Abstract
BackgroundThe objectives of this study were to understand the labour market dynamics among health workers, including their preferences and concerns, and to assess the skills, competence and performance (i.e. the ‘know–do gap’) of doctors working in Timor-Leste.MethodsThis cross-sectional survey was implemented in all 13 districts of Timor-Leste in 2014. We surveyed 443 health workers, including 175 doctors, 150 nurses and 118 midwives (about 20% of the health workers in the country). We also observed 632 clinical consultations with doctors, including 442 direct clinical observations, and tested 190 vignettes.ResultsThe study highlights some positive findings, including the gender balance of health workers overall, the concentration of doctors in rural areas, the high overall reported satisfaction of staff with their work and high motivation, the positive intention to stay in the public sector, the feeling of being well prepared by training for work, the relatively frequent and satisfactory supervisions, and the good attitudes towards patients as identified in observations and vignettes. However, some areas require more investigations and investments. The overall clinical performance of the doctors was very good in terms of attitude and moderate in regard to history taking, health education and treatment. However, the average physical examination performance score was low. Doctors performed better with simulated cases than the real cases in general, which means they have better knowledge and skills than they actually demonstrated. The factors that were significantly associated with the clinical performance of doctors were location of the health facility (urban doctors were better) and consultation time (cases with more consultation time were better). Regression analysis suggests that lack of knowledge was significantly associated with lack of performance, while lack of motivation and equipment were not significant.ConclusionsThe survey provides essential information for workforce planning and for developing training policies and terms and conditions that will attract and retain health workers in rural service. Improving the work environment and performance of doctors working in rural health facilities and ensuring compliance with clinical protocols are two priority areas needed to improve the performance of doctors in Timor-Leste.
Highlights
The objectives of this study were to understand the labour market dynamics among health workers, including their preferences and concerns, and to assess the skills, competence and performance of doctors working in Timor-Leste
The objectives of this study were to understand the labour market dynamics among health workers, including their preferences and concerns, especially regarding their revenues and rural jobs, and to assess the skills, competence and performance of doctors working in Timor-Leste
Seventy-one percent of the nurses and midwives were trained in Timor-Leste and 29% in Indonesia
Summary
The objectives of this study were to understand the labour market dynamics among health workers, including their preferences and concerns, and to assess the skills, competence and performance (i.e. the ‘know–do gap’) of doctors working in Timor-Leste. Timor-Leste represents a unique case to study human resources for health as it is one of the few countries in the world which has rapidly mobilised resources and has addressed the shortage of primary care doctors. In 2003, the government signed an agreement with the Cuban Government to train and deploy medical doctors throughout the country. The total health workforce has increased significantly, with the doctor-to-1000 population ratio at 0.8 per 1000 population in 2014, which is comparable to other countries in the region [2, 3]. The nurse-to-1000 population ratio remained 0.9 per 1000 population, lower than some countries in the region [2]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
