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This article discusses the concept of Reduced Health Workforce Syndrome and explores if substitution can be a viable solution to address the shortage, imbalance, or maldistribution of health workers in developing countries. It examines the current situation in Bangladesh's health system and proposes recommendations to enhance the role of non-medical health care providers.
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Substitution Reduced Health Workforce Syndrome: A way forward for Developing Countries Rafia Rahman Institute of Health Economics Bangladesh
Background and Introduction • Health and health workforce • Projection of health provider requirement • Current world health workforce situation (WHO) • Changes in health workforce • Syndrome in health workforce • How different countries of world address this
Justification and Objective • Bangladesh Health System (population,facility, provider, ESP services) • Health workforce situation in Bangladesh • Pattern of disease burden in the primary care (BBS) Objective: to eatablish if substitution is cope in the mainstream of health systems, people will get services at very low cost
Changes and syndrome in Health Workforce Changes in Health workforce Syndromes in Health workforce Conceptual Feamework Multi- disciplinary working Role enlargement Role enhancement Changesin skill mix Presence of any two of following is health work force syndrome Substitution of workers Role delegation Role substitution Scarcity of qualified providers Worker shortage Worker imbalance Address HWF syndrome Substitution Spatial maldistribution Legislation for provide services People will get desire health care services in term of equity and less waiting time Increase utilization of facilities and accessibility will increase Ensure efficiency of health workforce by maximum utilization Reduce Health Workforce Syndrome in terms of shortage, imbalance or maldistribution
Methodology • Both primary and secondary (BBS,BDHS) data were taken • Sample: Purpasive selective,at Union(2),Upazila (2) & NGO (2) • Variable: 115 variables address nine main variable • Data collection: A structure question was used, observation • Data management and draw result
Result Maternal Care; Preconception care, ANC, Normal delivery, PNC ;
Result Neonatal care; Immediate newborn care, Newborn care after delivery, Obs. & neonatal emergencies
Result Nutrition; Child nutrition, maternal nutrition and Adolescent nutrition
Result Non communicable and other disease Adolescent Health, Family planning
Rcommendation • For primary care service discourage medical graduates • Gradually involved non medical health care providers in specialization care (up to a extend). • This is high time for policy makers of developing countries to keep and allow non medical graduates in the mainstream of public health care service system • They were available in service center, ensure continuity of services irrespective of geographical challenge .It will ensure the accessibility, availability and continuity of services. • Proving top-up training undertake placement for experience and skill, paramedics would able to provide a length of health care services 24x7.