Health and care workforce: country illustrations from Albania, Costa Rica, Finland, the Netherlands, and Zambia (Chapter 8)
2024 | Policy and practice
Overview
"Chapter 8 of the report “Implementing the primary health care (PHC) approach: a primer” captures country illustrations from Albania, Costa Rica, Finland, the Netherlands, and Zambia on the health and care workforce.
Albania’s case study describes the investment in primary care development to address inadequate physician and nurse training. The Health for All Project created Peer Groups for primary care workers and launched a master’s course for family nurses in 2021. These efforts improved care quality and access, demonstrating that workforce investments yield measurable health gains.
Costa Rica’s case study captures the implementation of a decentralized, close-to-community model. National-level targets guide local hospitals and clinics, which have autonomy to make tailored decisions. This structure enhances PHC by encouraging local decision-making and sustainable community engagement.
Finland’s case study details the response to physician and nurse shortages by advancing practice roles for nurses and midwives. Since 2010, nurses can prescribe medications from an approved list and receive postgraduate training. Their expanded roles include counseling, minor condition consultations, and lifestyle monitoring, improving access to quality primary care.
The Netherlands' case study describes the Buurtzorg model, featuring nurse-led teams with autonomous clinical decision-making. These self-managing teams provide person-centered home care, fostering entrepreneurial skills and job satisfaction. The model has low staff turnover and absenteeism, boosting productivity and patient support.
Zambia’s case study details the introduction of community-based volunteers and community health assistants (CHAs) in 2011 to enhance community participation in healthcare. CHAs receive one-year primary care training and focus on disease prevention, health promotion, and outreach, improving health-seeking behavior. Volunteers link health services with communities, notably aiding in the early 2023 cholera outbreak by promoting good hygiene practices.
Income level
PHC components
PHC lever
Health programme (category)
Health programme (sub-category)
Copyright
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