research. This study aimed to identify laboratories within five World Health Organisation regions (South-East Asia, Eastern Mediterranean, Americas, Western Pacific and Europe) that provide NTD services and could be regarded as national or regional reference laboratories, and to conduct a survey to document their networks and capacity to support NTD programmes. Methods. Potential NTD reference laboratories were identified through systematic searches, snowball sampling and key informants. Results. Thirty-two laboratories responded to the survey. The laboratories covered 25 different NTDs and their main regional and national roles were to provide technical support and training, research, test validation and standard setting. Two thirds of the laboratories were based in academic institutions and almost half had less than 11 staff. Although greater than 90 per cent of the laboratories had adequate technical skills to function as an NTD reference laboratory, almost all laboratories lacked systems for external verification that their results met international standards. Conclusions. This study highlights that although  many laboratories believed they could act as a reference laboratory, only a few had all the characteristics required to fulfil this role as they fell short in the standard and quality assurance of laboratory processes. Networks of high quality laboratories are essential for the control and elimination of disease and this study presents a critical first step in the development of such networks for NTDs.

Assessment of the WHO Health Promoting Schools Framework among schools in selected villages of rural Puducherry, South India – a mixed method study

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Krishnamoorthy Yuvaraj ◽  
Dinesh Kumar ◽  
Shanthosh Priyan ◽  
Lakshminarayanan Subitha ◽  
Gokhale Tanmay ◽  
...  
Keyword(s):  
Health Promotion ◽  
Children And Adolescents ◽  
Qualitative Interviews ◽  
World Health Organisation ◽  
World Health ◽  
Promotion Policy ◽  
Health Promoting Schools ◽  
Health Promoting ◽  
Almost All ◽  
Depth Interviews

Abstract Background The health of children and adolescents can be promoted through schools as they spend most of their time in school. The Health Promoting Schools (HPS) framework provides a set of policies to be followed in schools for improving the health status of school-going children and adolescents. The current study was done to assess this framework among schools in rural Puducherry. Methods Key informant interviews were done with the teachers under the six World Health Organisation (WHO) HPS framework domains to develop an observation checklist for the assessment of schools in the study area. After the survey, in-depth interviews were conducted as an approach to explore the existing health promotion activities, facilitating or hindering factors in the implementation of health promotion framework and suggestions for improving the same. Results A quantitative survey on nine schools showed that almost all the schools were lacking in domains such as health promotion policy, behaviour counselling and mental and social support. Physical education, facilities and policies for nutrition and community collaboration exist in only some of the schools. Qualitative interviews also showed similar findings and most of the teachers suggested to include training for general health emergencies and behaviour counselling. Conclusion The current study showed that most of the schools were lacking in almost all the domains under the HPS framework. Hence, stakeholders at all levels should be made aware of this framework and develop a strategy for uniform implementation of it in all the schools in the region.

scholarly journals Human Resources in Healthcare and Health Outcomes in India

2020 ◽  
Vol 11 (2) ◽  
pp. 133-159
Author(s):  
Venkatanarayana Motkuri ◽  
Udaya S. Mishra
Keyword(s):  
Human Resources ◽  
Health Outcomes ◽  
Census Data ◽  
Health Workers ◽  
Human Resources For Health ◽  
Size Composition ◽  
Healthcare Services ◽  
World Health ◽  
Middle Income ◽  
Minimum Requirement

Human resources for health including health professionals and skilled health workers are crucial in shaping health outcomes. But the shortage of human resources in healthcare services is a reality and hence it has been a cause of concern in lower-middle income countries like India. The present exercise based on census data is a situation analysis of size, composition and distribution of human resources available in the Indian healthcare services. It also explores the relationship between educational development and health workers availability alongside the association between density of health workers and health outcomes across states of India. It is observed that despite the remarkable improvement in health workers density particularly during 2001–2011, the country is falling short of the World Health Organization’s (WHO) need-based minimum requirement (4.45 health workers per 1,000 population) of health workers. The exploratory verification asserts that there is a significant and strong positive relationship/association between the density of health workers and health outcomes.

P792 Breastfeeding in our patients with inflammatory bowel disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S623-S624
Author(s):  
M Charro Calvillo ◽  
M Charro-Calvillo ◽  
E Peña-Gonzalez ◽  
Y Ber-Nieto ◽  
M T Botella Esteban ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Disease Outbreaks ◽  
World Health Organisation ◽  
Public Hospitals ◽  
World Health ◽  
Great Opportunity ◽  
Inflammatory Bowel ◽  
Almost All ◽  
To Receive

Abstract Background Breastfeeding is one of the most important environmental factors in early childhood for later development of an Inflammatory Bowel Disease. The duration of lactation is essential for it to have a protective effect. In addition to IBD patients, breastfeeding can have a beneficial effect for preventing disease relapse. For these reasons, we plan to know how lactation develops in our group of patients with Inflammatory Bowel Disease (IBD). Methods A retrospective analysis of patients followed by gastroenterology consultations, with established diagnosis of IBD and with at least one gestation, in a period from January 2011 to January 2016. The data were collected a posteriori through two simple questionnaires, one completed by the patient, collecting the type of childbirth and breastfeeding she experienced and factors that influenced it. Another form is filled out by the gastroenterologist recording the characteristics of his inflammatory bowel disease. The data is collected in a structured database in Microsoft Excel and analysed with the SPSS statistic package for Windows. Results Data from 78 patients diagnosed with IBD are analysed from eight public hospitals in our autonomous community. 61.1% of patients have ulcerative colitis and 38.9% Crohn’s disease. The deliveries were mainly vaginal (82%), compared with 18% of caesarean-sections, four of them directly motivated by digestive disease. More than half of patients (57.7%) started breastfeeding after childbirth, 10.25% breastfeeding and 32.05% mixed breastfeeding But only 34.6% reach six months of breastfeeding, reaching 39.7% if we include mixed breastfeeding. In 17 patients (21.8%) their base-based inflammatory bowel disease directly influenced the development of lactation. Pharmacological treatment is the main cause for breastfeeding, followed by disease outbreaks, hospitalisations and surgery. Only 47.4% of the patients stated that in the IBD consultation they were given some information about breastfeeding, although almost all replied that they would have liked to receive it. Conclusion The majority of patients with inflammatory bowel disease in our consultations, do not reach six months of breastfeeding currently recommended by the World Health Organisation, so we have a great opportunity for improvement in this field and as gastroenterologists, we can contribute by providing more information to our patients about breastfeeding and its relationship with IBD.

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