Table 1 Summary of frameworks
From: Visualizing the drivers of an effective health workforce: a detailed, interactive logic model
Name | Author | Year | Summary/objectives | Outcomes | Relation to the final logic model |
|---|---|---|---|---|---|
HRH action framework [8] | World Health Organization (WHO) and Management Sciences for Health (MSH) | 2008 | Tool to guide policymakers and health managers to diagnose challenges with the health workforce (e.g., issues with shortages, distribution, competency, retention, and motivation) and determine solutions and implementation strategies to address underlying barriers, with the ultimate goal of improving workforce effectiveness and sustainability | Improved equity, effectiveness, efficiency, and accessibility of health services, leading to better health outcomes | “Action Fields” adapted to elements of the “Health system factors” |
HRH in Fragile States [12] | Fujita et al | 2013 | Adaptation of the HRH Action Framework tailored for post-conflict, fragile health systems. Builds on HRH Action Framework by including more specific HRH policy and intervention areas to affect HRH outcomes in fragile settings | Human resource systems that are responsive to health needs | Foundational components of health system adapted to “Health system factors” HRH policy areas adapted to “Health workforce processes” |
Developing the health workforce for universal health coverage [26] | Cometto et al | 2020 | Framework on individual, organizational, and systemic capacity-building for successful stewardship of HRH—building on HRH Action and systemic capacity-building frameworks [8, 64]. Shows health workforce policy levers at the individual and organizational levels and systems and contextual factors that are required for and enable effective HRH governance. Synthesizes effective policies for health workforce development within each HRH Action Field | Optimizing health workforce management to achieve UHC | Systemic capacity-building framework adapted to “HRH system governance” |
Health worker productivity and performance [10] | Dieleman et al Also adapted by Global Health Workforce Alliance [25] | 2006 2014 | Logic model to depict strategies for improving the performance and productivity of the health workforce. Shows the interrelated mechanisms and contextual determinants that lead to health workforce outcomes, effects, and impacts | Improved performance and productivity (responsiveness, availability, and competency), leading to health improvements | Macro-level context adapted to “Contextual factors” Inputs adapted to “Health system factors” Processes adapted to “Health workforce processes” Outputs and Outcomes adapted to “Health workforce outcomes” Effects adapted to “Health system outcomes” |
Systematic Approach to Health Workforce Management [28] | Dubois and Singh | 2009 | Framework for HR optimization, using a systems perspective to enhance the organizational unit. Management strategies should be aligned with one another and situated within the organizational environment and wider political, social, legal context—with individuals responding to organizational context, and organizations responding to policy environments | Organizational, staff, and patient outcomes | Institutional context adapted to “Contextual factors” Organizational context adapted to “Health system factors” Human resource management strategies adapted to “Health workforce processes” |
Comprehensive health labor market framework for universal health coverage [26] | Sousa et al | 2013 | Stresses that policymakers should take a more comprehensive market-based approach, beyond simply training more health workers. Shows how policy areas can affect and interact with health labor market dynamics and the education sector—which in turn shape the distribution, pay, quality, performance, etc., of the health workforce | Workforce able to deliver quality health services to achieve UHC | Education sector, labor market dynamics, and societal drivers adapted to “Contextual factors” Policy areas adapted to “Health workforce processes” |
Framework with health workers at the core of the health system [11] | Anand and Bärnighausen | 2011 | Framework that depicts health workers as the central element of a functioning health system, arguing that all functions of the health system depends on health workers, their activities, and the system elements that influence them | Appropriate size, composition, and distribution of health workforce providing access to treatment to improve population health and patient satisfaction | Health/HRH system inputs and mechanisms adapted to “Health workforce processes” Health workforce outcomes and activities adapted to “Health workforce outcomes” |
Stages of Health Workforce Development [13] | WHO | 2006 | "Working Lifespan" approach for analyzing and responding to dynamics of the health workforce. Strategies and policy interventions relate to stages of health workforce entry, participation, and exit | Availability, competence, responsiveness, and productivity of the health workforce | Entry, Workforce, and Exit cycle and policy options adapted to “Health workforce processes” Workforce performance outcomes adapted to “Health workforce outcomes” |
Imbalances in the health workforce [27] | Zurn et al | 2004 | Depicts the factors that affect imbalances in the health workforce (supply and demand of health labor, the health care system, policies, resources, and "global" factors). Develops policy tools to address these factors based on a typology of imbalances: profession/specialty imbalances, geographical imbalances, institutional and services imbalances, and gender imbalances | Correct health workforce imbalances | Wider context adapted to “Contextual factors” Policies adapted to “HRH policy formulation and implementation” Health Care System and Resources adapted to “Health system factors” |
Framework for analysis of health workers labor market dynamics [14] | McPake et al | 2013 | Uses health labor market analysis (predominantly supply and demand analysis) to unpack factors behind HRH constraints, to more effectively design policies that can affect health labor markets and subsequent employment conditions. Focused on accelerating progress towards UHC | Improved quality of care and productivity of health workforce, increasing overall health systems performance | HRH regulation and governance adapted to “Health system factors” HRH management, motivation, incentives, and training, education, migration, retirement, deaths adapted to “Health workforce processes” Supply for HRH and HRH employment adapted to “Health workforce outcomes” HRH performance adapted to “Health system outcomes” |