Advancing the science behind human resources for health: highlights from the Health Policy and Systems Research Reader on Human Resources for Health

Health workers are central to people-centred health systems, resilient economies and sustainable development. Given the rising importance of the health workforce, changing human resource for health (HRH) policy and practice and recent health policy and systems research (HPSR) advances, it is critical to reassess and reinvigorate the science behind HRH as part of health systems strengthening and social development more broadly. Building on the recently published Health Policy and Systems Research Reader on Human Resources for Health (the Reader), this commentary reflects on the added value of HPSR underpinning HRH. HPSR does so by strengthening the multi-disciplinary base and rigour of HRH research by (1) valuing diverse research inferences and (2) deepening research enquiry and quality. It also anchors the relevance of HRH research for HRH policy and practice by (3) broadening conceptual boundaries and (4) strengthening policy engagement. Most importantly, HPSR enables us to transform HRH from being faceless numbers or units of health producers to the heart and soul of health systems and vital change agents in our communities and societies. Health workers’ identities and motivation, daily routines and negotiations, and training and working environments are at the centre of successes and failures of health interventions, health system functioning and broader social development. Further, in an increasingly complex globalised economy, the expansion of the health sector as an arena for employment and the liberalisation of labour markets has contributed to the unprecedented movement of health workers, many or most of whom are women, not only between public and private health sectors, but also across borders. Yet, these political, human development and labour market realities are often set aside or elided altogether. Health workers’ lives and livelihoods, their contributions and commitments, and their individual and collective agency are ignored. The science of HRH, offering new discoveries and deeper understanding of how universal health coverage and the Sustainable Development Goals are dependent on millions of health workers globally, has the potential to overcome this outdated and ineffective orthodoxy

Redox-controlled iron isotope fractionation during magmatic differentiation: An example from the Red Hill intrusion, S. Tasmania

This study presents accurate and precise iron isotopic data for 16 co-magmatic rocks and 6 pyroxene-magnetite pairs from the classic, tholeiitic Red Hill sill in southern Tasmania. The intrusion exhibits a vertical continuum of compositions created by in situ fractional crystallisation of a single injection of magma in a closed igneous system and, as such, constitutes a natural laboratory amenable to determining the causes of Fe isotope fractionation in magmatic rocks. Early fractionation of pyroxenes and plagioclase, under conditions closed to oxygen exchange, gives rise to an iron enrichment trend and an increase in fo2 of the melt relative to the Fayalite-Magnetite-Quartz (FMQ) buffer. Enrichment in Fe3+/ΣFemelt is mirrored by δ57Fe, where VIFe2+-bearing pyroxenes partition 57Fe-depleted iron, defining an equilibrium pyroxene-melt fractionation factor of Δ57 Fepx-melt ≤ -0.25‰ × 106/T2 Upon magnetite saturation, the fo2 and δ57Fe of the melt fall, commensurate with the sequestration of the oxidised, 57Fe-enriched iron into magnetite, quantified as Δ57 Femtn-melt= +0.20‰ × 106/T2 Pyroxene-magnetite pairs reveal an equilibrium fractionation factor of Δ57 Femtn-px= ≈ + 0.30‰ at 900-1,000 °C. Iron isotopes in differentiated magmas suggest that they may act as an indicator of their oxidation state and tectonic setting. © 2012 Springer-Verlag.Paolo A. Sossi, John D. Foden, Galen P. Halverso