Do health policies address the availability, accessibility, acceptability, and quality of human resources for health? Analysis over three decades of National Health Policy of India

Abstract Background Human Resources for Health (HRH) are crucial for improving health services coverage and population health outcomes. The World Health Organisation (WHO) promotes countries to formulate holistic policies that focus on four HRH dimensions—availability, accessibility, acceptability,...

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Autores principales:	Sweta Dubey, Jeel Vasa, Siddhesh Zadey
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Human Resources for Health India Policy analysis Health system strengthening Deficit indices National Health Policy Medicine (General) R5-920 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/a7bdbce4e9cf41a3bbb2e328bdcdff53
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spelling	oai:doaj.org-article:a7bdbce4e9cf41a3bbb2e328bdcdff532021-11-14T12:39:18ZDo health policies address the availability, accessibility, acceptability, and quality of human resources for health? Analysis over three decades of National Health Policy of India10.1186/s12960-021-00681-11478-4491https://doaj.org/article/a7bdbce4e9cf41a3bbb2e328bdcdff532021-11-01T00:00:00Zhttps://doi.org/10.1186/s12960-021-00681-1https://doaj.org/toc/1478-4491Abstract Background Human Resources for Health (HRH) are crucial for improving health services coverage and population health outcomes. The World Health Organisation (WHO) promotes countries to formulate holistic policies that focus on four HRH dimensions—availability, accessibility, acceptability, and quality (AAAQ). The status of these dimensions and their incorporation in the National Health Policies of India (NHPIs) are not well known. Methods We created a multilevel framework of strategies and actions directed to improve AAAQ HRH dimensions. HRH-related recommendations of NHPI—1983, 2002, and 2017 were classified according to targeted dimensions and cadres using the framework. We identified the dimensions and cadres focussed by NHPIs using the number of mentions. Furthermore, we introduce a family of dimensionwise deficit indices formulated to assess situational HRH deficiencies for census years (1981, 2001, and 2011) and over-year trends. Finally, we evaluated whether or not the HRH recommendations in NHPIs addressed the deficient cadres and dimensions of the pre-NHPI census years. Results NHPIs focused more on HRH availability and quality compared to accessibility and acceptability. Doctors were prioritized over auxiliary nurses-midwives and pharmacists in terms of total recommendations. AAAQ indices showed deficits in all dimensions for almost all HRH cadres over the years. All deficit indices show a general decreasing trend from 1981 to 2011 except for the accessibility deficit. The recommendations in NHPIs did not correspond to the situational deficits in many instances indicating a policy priority mismatch. Conclusion India needs to incorporate AAAQ dimensions in its policies and monitor their progress. The framework and indices-based approach can help identify the gaps between targeted and needed dimensions and cadres for effective HRH strengthening. At the global level, the application of framework and indices will allow a comparison of the strengths and weaknesses of HRH-related policies of various nations.Sweta DubeyJeel VasaSiddhesh ZadeyBMCarticleHuman Resources for HealthIndiaPolicy analysisHealth system strengtheningDeficit indicesNational Health PolicyMedicine (General)R5-920Public aspects of medicineRA1-1270ENHuman Resources for Health, Vol 19, Iss 1, Pp 1-19 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Human Resources for Health India Policy analysis Health system strengthening Deficit indices National Health Policy Medicine (General) R5-920 Public aspects of medicine RA1-1270
spellingShingle	Human Resources for Health India Policy analysis Health system strengthening Deficit indices National Health Policy Medicine (General) R5-920 Public aspects of medicine RA1-1270 Sweta Dubey Jeel Vasa Siddhesh Zadey Do health policies address the availability, accessibility, acceptability, and quality of human resources for health? Analysis over three decades of National Health Policy of India
description	Abstract Background Human Resources for Health (HRH) are crucial for improving health services coverage and population health outcomes. The World Health Organisation (WHO) promotes countries to formulate holistic policies that focus on four HRH dimensions—availability, accessibility, acceptability, and quality (AAAQ). The status of these dimensions and their incorporation in the National Health Policies of India (NHPIs) are not well known. Methods We created a multilevel framework of strategies and actions directed to improve AAAQ HRH dimensions. HRH-related recommendations of NHPI—1983, 2002, and 2017 were classified according to targeted dimensions and cadres using the framework. We identified the dimensions and cadres focussed by NHPIs using the number of mentions. Furthermore, we introduce a family of dimensionwise deficit indices formulated to assess situational HRH deficiencies for census years (1981, 2001, and 2011) and over-year trends. Finally, we evaluated whether or not the HRH recommendations in NHPIs addressed the deficient cadres and dimensions of the pre-NHPI census years. Results NHPIs focused more on HRH availability and quality compared to accessibility and acceptability. Doctors were prioritized over auxiliary nurses-midwives and pharmacists in terms of total recommendations. AAAQ indices showed deficits in all dimensions for almost all HRH cadres over the years. All deficit indices show a general decreasing trend from 1981 to 2011 except for the accessibility deficit. The recommendations in NHPIs did not correspond to the situational deficits in many instances indicating a policy priority mismatch. Conclusion India needs to incorporate AAAQ dimensions in its policies and monitor their progress. The framework and indices-based approach can help identify the gaps between targeted and needed dimensions and cadres for effective HRH strengthening. At the global level, the application of framework and indices will allow a comparison of the strengths and weaknesses of HRH-related policies of various nations.
format	article
author	Sweta Dubey Jeel Vasa Siddhesh Zadey
author_facet	Sweta Dubey Jeel Vasa Siddhesh Zadey
author_sort	Sweta Dubey
title	Do health policies address the availability, accessibility, acceptability, and quality of human resources for health? Analysis over three decades of National Health Policy of India
title_short	Do health policies address the availability, accessibility, acceptability, and quality of human resources for health? Analysis over three decades of National Health Policy of India
title_full	Do health policies address the availability, accessibility, acceptability, and quality of human resources for health? Analysis over three decades of National Health Policy of India
title_fullStr	Do health policies address the availability, accessibility, acceptability, and quality of human resources for health? Analysis over three decades of National Health Policy of India
title_full_unstemmed	Do health policies address the availability, accessibility, acceptability, and quality of human resources for health? Analysis over three decades of National Health Policy of India
title_sort	do health policies address the availability, accessibility, acceptability, and quality of human resources for health? analysis over three decades of national health policy of india
publisher	BMC
publishDate	2021
url	https://doaj.org/article/a7bdbce4e9cf41a3bbb2e328bdcdff53
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Do health policies address the availability, accessibility, acceptability, and quality of human resources for health? Analysis over three decades of National Health Policy of India

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