Abstract
BackgroundThe Lao People’s Democratic Republic is facing a critical shortage and maldistribution of health workers. Strengthening of the health workforce has been adopted as one of the five priorities of the National Health Sector Strategy (2013–2025). This study aims to identify, explore, and better understand the key challenges for strengthening the Laotian health workforce.MethodsThis study applied exploratory and descriptive qualitative methods and adapted a working life-span framework. Twenty-three key stakeholders with particular insights into the current situation of the health workforce were purposively recruited for in-depth interviews. Important policy documents were also collected from key informants during the interviews. Thematic analysis was employed for the textual data using MAXQDA 10.ResultsThe overarching problem is that there is a perceived severe shortage of skilled health workers (doctors, nurses, and midwives) and lab technicians, especially in primary health facilities and rural areas. Key informants also identified five problems: insufficient production of health workers both in quantity and quality, a limited national budget to recruit enough health staff and provide sufficient and equitable salaries and incentives, limited management capacity, poor recruitment for work in rural areas, and lack of well-designed continuing education programs for professional development. These problems are interrelated, both in how the issues arise and in the effect they have on one another.ConclusionsTo improve the distribution of health workers in rural areas, strategies for increasing production and strengthening retention should be well integrated for better effectiveness. It is also essential to take the Laotian-specific context into consideration during intervention development and implementation. Furthermore, the government should acknowledge the inadequate health management capacity and invest to improve human resource management capacity at all levels. Finally, assessment of interventions for health workforce strengthening should be developed as early as possible to learn from the experiences and lessons in the Lao People’s Democratic Republic.Electronic supplementary materialThe online version of this article (doi:10.1186/s12960-016-0167-y) contains supplementary material, which is available to authorized users.
Highlights
The Lao People’s Democratic Republic is facing a critical shortage and maldistribution of health workers
Study design and framework This study was designed to utilize exploratory and descriptive qualitative methods as it was the best option for achieving the scope of this study [15], mainly through the in-depth interviews (IDIs) with key informants
Most key informants reported the biggest problem to be the severe shortage in health workers, especially in rural and remote areas
Summary
The Lao People’s Democratic Republic is facing a critical shortage and maldistribution of health workers. This study aims to identify, explore, and better understand the key challenges for strengthening the Laotian health workforce. Uneven distribution across the globe and within countries is another big challenge [1, 3]. The countries who suffer greater burden of disease and require more sufficient health staff usually have more severe shortage of health workers. The inequitable distribution of health workers is evident between urban and rural areas. It is important to rethink the models of education, deployment, and remuneration of the health workforce and start a new global agenda relating to human resources for health development to reinforce the health workforce based on better evidence and practices
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