Human resources for health (and rehabilitation): Six Rehab-Workforce Challenges for the century

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Abstract

Background

People with disabilities face challenges accessing basic rehabilitation health care. In 2006, the United Nations Convention on the Rights of Persons with Disabilities (CRPD) outlined the global necessity to meet the rehabilitation needs of people with disabilities, but this goal is often challenged by the undersupply and inequitable distribution of rehabilitation workers. While the aggregate study and monitoring of the physical rehabilitation workforce has been mostly ignored by researchers or policy-makers, this paper aims to present the ‘challenges and opportunities’ for guiding further long-term research and policies on developing the relatively neglected, highly heterogeneous physical rehabilitation workforce.

Methods

The challenges were identified through a two-phased investigation. Phase 1: critical review of the rehabilitation workforce literature, organized by the availability, accessibility, acceptability and quality (AAAQ) framework. Phase 2: integrate reviewed data into a SWOT framework to identify the strengths and opportunities to be maximized and the weaknesses and threats to be overcome.

Results

The critical review and SWOT analysis have identified the following global situation: (i) needs-based shortages and lack of access to rehabilitation workers, particularly in lower income countries and in rural/remote areas; (ii) deficiencies in the data sources and monitoring structures; and (iii) few exemplary innovations, of both national and international scope, that may help reduce supply-side shortages in underserved areas.

Discussion

Based on the results, we have prioritized the following ‘Six Rehab-Workforce Challenges’: (1) monitoring supply requirements: accounting for rehabilitation needs and demand; (2) supply data sources: the need for structural improvements; (3) ensuring the study of a whole rehabilitation workforce (i.e. not focused on single professions), including across service levels; (4) staffing underserved locations: the rising of education, attractiveness and tele-service; (5) adapt policy options to different contexts (e.g. rural vs urban), even within a country; and (6) develop international solutions, within an interdependent world.

Conclusions

Concrete examples of feasible local, global and research action toward meeting the Six Rehab-Workforce Challenges are provided. Altogether, these may help advance a policy and research agenda for ensuring that an adequate rehabilitation workforce can meet the current and future rehabilitation health needs.

Electronic supplementary material

The online version of this article (doi:10.1186/s12960-017-0182-7) contains supplementary material, which is available to authorized users.

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Staffing remote rural areas in middle- and low-income countries: A literature review of attraction and retention

Uta Lehmann, Marjolein Dieleman, Tim Martineau (2008)

Background Many countries in middle- and low-income countries today suffer from severe staff shortages and/or maldistribution of health personnel which has been aggravated more recently by the disintegration of health systems in low-income countries and by the global policy environment. One of the most damaging effects of severely weakened and under-resourced health systems is the difficulty they face in producing, recruiting, and retaining health professionals, particularly in remote areas. Low wages, poor working conditions, lack of supervision, lack of equipment and infrastructure as well as HIV and AIDS, all contribute to the flight of health care personnel from remote areas. In this global context of accelerating inequities health service policy makers and managers are searching for ways to improve the attraction and retention of staff in remote areas. But the development of appropriate strategies first requires an understanding of the factors which influence decisions to accept and/or stay in a remote post, particularly in the context of mid and low income countries (MLICS), and which strategies to improve attraction and retention are therefore likely to be successful. It is the aim of this review article to explore the links between attraction and retention factors and strategies, with a particular focus on the organisational diversity and location of decision-making. Methods This is a narrative literature review which took an iterative approach to finding relevant literature. It focused on English-language material published between 1997 and 2007. The authors conducted Pubmed searches using a range of different search terms relating to attraction and retention of staff in remote areas. Furthermore, a number of relevant journals as well as unpublished literature were systematically searched. While the initial search included articles from high- middle- and low-income countries, the review focuses on middle- and low-income countries. About 600 papers were initially assessed and 55 eventually included in the review. Results The authors argue that, although factors are multi-facetted and complex, strategies are usually not comprehensive and often limited to addressing a single or limited number of factors. They suggest that because of the complex interaction of factors impacting on attraction and retention, there is a strong argument to be made for bundles of interventions which include attention to living environments, working conditions and environments and development opportunities. They further explore the organisational location of decision-making related to retention issues and suggest that because promising strategies often lie beyond the scope of human resource directorates or ministries of health, planning and decision-making to improve retention requires multi-sectoral collaboration within and beyond government. The paper provides a simple framework for bringing the key decision-makers together to identify factors and develop multi-facetted comprehensive strategies. Conclusion There are no set answers to the problem of attraction and retention. It is only through learning about what works in terms of fit between problem analysis and strategy and effective navigation through the politics of implementation that any headway will be made against the almost universal challenge of staffing health service in remote rural areas.

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World report on disability.

(2011)

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Prevalence and risk of violence against adults with disabilities: a systematic review and meta-analysis of observational studies.

Karen Hughes, Mark Bellis, Lisa Jones … (2012)

About 15% of adults worldwide have a disability. These individuals are frequently reported to be at increased risk of violence, yet quantitative syntheses of studies of this issue are scarce. We aimed to quantify violence against adults with disabilities.

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Author and article information

Contributors

Tiago S. Jesus: +351917410478 , jesus-ts@outlook.com

Michel D. Landry: mike.landry@duke.edu

Gilles Dussault: gillesdussault@ihmt.unl.pt

Inês Fronteira: ifronteira@ihmt.unl.pt

Journal

Journal ID (nlm-ta): Hum Resour Health

Journal ID (iso-abbrev): Hum Resour Health

Title: Human Resources for Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1478-4491

Publication date (Electronic): 23 January 2017

Publication date PMC-release: 23 January 2017

Publication date Collection: 2017

Volume: 15

Electronic Location Identifier: 8

Affiliations

[1 ]Portuguese Ministry of Education, Aggregation of Schools of Escariz, 4540-320 Escariz, Portugal

[2 ]ISNI 0000 0004 1936 7961, GRID grid.26009.3d, Doctor of Physical Therapy Division, , Duke University Medical Center, Duke University, ; Box 104002, 27710 Durham, NC United States of America

[3 ]ISNI 0000 0004 1936 7961, GRID grid.26009.3d, , Duke Global Health Institute, Duke University, ; Durham, NC United States of America

[4 ]ISNI 0000000121511713, GRID grid.10772.33, Global Health and Tropical Medicine (GHTM) & WHO Collaborating Center on Health Workforce Policy and Planning, , Institute of Hygiene and Tropical Medicine-NOVA University of Lisbon (IHMT-UNL), ; Rua da Junqueira 100, 1349-008 Lisbon, Portugal

Article

Publisher ID: 182

DOI: 10.1186/s12960-017-0182-7

PMC ID: 5259954

PubMed ID: 28114960

SO-VID: 770ff00e-df86-42ba-91db-a1bc28af3d5f

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 5 July 2016

Date accepted : 12 January 2017

Custom metadata

ScienceOpen disciplines: Health & Social care

Keywords: workforce,rehabilitation,health services for persons with disabilities,global health,health equity,human rights

Data availability: