Child Health Workforce Research Articles

Driving culture change to empower the Aboriginal and Torres Strait Islander Child and Youth Health (ATSIHW) workforce

Introduction: ATSIHW face significant unique workforce challenges which hinder efforts to improve health for their communities. Practice change: Extensive consultation led to the Qld Child and Youth Clinical Network (QCYCN) establishing a statewide governance model to drive workforce culture change. Aim: To empower ATSIHW to drive change within their workforce & lead an integrated cultural shift toward respect & equity, enabling better health outcomes for ATSI communities. Targeted stakeholders: ATSIHW, workforce managers, policy officers, ATSI communities. Timeline: Consultation, Steering Committee established, governance model to be implemented, evaluation. Highlights: Sustainable governance model for ATSIHW to minimise variability in care & facilitate clinical improvement; engaged, respected & supported ATSIHW workforce; stable workforce to deliver Close the Gap initiatives. Sustainability: Appropriate compliance processes developed to ensure sustainability and accountability of governance model. Transferability: This project will produce a proof of concept for a collaborative, sustainable approach to workforce governance that is transferable to other service areas & jurisdictions. Conclusions: There is clear need to develop a sustainable & equitable ATISHW governance model which fosters statewide collaboration. Improvements in workforce will have a positive impact on health outcomes & Closing the Gap. Discussions: The Steering Committee is the driving force to create a positive, cohesive and productive workforce culture. Through their leadership, a statewide governance model will be developed utilising strengths of the workforce & QCYCN, leading to better health outcomes for ATSI children, young people & families. Lessons learned: Extensive consultation is crucial; understanding effective mechanisms for Indigenous leadership & cultural support will improve health care for ATSI children & youth; leveraging off established successful platforms enables change from ground up.

Developing Collaborative Maternal and Child Health Leaders: A Descriptive Study of the National Maternal and Child Health Workforce Development Center.

Purpose An assessment of the National Maternal and Child Health Workforce Development Center (the Center) was conducted to describe (1) effects of the Center's training on the use of collaborative leadership practices by MCH leaders, and (2) perceived barriers to collaboration for MCH leaders. The Center provides services to strengthen MCH professionals' skills in three core areas: Change Management/Adaptive Leadership, Evidence-Based Decision Making, and Systems Integration. Description This descriptive qualitative study compares eight interview responses from a sample of the Center's participants and findings from a document review of the training curriculum against an existing framework of collaborative leadership themes. Assessment Systems thinking tools and related training were highly referenced, and the interviewees often related process-based leadership practices with their applied learning health transformation projects. Perceived barriers to sustaining collaborative work included: (1) a tendency for state agencies to have siloed priorities, (2) difficulty achieving a consensus to move a project forward without individual partners disengaging, (3) strained organizational partnerships when the individual representative leaves that partnering organization, and (4) difficulty in sustaining project-based partnerships past the short term. Conclusion The findings in this study suggest that investments in leadership development training for MCH professionals, such as the Center, can provide opportunities for participants to utilize collaborative leadership practices.

Partnerships for Global Child Health.

Child mortality remains a global health challenge and has resulted in demand for expanding the global child health (GCH) workforce over the last 3 decades. Institutional partnerships are the cornerstone of sustainable education, research, clinical service, and advocacy for GCH. When successful, partnerships can become self-sustaining and support development of much-needed training programs in resource-constrained settings. Conversely, poorly conceptualized, constructed, or maintained partnerships may inadvertently contribute to the deterioration of health systems. In this comprehensive, literature-based, expert consensus review we present a definition of partnerships for GCH, review their genesis, evolution, and scope, describe participating organizations, and highlight benefits and challenges associated with GCH partnerships. Additionally, we suggest a framework for applying sound ethical and public health principles for GCH that includes 7 guiding principles and 4 core practices along with a structure for evaluating GCH partnerships. Finally, we highlight current knowledge gaps to stimulate further work in these areas. With awareness of the potential benefits and challenges of GCH partnerships, as well as shared dedication to guiding principles and core practices, GCH partnerships hold vast potential to positively impact child health.

Title V Workforce Development in the Era of Health Transformation.

Purpose The National Maternal and Child Health Workforce Development Center at UNC Chapel Hill (the Center), funded by the Maternal and Child Health Bureau, provides Title V state/jurisdiction leaders and staff and partners from other sectors with opportunities to develop skills in quality improvement, systems mapping and analysis, change management, and strategies to enhance access to care to leverage and implement health transformation opportunities to improve the health of women and children. Description Since 2013, the Center has utilized a variety of learning platforms to reach state and jurisdiction Title V leaders. In the intensive training program, new skills and knowledge are applied to a state-driven health transformation project and include distance-based learning opportunities, multi-day, in-person training and/or onsite consultation, as well as individualized coaching to develop workforce skills. Assessment The first intensive cohort of eight states reported enhanced skills in the core areas of quality improvement, systems mapping and analysis, change management, and strategies to enhance access to care which guided changes at state system and policy levels. In addition, teams reported new and/or enhanced partnerships with many sectors, thereby leveraging Title V resources to increase its impact. Conclusion The Center's provision of core workforce skills and application to state-defined goals has enabled states to undertake projects and challenges that not only have a positive impact on population health, but also encourage collaborative, productive partnerships that were once found to be challenging-creating a workforce capable of advancing the health and wellbeing of women and children.

The changing UK paediatric consultant workforce: report from the Royal College of Paediatrics and Child Health

ObjectivesTo determine if there had been changes in the size of the UK paediatric workforce and working patterns between 1999 and 2013.DesignAnalysis of prospectively collected datasets.SettingUK consultant paediatricians.InterventionsData from the...

A Parallel Strategy: Deliberate Inclusion of Trained Traditional Birth Attendants in Maternal and Child Health Workforce of Low-Income Countries

The authors propose an interim parallel strategy for the thoughtful inclusion of trained traditional birth attendants (TTBAs) in the maternal and child health (MCH) human resources of low-resource nations to improve safe childbirth. This is in contrast with international policy recommendations that traditional birth attendants (TBAs) be eliminated and replaced by skilled birth attendants (SBAs). Dimensions for critical awareness that should inform global MCH enterprises are identified and elaborated in support of this proposal: omnipresent women’s status, international nursing and midwifery standards, ethnographic values and strategies, local government roles, culturally specific birthing expectations, and the realities of current MCH human resources infrastructures.

What constitutes ‘support’ for the role of the Aboriginal and Torres Strait Islander child health workforce?

As well as providing primary health care services, Aboriginal and Torres Strait Islander health workers are known to significantly contribute to the overall acceptability, access and use of health services through their role of cultural brokerage in the communities within which they work. As such they are uniquely positioned to positively influence health improvements for this vulnerable population. This study sought to identify key areas that both Aboriginal and Torres Strait Islander and non-Indigenous health professionals working within Indigenous communities felt were important in providing support for their roles. This group of workers require support within their roles particularly in relation to cultural awareness and capability, resource provision, educational opportunities, collaboration with colleagues and peers, and professional mentorship.

Building the analytic capacity of the State Maternal and Child Health workforce--a history of the HRSA/MCHB Academic Partnership.

The Maternal and Child Health Bureau of the Health Resources and Services Administration (HRSA) in conjunction with Schools of Public Health has sponsored a variety of graduate education and continuing education initiatives during the last 15 years aimed at enhancing the analytic capacity of the maternal and child health (MCH) workforce. These initiatives are described, with lessons learned as well as recommendations for future efforts provided.

General pediatrics, neonatology, and the law of diminishing returns.

The growing consensus is that the US physician workforce is too big, growing too fast, and is too highly specialized. These concerns merit attention by pediatric clinicians, researchers, and policymakers. Although differing in their suggested remedies, those proposing to slow the growth of new physicians include diverse organizations and interests—the Association of American Medical Colleges, the Institute of Medicine, the Council of Graduate Medical Education, the American Medical Association, and the Pew Health Professions Commission.1-4 A number of specialty organizations have also called for barriers to international medical graduates and fewer residency positions.5 6 The federal government recently responded with a pivotal change in federal policy. Teaching hospitals will receive transitional funds from Medicare to replace Medicare graduate medical education support if they cut back residency slots by 20% to 25% over a 5-year period.7 8Although the legislation doesn't target pediatric residency programs, it doesn't shield them from cutback decisions made by hospitals. The high costs of health care in the United States has long been the driving force behind the efforts to constrain the physician supply.9 Physicians are unarguably expensive to train and, as the primary decision makers in patient care, expensive in practice. This is especially true for highly-paid specialists using costly technologies. Primary care physicians are usually excluded from the call for downsizing because they are often viewed as the less expensive alternative to specialty care.10 Pediatrics is now assessing its own future role in serving the health care needs of children through the Future of Pediatric Education II Project. This 3-year project, funded by the American Academy of Pediatrics, is particularly interested in pediatric workforce requirements in addition to the content and funding of pediatric education.11 Similarly the American Academy of Family Physicians is reevaluating its position on workforce …