Human Resources for Health in Conflict Affected Settings: A Scoping Review of Primary Peer Reviewed Publications 2016–2022

Onvlee, O; Kok, M; Buchan, J; Dieleman, M; Hamza, M; Herbst, C

Human Resources for Health in Conflict Affected Settings: A Scoping Review of Primary Peer Reviewed Publications 2016–2022

Onvlee, O Kok, M Buchan, J Dieleman, M Hamza, M Herbst, C

Permalink

Publisher:: Maad Rayan Publishing Company
Publication Type:: Journal Article
Citation:: International Journal of Health Policy and Management, 2023, 12, (1), pp. 1-16
Issue Date:: 2023-01-01

Open Access

Copyright Clearance Process

Recently Added
In Progress
Open Access

This item is open access.

Adobe PDF

Download Published versionAdobe PDF (889.99 kB)

View on publisher's site

View statistics

Full metadata record

Field	Value	Language
dc.contributor.author	Onvlee, O
dc.contributor.author	Kok, M
dc.contributor.author	Buchan, J
dc.contributor.author	Dieleman, M
dc.contributor.author	Hamza, M
dc.contributor.author	Herbst, C
dc.date.accessioned	2024-03-07T03:56:09Z
dc.date.available	2024-03-07T03:56:09Z
dc.date.issued	2023-01-01
dc.identifier.citation	International Journal of Health Policy and Management, 2023, 12, (1), pp. 1-16
dc.identifier.issn	2322-5939
dc.identifier.issn	2322-5939
dc.identifier.uri	http://hdl.handle.net/10453/176253
dc.description.abstract	Background: Conflict has devastating effects on health systems, especially on healthcare workers (HCWs) working in under-resourced and hostile environments. However, little evidence is available on how policy-makers, often together with development partners, can optimize the organization of the health workforce and support HCWs to deliver accessible and trustworthy health services in conflict-affected settings (CAS). Methods: A scoping review was conducted to review recent evidence (2016-2022) on human resources for health (HRH) in CAS, and critically discuss HRH challenges in these settings. Thirty-six studies were included in the review and results were presented using an adapted version of the health labour market (HLM) framework. Results: Evidence from CAS highlights that conflict causes specific constraints in both the education sector and in the HLM, and deepens any existing disconnect between those sectors. Parallel and inadequate education and performance management systems, attacks on health facilities, and increased workload and stress, amongst other factors, affect HCW motivation, performance, distribution, and attrition. Short-term, narrowly focused policy-making undermines the long-term sustainability and resilience of the health workforce in CAS, and also contributes to the limited and narrow available research base. Conclusion: While HRH and workforce issues in CAS include those found in many other low- and middle-income countries (LMICs), an additional set of challenges for HCWs, governance dynamics and institutional constraints in CAS ‘multiply’ negative effects on the health workforce. HRH policies, programmes and interventions must be aligned with the political and broader societal context, including the stage, severity and other dynamics of conflict. During conflict, it is important to try to monitor in- and outflow of HCWs and provide HCWs the support they need at local level or through remote measures. The post-conflict situation may present opportunities for improvement in HRH, but a clear understanding of political economy dynamics is required to better act on any such a window of opportunity.
dc.language	en
dc.publisher	Maad Rayan Publishing Company
dc.relation.ispartof	International Journal of Health Policy and Management
dc.relation.isbasedon	10.34172/ijhpm.2023.7306
dc.rights	info:eu-repo/semantics/openAccess
dc.subject.classification	4203 Health services and systems
dc.subject.classification	4206 Public health
dc.subject.classification	4407 Policy and administration
dc.title	Human Resources for Health in Conflict Affected Settings: A Scoping Review of Primary Peer Reviewed Publications 2016–2022
dc.type	Journal Article
utslib.citation.volume	12
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
pubs.organisational-group	University of Technology Sydney/Strength - WHO CC
utslib.copyright.status	open_access	*
dc.date.updated	2024-03-07T03:56:09Z
pubs.issue	1
pubs.publication-status	Published
pubs.volume	12
utslib.citation.issue	1

Abstract:

Background: Conflict has devastating effects on health systems, especially on healthcare workers (HCWs) working in under-resourced and hostile environments. However, little evidence is available on how policy-makers, often together with development partners, can optimize the organization of the health workforce and support HCWs to deliver accessible and trustworthy health services in conflict-affected settings (CAS). Methods: A scoping review was conducted to review recent evidence (2016-2022) on human resources for health (HRH) in CAS, and critically discuss HRH challenges in these settings. Thirty-six studies were included in the review and results were presented using an adapted version of the health labour market (HLM) framework. Results: Evidence from CAS highlights that conflict causes specific constraints in both the education sector and in the HLM, and deepens any existing disconnect between those sectors. Parallel and inadequate education and performance management systems, attacks on health facilities, and increased workload and stress, amongst other factors, affect HCW motivation, performance, distribution, and attrition. Short-term, narrowly focused policy-making undermines the long-term sustainability and resilience of the health workforce in CAS, and also contributes to the limited and narrow available research base. Conclusion: While HRH and workforce issues in CAS include those found in many other low- and middle-income countries (LMICs), an additional set of challenges for HCWs, governance dynamics and institutional constraints in CAS ‘multiply’ negative effects on the health workforce. HRH policies, programmes and interventions must be aligned with the political and broader societal context, including the stage, severity and other dynamics of conflict. During conflict, it is important to try to monitor in- and outflow of HCWs and provide HCWs the support they need at local level or through remote measures. The post-conflict situation may present opportunities for improvement in HRH, but a clear understanding of political economy dynamics is required to better act on any such a window of opportunity.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/176253