The Human Resources for Health Crisis in Zambia : An Outcome of Health Worker Entry, Exit, and Performance within the National Health Labor Market
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World Bank
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This report compiles recent evidence on
the Zambian health labor market and provides some baseline
information on human resources for health (HRH) to help the
government address its HRH challenges. Rather than focusing
on making policy recommendations, the report is designed to
be a source book to benefit and fuel discussions related to
HRH in Zambia. Most of the data presented in the report
covers the period 2005-08. The report analyzes the national
health labor market to better understand the available
evidence related to the stock, distribution, and performance
of HRH in Zambia (that is, the HRH outcomes). It aims to
explain those HRH outcomes by mapping, assessing, and
analyzing pre-service education and labor market dynamics,
that is, the flow of health workers into, within, and out of
the health labor market, as well as the core factors
influencing these dynamics. Finally, this report examines
the issue of access and equity of HRH. It finds that even if
health workers are available, in either urban or rural
areas, and performing adequately, the wealthy in Zambia have
better access to services than the poor. This situation is
found in most if not all other countries. The report finds
that as far as access to health workers is concerned, the
poor generally loose out. It also reveals that even if
health workers are available, wealthier segments of the
population often continue to have better access to health
workers than poorer segments. Wealthier women have the
highest probability of receiving any antenatal care. There
is an even steeper pro-rich gradient in delivery attendance
in Zambia. In contrast to antenatal care, there is little
variation across socioeconomic quintiles among those seeking
medical treatment for children with diarrhea or cough and
fever. The poor are slightly more likely to be visited by a
health worker and receive certain services during visits.
The factors linked to these variations in use of services
remain to be examined (they could be linked to expense, fear
of receiving care from an individual belonging to a higher
social stratum, or different gender, and so forth). Either
way, they should be taken into consideration when planning
to improve access for the poor to health care services and providers.
Palabras clave
AGGRESSIVE, AGING, AID, AIDS RELIEF, ANTENATAL CARE, BEDS, BIRTH ATTENDANT, BLOOD SAMPLES, BULLETIN, CENSUSES, CHILD MORTALITY, CHILDBIRTH, CITIES, CITIZENS, CLINICS, COMMUNICABLE DISEASES, COTS, COUNSELING, COUNTRY OF ORIGIN, DEATH RATE, DEATH RATES, DEATHS, DECISION MAKING, DENTAL ASSISTANT, DENTIST, DENTISTRY, DENTISTS, DIAGNOSIS, DIARRHEA, DIARRHEAL DISEASES, DISSEMINATION, DOCTOR, DOCTORS, DROPOUT, EMERGENCY PLAN, ENVIRONMENTAL HEALTH, ESSENTIAL DRUGS, EXHAUSTION, EXPENDITURES, EXTERNAL MIGRATION, FAMILIES, FEMALE, FEVER, GENDER, GENERAL PRACTITIONERS, GROSS NATIONAL INCOME, HEALTH CARE, HEALTH CARE DELIVERY, HEALTH CARE MANAGEMENT, HEALTH CARE SERVICES, HEALTH CENTERS, HEALTH FACILITIES, HEALTH MANAGEMENT, HEALTH ORGANIZATION, HEALTH OUTCOMES, HEALTH PLANNING, HEALTH POSTS, HEALTH PROFESSIONAL, HEALTH PROFESSIONALS, HEALTH RISKS, HEALTH SECTOR, HEALTH SERVICE, HEALTH SERVICE DELIVERY, HEALTH SERVICE PROVIDERS, HEALTH SERVICE PROVISION, HEALTH SERVICES, HEALTH SPECIALIST, HEALTH SYSTEM, HEALTH SYSTEMS, HEALTH TRAINING, HEALTH WORKFORCE, HIV, HIV INFECTION, HIV/AIDS, HOSPITAL, HOSPITAL MANAGEMENT, HOSPITALS, HUMAN RESOURCES, ILLNESS, ILLNESSES, IMMIGRATION, INCOME, INFORMATION SYSTEM, INTERNAL MIGRATION, INTERVENTION, JOB OPPORTUNITIES, LABOR FORCE, LABOR MARKET, LABOR MARKETS, LABORATORY WORKERS, LEGAL STATUS, LIVE BIRTHS, LIVING CONDITIONS, MALARIA, MALARIAL DRUGS, MATERNAL HEALTH, MATERNAL MORTALITY, MATERNAL MORTALITY RATIO, MEDICAL ASSISTANCE, MEDICAL DOCTORS, MEDICAL PRACTICE, MEDICAL SCHOOL, MEDICAL SCHOOLS, MEDICAL TREATMENT, MIDWIFE, MIDWIVES, MIGRATION, MILLENNIUM DEVELOPMENT GOALS, MINISTRY OF HEALTH, MORBIDITY, MORBIDITY AND MORTALITY, MORTALITY, MORTALITY RATE, MORTALITY RATES, MOTHER, MOTHER-TO-CHILD, MOTHER-TO-CHILD TRANSMISSION, MOTHERS, NATIONAL DEVELOPMENT, NATIONAL DEVELOPMENT PLAN, NATIONAL LEGISLATION, NATIONAL LEVEL, NEONATAL DEATH, NUMBER OF WORKERS, NURSE, NURSES, NURSING, NURSING HOMES, NUTRITION, NUTRITIONISTS, PARASITIC DISEASES, PATIENTS, PERINATAL MORTALITY, PERSONAL COMMUNICATION, PHARMACIST, PHARMACISTS, PHARMACY, PHYSICIAN, PHYSICIANS, PHYSIOTHERAPISTS, PNEUMONIA, POPULATION DENSITY, POPULATION GROWTH, PREGNANCIES, PREGNANCY, PREMATURE DEATH, PREVALENCE, PRIMARY CARE, PRIMARY HEALTH CARE, PRIVATE PHARMACIES, PROBABILITY, PROGRESS, PROVINCIAL HOSPITALS, PROVISION OF ASSISTANCE, PSYCHIATRY, PUBLIC HEALTH, PUBLIC HEALTH WORKERS, PUBLIC HOSPITALS, PUBLIC SERVICE, RADIOGRAPHY, RESOURCE NEEDS, ROOMS, RURAL AREAS, SCHOOL HEALTH, SECONDARY EDUCATION, SECONDARY SCHOOL, SKILLED WORKERS, SPECIALISTS, STILLBIRTH, SURGEONS, THERAPIST, THERAPY, TRAINING OPPORTUNITIES, TROPICAL MEDICINE, TUBERCULOSIS, UNDER-FIVE MORTALITY, UNEMPLOYMENT, UNIVERSAL ACCESS, UNIVERSAL ACCESS TO TREATMENT, UNMET DEMAND, URBAN AREAS, USER FEES, WAR, WORK ENVIRONMENT, WORKERS, WORKING CONDITIONS, WORLD HEALTH ORGANIZATION