Scrutinizing human resources for health availability and distribution in Mozambique between 2016 and 2020: a subnational descriptive longitudinal study
Abstract Introduction Overall, resilient health systems build upon sufficient, qualified, well-distributed, and motivated health workers; however, this precious resource is limited in numbers to meet people’s demands, particularly in LMICs. Understanding the subnational distribution of health worker...
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | Human Resources for Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12960-023-00815-7 |
| _version_ | 1827961235410255872 |
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| author | Quinhas Fernandes Orvalho Augusto Helena Machai James Pfeiffer Marco Carone Norton Pinto Naziat Carimo Isaías Ramiro Stephen Gloyd Kenneth Sherr |
| author_facet | Quinhas Fernandes Orvalho Augusto Helena Machai James Pfeiffer Marco Carone Norton Pinto Naziat Carimo Isaías Ramiro Stephen Gloyd Kenneth Sherr |
| author_sort | Quinhas Fernandes |
| collection | DOAJ |
| description | Abstract Introduction Overall, resilient health systems build upon sufficient, qualified, well-distributed, and motivated health workers; however, this precious resource is limited in numbers to meet people’s demands, particularly in LMICs. Understanding the subnational distribution of health workers from different lens is critical to ensure quality healthcare and improving health outcomes. Methods Using data from Health Personnel Information System, facility-level Service Availability and Readiness Assessment, and other sources, we performed a district-level longitudinal analysis to assess health workforce density and the ratio of male to female health workers between January 2016 and June 2020 across all districts in Mozambique. Results 22 011 health workers were sampled, of whom 10 405 (47.3%) were male. The average age was 35 years (SD: 9.4). Physicians (1025, 4.7%), maternal and child health nurses (4808, 21.8%), and nurses (6402, 29.1%) represented about 55% of the sample. In January 2016, the average district-level workforce density was 75.8 per 100 000 population (95% CI 65.9, 87.1), and was increasing at an annual rate of 8.0% (95% CI 6.00, 9.00) through January 2018. The annual growth rate declined to 3.0% (95% CI 2.00, 4.00) after January 2018. Two provinces, Maputo City and Maputo Province, with 268.3 (95% CI 186.10, 387.00) and 104.6 (95% CI 84.20, 130.00) health workers per 100 000 population, respectively, had the highest workforce density at baseline (2016). There were 3122 community health workers (CHW), of whom 72.8% were male, in January 2016. The average number of CHWs per 10 000 population was 1.33 (95% CI 1.11, 1.59) in 2016 and increased by 18% annually between January 2016 and January 2018. This trend reduced to 11% (95% CI 0.00, 13.00) after January 2018. The sex ratio was twice as high for all provinces in the central and northern regions relative to Maputo Province. Maputo City (OR: 0.34; 95% CI 0.32, 0.34) and Maputo Province (OR: 0.56; 95% CI 0.49, 0.65) reported the lowest sex ratio at the baseline. Encouragingly, important sex ratio improvements were observed after January 2018, particularly in the northern and central regions. Conclusion Mozambique made substantial progress in health workers’ availability during the study period; however, with a critical slowdown after 2018. Despite the progress, meaningful shortages and distribution disparities persist. |
| first_indexed | 2024-04-09T16:23:32Z |
| format | Article |
| id | doaj.art-0a1c61636b8a49c68915b45cadaffff1 |
| institution | Directory Open Access Journal |
| issn | 1478-4491 |
| language | English |
| last_indexed | 2024-04-09T16:23:32Z |
| publishDate | 2023-04-01 |
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| series | Human Resources for Health |
| spelling | doaj.art-0a1c61636b8a49c68915b45cadaffff12023-04-23T11:19:28ZengBMCHuman Resources for Health1478-44912023-04-0121111310.1186/s12960-023-00815-7Scrutinizing human resources for health availability and distribution in Mozambique between 2016 and 2020: a subnational descriptive longitudinal studyQuinhas Fernandes0Orvalho Augusto1Helena Machai2James Pfeiffer3Marco Carone4Norton Pinto5Naziat Carimo6Isaías Ramiro7Stephen Gloyd8Kenneth Sherr9National Directorate of Public Health, Ministry of HealthDepartment of Global Health, University of WashingtonDirectorate of Human Resources, Ministry of HealthDepartment of Global Health, University of WashingtonDepartment of Biostatistics, School of Public Health, University of WashingtonDirectorate of Human Resources, Ministry of HealthDepartment of Global Health, University of WashingtonComité para a Saúde de MoçambiqueDepartment of Global Health, University of WashingtonDepartment of Global Health, University of WashingtonAbstract Introduction Overall, resilient health systems build upon sufficient, qualified, well-distributed, and motivated health workers; however, this precious resource is limited in numbers to meet people’s demands, particularly in LMICs. Understanding the subnational distribution of health workers from different lens is critical to ensure quality healthcare and improving health outcomes. Methods Using data from Health Personnel Information System, facility-level Service Availability and Readiness Assessment, and other sources, we performed a district-level longitudinal analysis to assess health workforce density and the ratio of male to female health workers between January 2016 and June 2020 across all districts in Mozambique. Results 22 011 health workers were sampled, of whom 10 405 (47.3%) were male. The average age was 35 years (SD: 9.4). Physicians (1025, 4.7%), maternal and child health nurses (4808, 21.8%), and nurses (6402, 29.1%) represented about 55% of the sample. In January 2016, the average district-level workforce density was 75.8 per 100 000 population (95% CI 65.9, 87.1), and was increasing at an annual rate of 8.0% (95% CI 6.00, 9.00) through January 2018. The annual growth rate declined to 3.0% (95% CI 2.00, 4.00) after January 2018. Two provinces, Maputo City and Maputo Province, with 268.3 (95% CI 186.10, 387.00) and 104.6 (95% CI 84.20, 130.00) health workers per 100 000 population, respectively, had the highest workforce density at baseline (2016). There were 3122 community health workers (CHW), of whom 72.8% were male, in January 2016. The average number of CHWs per 10 000 population was 1.33 (95% CI 1.11, 1.59) in 2016 and increased by 18% annually between January 2016 and January 2018. This trend reduced to 11% (95% CI 0.00, 13.00) after January 2018. The sex ratio was twice as high for all provinces in the central and northern regions relative to Maputo Province. Maputo City (OR: 0.34; 95% CI 0.32, 0.34) and Maputo Province (OR: 0.56; 95% CI 0.49, 0.65) reported the lowest sex ratio at the baseline. Encouragingly, important sex ratio improvements were observed after January 2018, particularly in the northern and central regions. Conclusion Mozambique made substantial progress in health workers’ availability during the study period; however, with a critical slowdown after 2018. Despite the progress, meaningful shortages and distribution disparities persist.https://doi.org/10.1186/s12960-023-00815-7Workforce densityHRH availability and distributionLongitudinal analysisMozambique |
| spellingShingle | Quinhas Fernandes Orvalho Augusto Helena Machai James Pfeiffer Marco Carone Norton Pinto Naziat Carimo Isaías Ramiro Stephen Gloyd Kenneth Sherr Scrutinizing human resources for health availability and distribution in Mozambique between 2016 and 2020: a subnational descriptive longitudinal study Human Resources for Health Workforce density HRH availability and distribution Longitudinal analysis Mozambique |
| title | Scrutinizing human resources for health availability and distribution in Mozambique between 2016 and 2020: a subnational descriptive longitudinal study |
| title_full | Scrutinizing human resources for health availability and distribution in Mozambique between 2016 and 2020: a subnational descriptive longitudinal study |
| title_fullStr | Scrutinizing human resources for health availability and distribution in Mozambique between 2016 and 2020: a subnational descriptive longitudinal study |
| title_full_unstemmed | Scrutinizing human resources for health availability and distribution in Mozambique between 2016 and 2020: a subnational descriptive longitudinal study |
| title_short | Scrutinizing human resources for health availability and distribution in Mozambique between 2016 and 2020: a subnational descriptive longitudinal study |
| title_sort | scrutinizing human resources for health availability and distribution in mozambique between 2016 and 2020 a subnational descriptive longitudinal study |
| topic | Workforce density HRH availability and distribution Longitudinal analysis Mozambique |
| url | https://doi.org/10.1186/s12960-023-00815-7 |
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