Supply (quantity) of health workers |
Distribution of health workers |
Efficient use of health workers |
Performance of health workers |
|
Training interventions | ||||
Increase numbers of new students | Yes | |||
Recruit foreign graduates | Yes | |||
Recognise previous learning | Yes | |||
Improve curriculum content | Yes | Yes⁹ | Yes | |
Adjust relative numbers of specialists, generalist, and midlevel training positions | Yes | |||
Refine admission criteria | Yes⁹ | Yes | ||
Use reserved entry or quotas for specific groups | Yes | Yes | ||
Introduce conditional scholarships | Yes | Yes | ||
Diversity location of training sites | Yes⁹ | |||
Involve communities (eg, in selection of trainees) | Yes | Yes | ||
Recruit and train faculty | Yes | |||
Introduce training approaches (eg, problem-based learning) | Yes |
Supply (quantity) of health workers |
Distribution of health workers |
Efficient use of health workers |
Performance of health workers |
|
Regulatory mechanisms | ||||
Recognise overseas qualifications | Yes | Yes⁹ | Yes | |
Introduce temporary employment regulations | Yes | Yes | ||
Expand roles of midlevel workers | Yes | |||
Require service in underserved regions | Yes⁹ | |||
Restrict migration of workers | Yes | |||
Ensure competence | Yes | |||
Introduce malpractice regulations | Yes |
Supply (quantity) of health workers |
Distribution of health workers |
Efficient use of health workers |
Performance of health workers |
|
Financial mechanisms | ||||
Increase trainee salaries | Yes | Yes |
Supply (quantity) of health workers |
Distribution of health workers |
Efficient use of health workers |
Performance of health workers |
|
Organisational mechanisms | ||||
Change recruitment policies | ||||
Introduce performance management systems | ||||
Change workflow or workload | ||||
Increase numbers of nurses | ||||
Improve information flow or use electronic health records | ||||
Allow medical care for staff (eg, HIV/AIDS treatment) | ||||
Employ lay health workers | ||||
Use private-sector workers | ||||
Integrate health-care services | ||||
Promote team work | ||||
Use community health planning | ||||
Substitute or extend roles of health workers |
Supply (quantity) of health workers |
Distribution of health workers |
Efficient use of health workers |
Performance of health workers |
|
Involve the community | ||||
Adopt quality improvement and continuous education strategies |
Supply (quantity) of health workers |
Distribution of health workers |
Efficient use of health workers |
Performance of health workers |
|
Macro policies and mechanisms In other sectors | ||||
Estimate human resource needs and plan for supply | ||||
Regulate the civil service |
Fonte: Chopra et al. Lancet 2008;371:668-674