a review

Introduction: eHealth and mHealth are technologies that allow services to be extended closer to patients, in pursuit of the objectives of Health 2020: a European policy framework and strategy for the 21st century and of the Global Strategy on Human Resources for Health: workforce 2030. As Europe faces increased demand for health services due to ageing populations, rising patient mobility, and a diminishing supply of health workers caused by retirement rates that surpass recruitment rates, this paper illustrates how eHealth and mHealth can improve the delivery of services by the health workforce in response to increasing demands. Methods: Through a scoping literature review, the impact of eHealth/mHealth on the health workforce was assessed by examining how these technologies affect four dimensions of the performance of health professionals, according to the so-called AAAQ: availability, accessibility, acceptability, and quality. Results: Few high-quality studies were found. Most studies focused on the utilization of text messaging (SMS) for patient behavior change, and some examined the potential of mhealth to strengthen health systems. We also found some limited literature reporting effects on clinical effectiveness, costs, and patient acceptability; we found none reporting on equity and safety issues. Facilitators and barriers to the optimal utilization of eHealth and mHealth were identified and categorized as they relate to individuals, professional groups, provider organizations, and the institutional environment. Discussion: There are ongoing clinical trial protocols of largescale, multidimensional mHealth interventions, suggesting that the current limited evidence base will expand in coming years. The requirement for new digital skills for human resources for health (HRH) was observed as significant. This has implications for the education of health workers, the management of health services, policy-making, and research.publishersversionpublishe

Impact of the economic crisis on human resources for health policies in Southern EU countries

Background The economic and financial crisis which started in the European Union in 2008 affected some countries more than others. Cyprus, Greece, and Portugal had to receive emergency financial aid from the so-called Troika (International Monetary Fund, Central European Bank, European Commission) and consequently were imposed severe austerity measures. All sectors were affected, including health. This paper focuses on the effects of the crisis on the health workforce, which represents the largest share of expenditures in the sector, and on policy responses from these three governments to measures ‘imposed' by the Troika. Methods A systematic search of peer-reviewed and grey literature, and key sources such as government websites was performed. Interviews with key informants were also conducted. Country data and information served to assess policy responses and their effects on the availability, accessibility, acceptability and quality of human resources for health. Results Countries responded to the crisis and to the conditions set by lenders by reducing or freezing salaries and benefits, by cutting on recruitment and even dismissing personnel, by increasing workloads, and by introducing other cost containment measures. The three countries do not seem to have used the crisis as an opportunity to make efficiency gains and thereby improve the performance of their health workforce. Conclusions This paper is included in the Workshop because it discusses policy responses to a major economic shock by governments facing external constraints, which at the same time limited their capacity for action and provided opportunities for reforminfo:eu-repo/semantics/acceptedVersio

Perceptions of portuguese family health care teams regarding the expansion of nurses’ scope of practice = Perceções de equipas de saúde familiar portuguesas sobre o alargamento do campo de exercício da enfermagem

Theoretical framework: Expanding primary health care nurses’ scope of practice is a strategy that has been used in various health systems to good advantage. Its feasibility depends on the health professionals’ consensus as to its suitability. Objectives: To find out the perceptions of Portuguese family health care teams regarding the expansion of primary care nurses’ scope of practice. Methodology: Focus groups. Results: The team perception is that citizen expectations, the shortage of nurses and the need for specific training are the main issues to be faced. The teams discussed various roles that the nursing profession could take on in Primary Health Care (PHC) via a work reorganisation included in the regulatory framework. Conclusion: The assignment of wider clinical roles to PHC nurses is not unanimously approved of, since it is perceived by some doctors and nurses as inappropriate and unfair. Some health care teams expressed their willingness to take part in this option, due to its potential contribution to improving the response to care needs not currently being met. Enquadramento: O alargamento do campo de exercício do enfermeiro de cuidados primários tem constituído uma estratégia utilizada em diversos sistemas de saúde com ganhos conhecidos. A sua exequibilidade depende do consenso dos profissionais de saúde sobre a sua adequação. Objetivos: Conhecer as perceções de equipas de saúde familiar portuguesas sobre o alargamento do campo de exercício do enfermeiro de cuidados primários. Metodologia: Grupos focais. Resultados: Na perceção das equipas, as expetativas dos cidadãos, a escassez de enfermeiros e a necessidade de formação específica são os principais problemas a enfrentar. As equipas discutiram vários papéis que a profissão de enfermagem poderia assumir em Cuidados de Saúde Primários (CSP), mediante uma reorganização do trabalho, enquadrada normativamente. Conclusão: A atribuição de papéis clínicos mais vastos ao enfermeiro de CSP não reúne unanimidade, por ser percebida, por alguns médicos e enfermeiros, como desajustada e iníqua. Algumas equipas de saúde manifestaram disponibilidade para aderir a esta opção, face ao seu potencial contributo para melhorar a resposta a necessidades assistenciais atualmente não satisfeitas.publishersversionpublishe

Defining medical deserts-an international consensus-building exercise

Publisher Copyright: © 2023 Oxford University Press. All rights reserved.Background: Medical deserts represent a pressing public health and health systems challenge. The COVID-19 pandemic further exacerbated the gap between people and health services, yet a commonly agreed definition of medical deserts was lacking. This study aims to define medical deserts through a consensus-building exercise, explaining the phenomenon to its full extent, in a manner that can apply to countries and health systems across the globe. Methods: We used a standard Delphi exercise for the consensus-building process. The first phase consisted of one round of individual online meetings with selected key informants; the second phase comprised two rounds of surveys when a consensus was reached in January 2023. The first phase-the in-depth individual meetings-was organized online. The dimensions to include in the definition of medical deserts were identified, ranked and selected based on their recurrence and importance. The second phase-the surveys-was organized online. Finally, external validation was obtained from stakeholders via email. Results: The agreed definition highlight five major dimensions: 'Medical deserts are areas where population healthcare needs are unmet partially or totally due to lack of adequate access or improper quality of healthcare services caused by (i) insufficient human resources in health or (ii) facilities, (iii) long waiting times, (iv) disproportionate high costs of services or (v) other socio-cultural barriers'. Conclusions: The five dimensions of access to healthcare: (i) insufficient human resources in health or (ii) facilities, (iii) long waiting times, (iv) disproportionate high costs of services and (v) other socio-cultural barriers-ought to be addressed to mitigate medical deserts. The Author(s) 2023.publishersversionpublishe

Health workforce metrics pre- and post-2015: A stimulus to public policy and planning

© 2017 The Author(s). Background: Evidence-based health workforce policies are essential to ensure the provision of high-quality health services and to support the attainment of universal health coverage (UHC). This paper describes the main characteristics of available health workforce data for 74 of the 75 countries identified under the 'Countdown to 2015' initiative as accounting for more than 95% of the world's maternal, newborn and child deaths. It also discusses best practices in the development of health workforce metrics post-2015. Methods: Using available health workforce data from the Global Health Workforce Statistics database from the Global Health Observatory, we generated descriptive statistics to explore the current status, recent trends in the number of skilled health professionals (SHPs: physicians, nurses, midwives) per 10 000 population, and future requirements to achieve adequate levels of health care in the 74 countries. A rapid literature review was conducted to obtain an overview of the types of methods and the types of data sources used in human resources for health (HRH) studies. Results: There are large intercountry and interregional differences in the density of SHPs to progress towards UHC in Countdown countries: a median of 10.2 per 10 000 population with range 1.6 to 142 per 10 000. Substantial efforts have been made in some countries to increase the availability of SHPs as shown by a positive average exponential growth rate (AEGR) in SHPs in 51% of Countdown countries for which there are data. Many of these countries will require large investments to achieve levels of workforce availability commensurate with UHC and the health-related sustainable development goals (SDGs). The availability, quality and comparability of global health workforce metrics remain limited. Most published workforce studies are descriptive, but more sophisticated needs-based workforce planning methods are being developed. Conclusions: There is a need for high-quality, comprehensive, interoperable sources of HRH data to support all policies towards UHC and the health-related SDGs. The recent WHO-led initiative of supporting countries in the development of National Health Workforce Accounts is a very promising move towards purposive health workforce metrics post-2015. Such data will allow more countries to apply the latest methods for health workforce planning

O conhecimento sobre o medicamento e literacia em saúde. Um estudo em adultos utentes de farmácias do concelho de Lisboa

Estudos recentes realizados nas farmácias portuguesas evidenciaram elevadas percentagens de indivíduos que não aderem à terapêutica. Em consequência, não controlam adequadamente o seu problema de saúde e geram desperdício do medicamento. A utilização do medicamento requer conhecimento, competências e motivação por parte do indivíduo/utilizador. A informação sobre o medicamento é disponibilizada de forma verbal e escrita, desconhecendo-se até hoje, na população portuguesa, em que medida as competências de literacia em saúde permitem a sua obtenção, o uso e a compreensão quando perante a necessidade de utilizar medicamentos. Foi objetivo do presente estudo a medição do conhecimento sobre o medicamento numa amostra de utentes de farmácia com idades compreendidas entre os 45 e os 64 anos, analisando de que forma está associado a competências de literacia em saúde. Realizou-se um estudo descritivo transversal com a colaboração voluntária de farmácias do concelho de Lisboa, que recolheram os dados mediante inquérito por entrevista quando o utente se encontrava na farmácia a adquirir a sua terapêutica. A amostra estudada foi constituída por 233 utentes com uma idade média de 57 anos (dp = 5,7), maioritariamente do género feminino, ativos, com uma escolaridade igual ou inferior ao 9.º ano e com hábitos gerais de leitura referindo ler frequentemente (26 por cento) ou muito frequentemente (30 por cento). Em média responderam corretamente a 10,48 perguntas num total de 13 (dp = 1,779), sendo este conhecimento independente do sexo (p = 0,791) e da idade (p = 0,131). O número de respostas corretas é, no entanto, maior quanto mais elevado o grau de escolaridade (p = 0,000), a categoria profissional exercida (p=0,000), os hábitos de leitura (p=0,000), o índice de compreensão de informação (p = 0,003), a intensidade de leitura de informação sobre saúde ou medicamento (p = 0,005), a facilidade de utilização do folheto informativo do medicamento (p = 0,027), a intensidade de cálculo (p = 0,018) e o tempo de utilização do medicamento (p = 0,047). Do conjunto de indicadores de literacia analisados, o grau de escolaridade, o índice de compreensão da informação transmitida pelos profissionais de saúde e a intensidade de leitura de materiais escritos relacionados com o medicamento ou saúde são os que mais contribuem para o conhecimento sobre o medicamento, embora se revelem fracamente preditivos do nível de conhecimento (r2 = 0,013). Evidencia-se neste estudo que o conhecimento que os indivíduos possuem sobre o medicamento é influenciado de forma positiva por competências de literacia em saúde. Em consequência, as intervenções que visam melhorar a utilização do medicamento e as estratégias de comunicação em saúde, tanto verbal como escrita, devem ter em consideração o nível de literacia em saúde da população.info:eu-repo/semantics/publishedVersio

Assessment of human resources management practices in Lebanese hospitals

© 2009 El-Jardali et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Prospectives

Tiré de: Prospectives, vol. 7, no 3. juin 1971Titre de l'écran-titre (visionné le 24 janv. 2013