Priorities for research into human resources for health in low- and middle-income countries
Michael Kent Ranson, Mickey Chopra, Salla Atkins, Mario Roberto Dal Poz & Sara Bennett
Volume 88, Number 6, June 2010, 435-443
Table 2. Research questions on human resources for health (HRH) emerging from regional reports on key informant interviews and quality of existing research and literature reviews on specific questions, 2007–2008
| Research questions on HRH emerging from regional reports | Quality/quantity of existing research | Literature reviews identified (references) |
|---|---|---|
| Training | ||
| 1. Which cost-effective mechanisms can increase the number of HRH training programmes? | None | None |
| 2. How effective are accreditation interventions in improving performance? | Poor | |
| 3. What are the optimal size and composition of outreach meetings and workshops for changing health worker behaviour? | Good but only in HICs | |
| Regulatory mechanisms | ||
| 4. How effective is re-licensing in improving doctor performance? | Poor | |
| 5. What is the impact of dual practice (i.e. a health-care worker practising in both public and private sectors)? Are regulations on dual practice required and, if so, how should they be designed and implemented? | None | None |
| 6. What are the relative strengths and weaknesses of different models for regulating the private sector in LMICs? | None | None |
| 7. How can professional bodies be made more effective in regulating practice? | Poor | |
| Financial mechanisms | ||
| 8. What is the relative significance of identified barriers to the effective design and implementation of pay-for-performance initiatives? | Good but only in HICs | |
| 9. How sensitive are skilled health workers to financial incentives for working in underserved areas? | Poor | |
| Organizational mechanisms | ||
| 10. How can non-wage incentives be used to optimize the efficiency and quality of health care? | None | None |
| 11. Which kinds of performance management systems can be implemented to optimize staff performance? | Poor | |
| 12. What can be done to improve the day-to-day management and supervision of HRH? | Good but little in LMICs | |
| 13. How can one assess whether health-care staff are satisfied with their work? Which cost-effective measures increase the level of job-satisfaction? | None | None |
| 14. How can human resources in the private sector be harnessed for achieving health systems goals? | None | None |
| 15. What is the minimum level of inputs required to safely allow substitution? | Good but little in LMICs | |
| 16. Which cost-effective mechanisms can be used to collect consumer feedback on the performance of health workers? | None | None |
| Planning, policy development and intersectoral collaboration | ||
| 17. How does one establish a national HRH plan? How does one assess supply and demand in HRH? | Good but little in LMICs | |
| 18. Which types of data are required for HRH planning and how can a system for collecting them be established? | Good but little in LMICs | |
| 19. How great is the problem caused by the out-migration of health workers? What can be done to address this problem? | Poor | |
| 20. What is the optimal mix of financial, regulatory and non-financial policies for improving the distribution of health workers? | Poor | |
| 21. What can be done to improve the role of women as health-care providers? | Poor |
LMIC, low- and middle-income country; HIC, high-income country.