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other·public health, epidemiology, research methods, infectious disease, preclinical research·PMC10441693

A novel approach to estimate the impact of health workforce investments on health outcomes through increased coverage of HIV, TB and malaria services

Human Resources for Health · 7 authors, 4 centres

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TL;DR

The authors developed a user-friendly Excel-based modeling tool to estimate associations between investments in doctors, nurses, and midwives and increased coverage of treatment services for HIV, TB, and malaria, leading to potential lives saved. The tool was illustrated with hypothetical data and piloted in Zambia and Pakistan, showing feasibility for health workforce planning.

Full summary

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The study developed a modeling tool with two Excel components to estimate the impact of health workforce (doctors, nurses, midwives) investments on treatment coverage and lives saved for HIV, TB, and malaria. The methodology used literature-derived parameters for workforce-productivity links and log-linear regression to associate workforce density with service coverage. The tool was illustrated with a hypothetical country and piloted in Zambia and Pakistan. The authors found positive associations between investments and coverage/lives saved but emphasize the tool produces modelled estimates, not direct causal evidence. Key limitations include the descriptive, cross-sectional nature of the underlying regressions, which cannot account for unmeasured confounders, and the use of simplifying assumptions. The tool is intended for planning purposes to estimate the 'value added' of investments, not for prioritizing specific investment types.

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other

SPECIALTY

public health

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AI pipeline

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ORIGINAL PAPER

PMC10441693

A novel approach to estimate the impact of health workforce investments on health outcomes through increased coverage of HIV, TB and malaria services

Human Resources for Health

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ABSTRACT

Background Globally, HIV, TB and malaria account for an estimated three million deaths annually. The Global Fund partnered with the World Health Organization to assist countries with health workforce planning in these areas through the development of an integrated health workforce investment impact tool. Our study illustrates the development of a user-friendly tool (with two MS Excel calculator subcomponents) that computes associations between human resources for health (HRH) investment inputs and reduced morbidity and mortality from HIV, TB, and malaria via increased coverage of effective treatment services. Methods We retrieved from the peer-reviewed literature quantitative estimates of the relation among HRH inputs and HRH employment and productivity. We converted these values to additional full-time-equivalent doctors, nurses and midwives (DNMs). We used log-linear regression to estimate the relation between DNMs and treatment service coverage outcomes for HIV, TB, and malaria. We then retrieved treatment effectiveness parameters from the literature to calculate lives saved due to expanded treatment coverage for HIV, TB, and malaria. After integrating these estimates into the tool, we piloted it in four countries. Results In most countries with a considerable burden of HIV, TB, and malaria, the health workforce investments include a mix of pre-service education, full remuneration of new hires, various forms of incentives and in-service training. These investments were associated with elevated HIV, TB and malaria treatment service coverage and additional lives saved. The country case studies we developed in addition, indicate the feasibility and utility of the tool for a variety of international and local actors interested in HRH planning. Conclusions The modelled estimates developed for illustrative purposes and tested through country case studies suggest that HRH investments result in lives saved across HIV, TB, and malaria. Furthermore, findings show that attainment of high targets of specific treatment coverage indicators would require a substantially greater health workforce than what is currently available in most LMICs. The open access tool can assist with future HRH planning efforts, particularly in LMICs. Supplementary Information The online version contains supplementary material available at 10.1186/s12960-023-00854-0.

CITATION EXPORT

Tim A. Bruckner, Tracy K. Lin, Jenny Liu et al.. A novel approach to estimate the impact of health workforce investments on health outcomes through increased coverage of HIV, TB and malaria services. Human Resources for Health. (2023). https://doi.org/10.1186/s12960-023-00854-0

AUTHORS

7 · 4 CENTRES

Tim A. Bruckner, Tracy K. Lin, Jenny Liu, Olga Bornemisza, Onyema Ajuebor, Khassoum Diallo, Giorgio Cometto

1grid.266093.80000 0001 0668 7243Program in Public Health and Center for Population, Inequality, and Policy, University of California, Irvine, USA
2grid.266102.10000 0001 2297 6811Institute for Health and Aging, Bixby Center for Global Reproductive Health, University of California, San Francisco. 409 Illinois St. 123J, San Francisco, CA 94158 USA
3https://ror.org/02gysew38grid.452482.d0000 0001 1551 6921Technical Advice and Partnerships Department, The Global Fund, Chem. du Pommier 40, Le Grand-Saconnex, 1218 Geneva, Switzerland
4https://ror.org/01f80g185grid.3575.40000 0001 2163 3745Health Workforce Department, World Health Organization, 20 Avenue Appia, 1211 Geneva, Switzerland