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

International Journal of Health Policy and Management · 6 authors, 3 centres

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TL;DR

This scoping review of primary studies from 2016-2022 synthesized evidence on human resources for health (HRH) challenges in conflict-affected countries, finding that conflict exacerbates existing low- and middle-income country HRH issues and creates unique, complex challenges for healthcare workers and health systems.

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533 CHARS

This scoping review analyzed 36 primary peer-reviewed studies published between 2016 and August 2022 to identify HRH challenges specific to conflict-affected settings (CAS) listed by the World Bank. Limitations include the exclusion of grey literature and a lack of formal quality assessment of included studies. The findings suggest a need for context-specific HRH policies that consider conflict dynamics, governance issues, and the role of non-state actors, with implications for improving planning and resource allocation in CAS.

STUDY TYPE

systematic_review

SPECIALTY

public health

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AI pipeline

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100% · A

ORIGINAL PAPER

PMC10590254

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

International Journal of Health Policy and Management

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ABSTRACT

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. Keywords: Health Workforce, Health Policy, Health Labour Market, Health Systems, War, HRH

CITATION EXPORT

Olivier Onvlee, Maryse Kok, James Buchan et al.. Human Resources for Health in Conflict Affected Settings: A Scoping Review of Primary Peer Reviewed Publications 2016–2022. International Journal of Health Policy and Management. (2023). https://doi.org/10.34172/ijhpm.2023.7306

AUTHORS

6 · 3 CENTRES

Olivier Onvlee, Maryse Kok, James Buchan, Marjolein Dieleman, Mariam Hamza, Christopher Herbst

1KIT Royal Tropical Institute, Amsterdam, The Netherlands
2Faculty of Health, WHO Collaborating Centre, University of Technology, Sydney, NSW, Australia
3World Bank, Washington, DC, USA