Health Professional Education And Universal Health Coverage: A Summary Of Challenges And Selected Case Studies

• Published in: Health Affairs Vol. 36; no. 11; pp. 1928 - 1936
• Main Authors: Sripathy, Arthika, Marti, Joachim, Patel, Hannah, Sheikh, Javaid I, Darzi, Ara W
• Format: Journal Article
• Language: English
• Published: United States The People to People Health Foundation, Inc., Project HOPE 01-11-2017
• Subjects: Adaptation; Adequacy; Affordability; Ambulatory care; Brazil; Case studies; Child mortality; Clinical outcomes; Community health care; Community health workers; Community Health Workers - education; Cost analysis; Education reform; Education, Nursing, Diploma Programs; Education, Professional - methods; Effectiveness; Employment; Graduate studies; Health care; Health care access; Health care expenditures; Health care policy; Health education; Health initiatives; Health services; Humans; India; Infant mortality; Infants; Innovations; Internet; Low income groups; Maternal & child health; Medical personnel; Mortality rates; Multidisciplinary teams; National health insurance; Nurse practitioners; Nurses; Organizational Case Studies; Patient Care Team - utilization; Personnel Selection; Physicians; Physicians, Primary Care - education; Population; Primary care; Primary Care Nursing; Professional education; Professionals; R&D; Recruitment; Research & development; Retention; Rural areas; Rural communities; Rural Health Services - manpower; Shortages; Skilled workers; Teams; Training; Trends; Universal Coverage; Workers; Workforce; Universal Health Coverage; Health Professions Education; Rural Health Care; Workforce Issues; Primary Care
• ISSN: 0278-2715; 1544-5208
• DOI: 10.1377/hlthaff.2017.0517

Low- and middle-income countries are experiencing serious shortages in meeting health workforce requirements for universal health coverage. We examine how national-level policies can address these deficiencies and support the development of an appropriately skilled health workforce in line with population needs. We discuss three innovative, government-led solutions that are designed to align health workforce training with the demands of universal health coverage. Specifically, we discuss two initiatives to train and retain doctors in rural areas of Thailand, the large-scale training of community health workers within multidisciplinary primary health care teams in Brazil, and the introduction of a postgraduate diploma program in primary care for nurses in India. Several positive outcomes have been associated with these initiatives, including improvements in the rural retention of doctors in Thailand and reductions in infant and child mortality rates in Brazil. However, further research is needed to assess the impact of such initiatives on the long-term retention of workers-particularly doctors-and the adequacy of the training offered to lower-skilled workers to effectively plug medical personnel gaps. Systematic monitoring of program affordability and cost-effectiveness over time must be prioritized, alongside efforts to disseminate lessons learned.