Abstract
ABSTRACTOBJECTIVE To describe the human resources for health and analyze the inequality in its distribution in Mexico.METHODS Cross-sectional study based on the National Occupation and Employment Survey (ENOE in Spanish) for the fourth quarter of 2018 in Mexico. Graduated physicians and nurses, and auxiliary/technician nurses with completed studies were considered as human resources for health. States were grouped by degree of marginalization. Densities of human resources for health per 1,000 inhabitants, Index of Dissimilarity (DI) and Concentration Indices (CI) were estimated as measures of unequal distribution.RESULTS The density of human resources for health was 4.6 per 1,000 inhabitants. We found heterogeneity among states with densities from 2.3 to 10.5 per 1,000 inhabitants. Inequality was higher in the states with a very low degree of marginalization (CI = 0.4) than those with high marginalization (CI = 0.1), and the inequality in the distribution of physicians (CI = 0.5) was greater than in graduated nurses (CI = 0.3) among states. In addition, 17 states showed a density above the threshold of 4.5 per 1,000 inhabitants proposed in the Global Strategy on Human Resources for Health. That implies a deficit of nearly 60,000 human resources for health among the 15 states below the threshold. For all states, to reach a density equal to the national density of 4.6, about 12.6% of human health resources would have to be distributed among states that were below national density.CONCLUSIONS In Mexico, there is inequality in the distribution of human resources for health, with state differences. Government mechanisms could support the balance in the labor market of physicians and nurses through a human resources policy.
Highlights
Human resources working in health institutions are considered one of the fundamental components for the proper performance of health systems[1,2]
17 states showed a density above the threshold of 4.5 per 1,000 inhabitants proposed in the Global Strategy on Human Resources for Health
That implies a deficit of nearly 60,000 human resources for health among the 15 states below the threshold
Summary
Human resources working in health institutions are considered one of the fundamental components for the proper performance of health systems[1,2]. Anand and Bärnighausen criticize the conceptual framework of health systems proposed by the World Health Organization (WHO), which considers human resources for health (HRH) as one of the building blocks of the system[1]. The fulfillment of goals and patient satisfaction depend on the HRH, since they provide preventive and curative care, as well as information on diagnosis, treatment and monitoring, and decide which technology and/or drug to use. Their size, composition and distribution are very relevant to ensure the population’s access to health services[3]. Under the Millennium Development Goals (MDG), the 2006 WHO Global Report suggested a minimum threshold of 2.3 physicians, nurses and midwives per thousand inhabitants to reach 80.0% of deliveries performed by qualified personnel; 57 countries did not reach such an indicator[4]
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