With approximately 1.3 billion births estimated to be taking place globally over a decade up to 2020, the demand for maternal and newborn health (MNH) workforce continues to be a key aspect of public health service delivery. Human resources for health (HRH) projection models can contribute the quantitative evidence required for policy design for education commissioning and distribution of skilled personnel. To date, HRH supply and requirement projection models have not been developed specifically for system-based subnational planning within maternal and newborn care. In addition, current methodologies are often limited to national level and have a professional silo approach to considering the workforce, with informing policy and planning as a secondary consideration. The aim of this thesis was to fill the gap through improved understanding of the role of HRH projections for policy and development of a new model for projecting the future MNH clinical teams with spatial equity and system perspective at the centre of the planning framework.
The specific objectives were to
• review the literature for strengths and limitations for current HRH planning and outline the main components of an evidence-informed MNH-HRH planning framework with relevance to subnational contexts and MNH systems
• translate the main components into a working prototype as a spreadsheet-based model to estimate and MNH-HRH requirements and supply for each occupation
• apply the MNH-HRH planning model in three countries from low to high income contexts and critique the implications for future research and development in this field.
Following the construction of a new planning framework, a working prototype called the ‘MNH.HRH Planning App’ was developed. The spreadsheet-based model was applied using secondary data sources to England, Bangladesh, and Ethiopia which have varied health systems, levels of spatial disaggregation and HRH structures for MNH care. The thesis concludes by highlighting the implications of the new planning framework for the future development of a web-based MNH.HRH Planning App, potential for engaging policy-makers for evidence-informed planning and contributes to the wider discourse on the use of quantitative projection models for planning the future human resources for healthcare
