兰州大学循证社会科学交叉创新实验室 Innovation Laboratory of Evidence-based Social Sciences,Lanzhou University

A systematic review of the profile and density of the maternal and child health workforce in China

2021-10-9

BACKGROUND: To track progress in maternal and child health (MCH), understanding the health workforce is important. This study seeks to systematically review evidence on the profile and density of MCH workers in China. METHODS: We searched 6 English and 2 Chinese databases for studies published between 1 October 1949 and 20 July 2020. We included studies that reported on the level of education or the certification status of all the MCH workers in one or more health facilities and studies reporting the density of MCH workers per 100 000 population or per 1000 births. MCH workers were defined as those who provided MCH services in mainland China and had been trained formally or informally. RESULTS: Meta-analysis of 35 studies found that only two-thirds of obstetricians and paediatricians (67%, 95% CI: 59.6-74.3%) had a bachelor or higher degree. This proportion was lower in primary-level facilities (28% (1.5-53.9%)). For nurses involved in MCH care the proportions with a bachelor or higher degree were lower (20.0% (12.0-30.0%) in any health facility and 1% (0.0-5.0%) in primary care facilities). Based on 18 studies, the average density of MCH doctors and nurses was 11.8 (95% CI: 7.5-16.2) and 11.4 (7.6-15.2) per 100 000 population, respectively. The average density of obstetricians was 9.0 (7.9-10.2) per 1000 births and that of obstetric nurses 16.0 (14.8-17.2) per 1000 births. The density of MCH workers is much higher than what has been recommended internationally (three doctors and 20 midwives per 3600 births). CONCLUSIONS: Our review suggests that the high density of MCH workers in China is achieved through a mix of workers with high and low educational profiles. Many workers labelled as "obstetricians" or "paediatrician" have lower qualifications than expected. China compensates for these low educational levels through task-shifting, in-service training and supervision.

研究类型
系统评价
人群
混合人群
主题
["医疗服务人员","人力资源","妇幼卫生"]
作者
Huan Zhang; Xiaoyun Liu; Loveday Penn-Kekana; Carine Ronsmans
国家
United Kingdom
关键词
China; Human resources for health; Maternal and child health; Systematic review.
来源期刊
Hum Resour Health
发布日期
2021-10-9
相关网址
https://www.healthsystemsevidence.org/articles/62fe6fc3ef088708d8e0b619-a-systematic-review-of-the-profile-and-density-of-the-maternal-and-child-health-workforce-in-china?source=saved_email
DOI
10.1186/s12960-021-00662-4
学科领域
DiseasesOtherMaternal and child healthProvidersPhysiciansSpecialistsPhysiciansSpecialistsAllied health professionals