Health Labor Market Analyses in Low- and Middle-Income Countries : An Evidence-Based Approach / Richard M Scheffler.

Format:

Book

Government document

Author/Creator:

Scheffler, Richard M.

Contributor:

Scheffler, Richard M., editor.

Series:

World Bank e-Library.

Directions in Development;Directions in Development - Human Development

Language:

English

Subjects (All):

Labor supply--Developing countries.

Labor supply.

Manpower policy--Developing countries.

Manpower policy.

Physical Description:

1 online resource (286 pages)

Edition:

1st ed.

Place of Publication:

Washington, D.C. : The World Bank, 2016.

System Details:

data file

Summary:

This book, produced jointly by the World Bank, the University of California, Berkeley, and the WHO, aims to provide decision-makers at sub-national, national, regional and global levels with additional insights into how to address their workforce challenges rather than describe them. In order to optimize and align HRH investments and develop targeted policy responses, a thorough understanding of unique, country-specific labor market dynamics and determinants of these dynamics is critical. Policies need to take into account the fact that workers are economic actors, responsive to different levels of compensation and opportunities to generate revenue found in different sub-labor markets. Policies need to take into account the behavioral characteristics of the individuals who provide health care, but also the individuals who consume health care services and the institutions that employ health personnel. In other words, it is necessary to understand the determinants of both the supply (numbers of health workers willing to work in the health sector) and the demand for health workers (resources available to hire health workers), how these interact, and how this interaction varies in different contexts. This interaction will determine the availability of health personnel, their distribution as well as their performance levels, thus ensuring stronger health systems capable to deliver universal health coverage. The book is structured to be of use to researchers, planners, and economists who are tasked with analyzing key areas of health labor markets, including overall labor market assessments as well as and more narrow and targeted analyses of demand and supply (including production and migration), performance, and remuneration of health workers. The chapters, written by a number of internationally renowned experts on Human Resources for Health, discuss data sources and empirical tools that can be used to assess health labor markets across high-, middle- or low-income countries, but draws primarily from examples and case-studies in LMICs.

Contents:

Front Cover

Contents

Foreword

Acknowledgments

About the Contributors

Abbreviations

Overview Tools and Data Needs to Guide Evidence-Based Policy Making on Human Resources for Health

Introduction

Chapter Summaries

Conclusion

References

Chapter 1 A Labor Market Framework for Human Resources for Health in Low- and Middle-Income Countries

Forces Affecting HLM

Health Workers Labor Market and Health and Medical Services Market

Integrated Framework for the HLM

Technical Structure and Dynamics of the Impact of the HLM

Task Shifting in the HLM

Health Worker Productivity

Health Worker Performance

HLM Indicators

Development of a Future Health Workforce

Annex 1A: Preliminary List of Data Needed to Analyze the HLM

Notes

Chapter 2 Data Requirements for the Economic Analysis of Health Labor Markets

Data Requirements for HLM Analysis

Identifying Data Sets for Review

Results of the Review of Data Sets

Recommendations for Collecting Health Workforce Data for HLM Analysis

Conclusions

Annex 2A: Data Sets Included in This Review

Annex 2B: International Standard Classification of Occupations: ISCO-08 22 Health Professionals

Chapter 3 Demand-Based and Needs-Based Forecasts for Health Workers

Needs-Based Forecasts of Health Workers

Demand-Based Forecasts of Health Workers

Supply of Health Workers

Needs-Based and Demand-Based Forecast Comparisons and Shortage Calculations

Chapter 4 Measuring and Analyzing Production Supply

Institutional Dynamics

Medical Education Transformation

Data Needs

Indicators That Measure Progress

Financing

Effective Regulation

Stakeholders

Health Professional Schools.

Health Facilities

Employers

Chapter 5 Health Worker Labor Supply, Absenteeism, and Job Choice

1. Framework for Analysis

2. Evidence

3. Ways Forward

Annex 5A: Cross-Country Data Set

Annex 5B: Equations and Variable Definitions for the Models

Chapter 6 Migration of Health Care Professionals from Sub-Saharan Africa: Issues, Data, and Evidence

Reasons for Migration

Data Needed to Analyze Health Care Professional Migrations

Ways to Measure the Relative Importance of Migration Determinants

Ways to Measure the Impact of Migration

Data Availability for Africa

Determinants of Migration: Ghana as a Case Study

Impact of Migration

Chapter 7 Measuring the Performance of Health Workers

Performance Is Presence, Quality, and Productivity

Difficulties Inherent in the Measurement of Performance

Tools for Measuring Performance

Indicators

Annex 7A: Examples of Tools for Measuring Performance

Chapter 8 Analyzing the Determinants of Health Worker Performance

Indicators for Analyzing the Determinants of Performance

Ways of Understanding Process Quality Shortfalls

Ways of Understanding Productivity Shortfalls

Ways of Analyzing Motivation Shortfalls

Recommendations

Chapter 9 Measuring and Analyzing Salaries and Incentives

Health Workers' Actual Income

Official Income Sources

Unofficial Incomes of Health Workers and Their Side Effects

Methods for Measuring Official Income

Ways of Using Administrative Data from Government Agencies

Methods for Measuring Unofficial Income

Direct Health Worker Surveys

Sensitive Survey Techniques

Patient Surveys

Administrative Records.

Direct Observation

Chapter 10 Survey Techniques to Capture Sensitive Information from Health Workers: An Example of Their Application in Liberia

Item Count Technique

Aggregated Response (Sum Randomization)

Application of Sensitive Survey Techniques in Liberia

Testing Validity of Item Count and Aggregate Response Methods

Results

Regular Salary and Benefits

Sensitive Behaviors: Direct Responses

Sensitive Behaviors: Item Count and Aggregated Response

Conclusions and Considerations

Boxes

Box 1.1 Vignette 1: Workforce Shortage in Thailand

Box 1.2 Vignette 2: Unfilled Posts in Kenya

Box 1.3 Vignette 3: Maternal Health in Malawi

Box 1.4 Vignette 4: Ghost Workers in Rwanda

Box 1.5 Vignette 1: Response to Workforce Shortage in Thailand

Box 1.6 Vignette 2: Response to Unfilled Posts in Kenya

Box 1.7 Vignette 3: Response to Maternal Health in Malawi

Box 1.8 Vignette 4: Response to Ghost Workers in Rwanda

Box 3.1 Calculation of Workforce Supply in Pakistan, 2020

Box 4.1 Framework for Changing Regulatory Requirements

Box 7.1 Two Professionals Evaluating the Same Patient

Box 7.2 Quality of Care and Patient Outcomes

Box 9.1 Randomized Response Technique Calculations

Figures

Figure 1.1 HLM: An Integrated Framework

Figure 1.2 Demand and Supply of Nurses

Figure 1.3 Public and Private Market for Health Workers: One Worker's Hours and Wages

Figure 1.4 Rural and Urban HLMs

Figure 1.5 Task Shifting of Surgery Technicians

Figure 1.6 Function of a Health Worker

Figure 1.7 Health Worker Performance

Figure 2.1 Conceptual Framework Used to Define the Key Information Collected in the MABEL Survey

Figure 3.1 World Health Organization Skilled Birth Attendant Benchmark, 2006.

Figure 3.2 Hypothetical Fitted Health System Values as a Function of Health Workers

Figure 3.3 Hypothetical Health Worker Shortage per 1,000 Population, 2020: The 20 Countries with the Greatest Per Capita Shortage

Figure 3.4 Illustration of SDG Composite Index Method

Figure 3.5 Demand and Supply of Nurses

Figure 3.6 Assessing Shortages and Surpluses of Workers: Conceptual Forecasting Framework

Figure 6.1 Stock of Immigrant Physicians in OECD Countries as a Percentage of Locally Trained Physicians in Source Region

Figure 6.2 African Countries with the Highest Rates of Physician Emigration, 1991 and 2004

Figure 6.3 Number of Trained African Physicians in Africa and OECD Countries, 1991-2004

Figure 6.4 Number of African Physicians Working in Selected OECD Countries, 1991 and 2004

Figure 6.5 Estimated Years of Service in Country of Origin before Emigration, by Graduation Cohort

Figure 6.6 Number of Ghanaian Physicians at Home and Abroad, 1991-2004

Figure 6.7 Education Level of Ghanaian Migrant Physicians' Parents

Figure 6.8 Ghanaian Migrant Doctors' Top Reasons for Migration

Figure 6.9 Main Links with Ghana for Ghanaian Migrant Doctors

Figure B7.2.1 Outcomes Categorized by the Average Quality of Care at Location of First Visit, Rural Tanzania, 2003

Figure 8.1 Three-Gap Framework

Figure 8.2 Empirical Evidence of the Know-Do Gap

Figure 9.1 Common Forms of Individual Incentives and Compensation for Public Sector Health Workers in Low-Income Countries

Tables

Table O.1 Sustainable Development Goal 3

Table 2A.1 Characteristics of Data Sets

Table 3.1 Hypothetical Forecasts of Demand-Based and Needs-Based Health Worker Shortages per 1,000 Population: Pakistan

Table 4.1 Essential Domains of Health Professional Education

Table 4.2 Cost of Medical Education in Different Countries.

Table 4.3 Proposed Indicators of Health Professional Education Financing and Their Purpose

Table 4.4 Proposed Indicators of Health Professional Education Regulation and Their Purpose

Table 4.5 Proposed Indicators of Stakeholder Engagement in Health Professional Education and Their Purpose

Table 4.6 Proposed Indicators for Clinical Practicums as Part of Health Professional Education and Their Purpose

Table 4.7 Proposed Indicators of Employers' Engagement in the Health Professional Education System and Their Purpose

Table 5A.1 Cross-Country Data set

Table 6.1 Regions of Training of African Physicians Identified in the 2011 AMA Physician Masterfile

Table 6.2 Top 12 Countries of Emigration Physicians Appearing in the 2011 AMA Physician Masterfile, by Emigration Rate

Table 6.3 Main Differences between Ghana and Abroad for Ghanaian Migrant Doctors

Table 7.1 Indicators and Possible Tools to Describe Performance of Health Workers

Table 7A.1 General Health Management Information Systems

Table 7A.2 Attendance Check Data Sheet (Example)

Table 7A.3 Patient Exit Interview (Satisfaction, Example)

Table 7A.4 Patient Exit Interview (Travel and Expenditure, Example)

Table 7A.5 Household Survey Questionnaire on Decision Making (Example)

Table 7A.6 Household Survey Questionnaire, Health-Seeking Experience (Example)

Table 7A.7 Direct Observation Checklist

Table 8.1 Vignette to Measure Competence and Capacity

Table 8.2 Job Satisfaction and Motivation

Table 9.1 Sample Survey Question to Determine Benefits and Incentives

Table 10.1 Demographic Characteristics of Liberian Health Worker Respondents, 2012

Table 10.2 Regular Monthly Compensation and Benefits of Liberian Health Worker Respondents, 2010-12

Table 10.3 Results from Direct Responses of Liberian Health Workers.

Table 10.4 Results from Sensitive Survey Responses of Liberian Health Workers.

Notes:

Includes bibliographical references at the end of each chapters.

Description based on print version record.

ISBN:

9781464809323

1464809321

Publisher Number:

10.1596/978-1-4648-0931-6