Qualified Health Professionals Research Articles

QUALIDADE DO PARTO E IMPACTO NOS INDICADORES DA SAÚDE DA CRIANÇA

Introdução: A qualidade da assistência do parto indica um importante fator nas taxas de mortalidade infantil, pois os problemas decorrentes deste, quando realizado de forma inadequada, pode ter repercussão sobre o recém-nascido durante os primeiros dias de vida. Objetivo: Avaliar a qualidade da assistência do parto e a correlação com os indicadores de saúde da criança. Método: Trata-se de um estudo quantitativo e avaliativo dos indicadores de morbidade e mortalidade materno e infantil realizado nas Unidades Básicas de Saúde que integram a rede da Atenção Primária à Saúde (APS), do município de Santa Cruz, Rio Grande do Norte, Brasil. Com uma amostra de 200 mulheres mães de crianças menores de dois anos. Resultados: Foram entrevistadas mães com média de idade de 28,17 anos, com bebês com em média 10,42 meses de idade. 95,5% das mães afirmaram ter realizado o acompanhamento pré-natal. A maioria (60,5%) das mulheres classificou a assistência recebida no parto como boa; 74,5 % afirmaram que a criança foi colocada no peito após o parto; 90% dos binômios mãe-bebê estiverem juntos no quarto após o parto. Conclusões: Pode-se perceber que a assistência ao parto acontece de forma adequada e satisfatória, atendendo necessidades da maioria das entrevistadas. Porém ainda há uma necessidade de conscientização e qualificação dos profissionais de saúde, para que não ocorram situações indesejáveis na saúde materno-infantil e diminua as taxas de morbidade e mortalidade materna e neonatal.

Evidence-based public health: concepts, principles and applications to promote physical activity in the Brazilian context

Abstract The aim of this study was to present the Evidence-Based Public Health (EBPH), describing its concept, principles, application, and relate these theoretical elements for the promotion of Physical Activity (PA) in Brazil. A narrative research on EBPH was conducted in books and in the PUBMED database in 2017. EBPH stages comprise aspects widely disseminated in the public health area, which are beginning to be used for the promotion of PA in Brazil. The use of these concepts can improve Evidence-Based Decision Making (EBDM) through various aspects, including greater access to key scientific evidence, communication between those responsible for EBDM and researchers, in addition to investments in qualification of health professionals.

Size, composition and distribution of human resource for health in India: new estimates using National Sample Survey and Registry data.

ObjectivesWe provide new estimates on size, composition and distribution of human resource for health in India and compare with the health workers population ratio as recommended by the WHO. We also estimate size of non-health workers engaged in health sector and the size of technically qualified health professionals who are not a part of the health workforce.DesignNationally representative cross-section household survey and review of published documents by the Central Bureau of Health Intelligence.SettingNational.ParticipantsHead of household/key informant in a sample of 101 724 households.InterventionsNot applicable.Primary and secondary outcome measuresThe primary outcome was the number and density of health workers, and the secondary outcome was the percentage of health workers who are technically qualified and the percentage of individuals technically qualified and not in workforce.ResultsThe total size of health workforce estimated from the National Sample Survey (NSS) data is 3.8 million as of January 2016, which is about 1.2 million less than the total number of health professionals registered with different councils and associations. The density of doctors and nurses and midwives per 10 000 population is 20.6 according to the NSS and 26.7 based on the registry data. Health workforce density in rural India and states in eastern India is lower than the WHO minimum threshold of 22.8 per 10 000 population. More than 80% of doctors and 70% of nurses and midwives are employed in the private sector. Approximately 25% of the currently working health professionals do not have the required qualifications as laid down by professional councils, while 20% of adequately qualified doctors are not in the current workforce.ConclusionsDistribution and qualification of health professionals are serious problems in India when compared with the overall size of the health workers. Policy should focus on enhancing the quality of health workers and mainstreaming professionally qualified persons into the health workforce.

Adult family carers’ perceptions of their educational needs when providing end-of-life care: a systematic review of qualitative research

Background: There is an increasing emphasis on the importance of the palliative and end-of-life care being provided in the community. Key to the success of this is the availability of information and educational support to facilitate carers in their role. The aim of the paper is to explore the educational needs of adult carers providing physical and other care to people at the end of life Methods: A qualitative evidence synthesis was conducted using meta-ethnography. Five electronic databases were searched to January 2014, combining terms for: cancer, chronic obstructive pulmonary disease, neurodegenerative conditions, renal disease, heart failure and dementia, with terms for carers and education. Results: A total of 35 papers were included in the review, reporting the experiences of over 900 carers. Throughout the illness trajectory carers were either enabled or hindered in their role by the nature and way information and education were provided. Enabling factors included: a sense of trust in health professionals; timely and accurate information delivered compassionately; access to professionals for information and support particularly during out-of-hours. Where carers experienced a lack of information or support this added to the strain of caring. Carers then felt the need to take on a more active role, acting both as an advocate and decision maker. Conclusions: Carers express information and educational needs throughout the illness trajectory. The quality of health professionals’ communication with carers was fundamental in ensuring carers felt confident and supported. Timely access to information and support from appropriately qualified health professionals should be made available to carers, including the out-of-hours period.

‘12 tips for teaching environmental sustainability to health professionals’

Background: As recognition of the health impacts of climate change and other environmental challenges increases, so too does the need for health care professionals to practice healthcare sustainably. Environmental sustainability in healthcare extends beyond our traditional understanding of environmental health, which is often limited to environmental hazards and disease. Health services, professional organizations, and training institutions are increasingly forming climate and sustainability position statements and policies accordingly. To prepare future health professionals for global environmental change, environmental sustainability must be meaningfully integrated into health curricula. Aim: To provide educators with 12 tips for integrating environmental sustainability into health professional education. Methods: The authors reviewed the literature relating to climate change, environmental sustainability and health, and health professional education. By combining findings from this search with reflections on their own experience in clinical and public health teaching across nursing and midwifery, paramedicine, medicine, and public health, the authors developed recommendations for integrating environmental sustainability into health professional education. Results: These 12 tips can be used to teach students and qualified health professionals in nursing, allied health, and medicine to practice healthcare in an environmentally sustainable manner. Conclusions: Empowering health professionals to practice environmentally sustainable healthcare has economic, social, health, and environmental benefits. Teaching environmental sustainability to health professionals enhances existing learning by updating curricula with the latest evidence of how environmental determinants of health are rapidly changing and enables both educators and students to make an important contribution to safeguarding human health, the environment, and healthcare for future generations.

An innovative, integrated, and community based MBBS Curriculum: a humanistic and holistic approach for Karnali Academy of Health Sciences

Background: With the mission of providing easy and accessible health services/facilities for the people of backward areas by producing qualified and skillful health professionals, Karnali Academy of Health Sciences (KAHS) has been established in 2011, by an Act of parliament of Nepal. In the way of fulfilling its mission, PCL nursing program (2014), PCL in General Medicine (2015), Bachelor in Public Health (2018) and Bachelor in Midwifery Sciences (2018) programs have already started successfully; and next goal of our Academy is to start MDGP and MBBS in near future. In this context of its academic progress, KAHS is developing an ideal MBBS curriculum by introducing the recent innovation in the field of medical education. 
 Method: This was the cross-sectional study conducting among 100 public, 50 medical students and 20 professors and faculties of TU, KU, PAHS and BPKIHS from June, 2018 to November, 2018. The data were collected with the help of three different set of semi-structured questionnaires. Moreover, we had gone through the MBBS curriculum of 10 Universities/Academy, and the data regarding the type of curricular strategies, credit hours and course contents of individual subject, academic calendar, schedule of community posting, and evaluation pattern were collect in the performa. The collected data were analyzed and presented in the tables.
 Result: Present study found that out of 100 participants, almost all of the participants felt the need of one medical college and a well facilitated hospital in Karnali Province, especially in Jumla, with the qualified, skillful, patient-friendly medical doctors as well as other health professionals. After interviewed with the professors and faculties of various universities, we found that the integrated, community based and student centered curriculum had better level of understanding than the discipline based, teacher-centered MBBS curriculum. Out of the four prevailing MBBS curricula (TU, KU, PAHS and BPKIHS) in Nepal, all curricula incorporated the horizontal integration approach in basic sciences with early pre-clinical exposure and community posting. In addition to this, integrated MBBS curriculum of PAHS was fully problem-based, and community based.
 Conclusion: Integrated, student-centered, community based, problem based as well as problem oriented innovative teaching-learning method outweigh the contemporary teacher-centered hospital-based learning in medical education. So, we would like to recommend the development of integrated MBBS curriculum based on the organ system for the proper implementation recent innovation of medical education.

Reflections on Health Workforce Development Comment on "Health Professional Training and Capacity Strengthening Through International Academic Partnerships: The First Five Years of the Human Resources for Health Program in Rwanda"

This commentary addresses the statement that "the authors believe that the HRH [Human Resources for Health] Program can serve as a model for other initiatives that seek to address the shortage of qualified health professionals in low-income countries and strengthen the long-term capacity of local academic institutions." I adopt the position of the devil’s advocate and ask whether a country, with a profile comparable to Rwanda’s, should adopt this twinning model. I suggest that the alignment with population and other capacity development needs should be the main criteria of decision.

Harnessing technology to deliver care by physical therapists for people with persistent joint pain: Telephone and video‐conferencing service models

AbstractPurposeThe burden of musculoskeletal conditions, particularly osteoarthritis (OA), is expected to increase in coming decades as the world's population ages, and obesity rates continue to rise. Self‐management via lifestyle interventions, such as exercise and physical activity, is integral to minimizing pain and maintaining physical function, yet access to qualified health professionals for evidence‐based advice and support is difficult for many people. This article discusses how technology provides new opportunities for delivering physiotherapy services remotely to people with persistent joint pain, through telephone, and internet‐mediated video conferencing.MethodsThe evidence for effectiveness of such service models is reviewed. Key challenges to implementation are discussed, and future directions for research in the field are highlighted.ResultsThere is emerging evidence that the provision of care via telephone and internet‐mediated video technologies is effective for, and acceptable to, people with OA. Advantages include its convenience and accessibility, as well as the “hands‐off” nature of consultations. Challenges include patient safety and privacy and workforce willingness and capacity to deliver care via non‐traditional methods.ConclusionsUsing technology to deliver physiotherapy services to people with OA is feasible and acceptable to users; however, further research is required to expand the evidence‐base for remotely‐delivered physiotherapy service models.

Twenty-first century emergency response efforts of the Commissioned Corps of the US Public Health Service.

The impact of the Commissioned Corps of the US Public Health Service (Commissioned Corps) on the health and safety of the nation spans more than two centuries. The public health efforts of the highly qualified health professionals of this often-underreported uniformed service include fighting threats like the great flu pandemic of 1918, the anthrax attacks, Ebola, and natural disasters such as Hurricanes Maria, Irma, and Katrina. As we near the first quarter of the twenty-first century, it is important to take a snapshot of the critical contributions and response efforts the Commissioned Corps has made in the first 18 years of the twenty-first century. Today, the Commissioned Corps faces new challenges in the form of emerging diseases and a rapidly growing opioid epidemic, but under the guidance of the US Surgeon General, it remains vigilant and fully capable of minimizing any public health threat it encounters.

The role of national culture in shaping health workforce collaboration: Lessons learned from a case study on attitudes to interprofessional education in Malta

The World Health Organisation identifies interprofessional education (IPE) as a key element for preparing a collaborative workforce. However, global implementation remains challenging due to individual, professional and organisational barriers. A qualitative case study explored the concept of introducing an undergraduate IPE programme at the Faculty of Health Sciences, University of Malta. A combination of in-depth interviews and focus groups were conducted with a sample of sixty-four academics,health and education policy makers and newly qualified health professionals. The findings suggest that while participants support the notion of IPE, they identify multiple barriers that would challenge implementation. This includes particular cultural norms and values which participants perceived would conflict with IPE. These findings were interpreted through Hofstede’s theory of cultural dimensions as a means of theorising about the role that culture could play in implementing such an approach. This study contributes to the health policy debate by highlighting the potential impact of national culture in the planning, development and delivery of collaborative initiatives. It also highlights new insights for European small states and other countries by providing a lens through which culture needs to be taken into account in the transfer of innovation across health systems.

Teaching Principles of Deceased Organ Donation through a Massive Open Online Course - It’s Place in the World

Introduction In developing countries there are few transplant programs and insufficient resources to help educate the doctors who are relied upon to identify, refer, and manage donors while communicating with a grieving family. Online education platforms offer a method of teaching medical professionals and the public on a large scale about deceased organ donation best practices. Methods A 4 week curriculum was constructed with a multiple choice assessment at the end of each week. Content was delivered each week through a series of short videos each between 3 - 10 minutes Reinforcement of learning points was made through regular practice quizzes which gave feedback on all answers. An honours track was added with peer reviewed assignments on “How to break bad news” and “How to improve your local organ donation system”. The course was aimed at medical undergraduates completing their final years of training and qualified health professionals looking to learn more about deceased donation. The course was made available on the Coursera platform (https://www.coursera.org/learn/organ-donation) with a new course running every 4 weeks. Participants earn a course completion certificate by passing all graded assessments and either paying a fee or by applying for financial aid to have the fee waived. Discussion forums were moderated by transplant coordinators and the lead academic.Data were analysed over a 4 month period from July to November 2017 reviewing the demographics, location, gender, age, education and employment status of the course participants as well as the sign up and completion rate and course rating. Results and Discussion A total of 53 videos, 13 practice quizzes and 4 graded quizzes were created together with 2 peer reviewed assignments. A total of 1537 people viewed the welcome page with 563 signing up for the course. The largest number of participants came from the United States with 21%, followed by South Africa 14%, India 9.5% and Egypt 5.2%. There was an equal distribution between men and women with 74.4% being younger than 34 years of age.Over half (53%) of participants were not formally studying and 21% of participants were unemployed at the time of completing the coursConclusion Organ donor education projects using massive open online learning platforms offer an effective means to reach a potentially large audience. This course focused on the science behind organ donation, the ethics and the practicalities of the process with an acceptable completion rate. Marketing support is required. Fiona McCurdie. Maryn Reyneke. Luke Steenkamp. Louise Human. Ivan Joubert. Nawaal Deane. Rondine Carstens. Janet Small.

Diet 3.0: practical issues in everyday life

Internet and the new technologies have changed the way of obtaining information of all kinds; also, information related to food and health. The sources of information and content generators have multiplied Doctors followed by other health professionals are the professional's citizens trust most to consults their doubts regarding health, food and nutrition, but the internet and social networks are increasingly used. The information on food, nutrition and health available on the net comes from very different sources and areas; from scientific journals, academic institutions, health organizations, scientific societies, professional, consumer or other kind of associations, companies from an array of sector who offer information and sell their products, or individuals with different profiles, who may or may not be qualified and present personal opinions, either independent or interested. The fact that when searching the internet for health issues citizens can access together with contrasted sources, other sites which publish information of uncertain quality has worried competent bodies and health professionals. A number of initiatives have been promoted to develop systems that allow the identification of websites that offer trusted quality health content, useful for patients and consumers. It is necessary that qualified health professionals contribute to the dissemination of quality information, easy to understand, in the internet and facilitate access to reliable information sources through directories. Citizens-active patients- active consumers need trusted information a reach in order to adopt informed decisions related to food consumption, own care or that of their families as well as to be able to participate in community actions.

Spatial accessibility of primary health care in China: A case study in Sichuan Province

Access to primary health care is considered a fundamental right and an important facilitator of overall population health. Township health centers (THCs) and Community health centers (CHCs) serve as central hubs of China's primary health care system and have been emphasized during recent health care reforms. Accessibility of these hubs is poorly understood and a better understanding of the current situation is essential for proper decision making. This study assesses spatial access to health care provided by primary health care institutions (THCs/CHCs) in Sichuan Province as a microcosm in China. The Nearest-Neighbor method, Enhanced Two-Step Floating Catchment Area (E2SFCA) method, and Gini Coefficient are utilized to represent travel impedance, spatial accessibility, and disparity of primary health care resources (hospital beds, doctors, and health professionals). Accessibilities and Gini Coefficients are correlated with social development indexes (GDP, ethnicity, etc.) to identify influencing factors. Spatial access to primary health care is better in southeastern Sichuan compared to northwestern Sichuan in terms of shorter travel time, higher spatial accessibility, and lower inequity. Social development indexes all showed significant correlation with county averaged spatial accessibilities/Gini Coefficients, with population density ranking top. The disparity of access to primary health care is also apparent between ethnic minority and non-minority regions. To improve spatial access to primary health care and narrow the inequity, more township health centers staffed by qualified health professionals are recommended for northwestern Sichuan. Improved road networks will also help. Among areas with insufficient primary health care, the specific counties where demographics are dominated by older people and children due to widespread rural-urban migration of the workforce, and by ethnic minorities, should be especially emphasized in future planning.

Análise da formação pedagógica Lato Sensu em Direito Sanitário da Escola Fiocruz de Governo - Fiocruz Brasília

Objetivo: O artigo analisou a formação pedagógica da especialização em Direito Sanitário da Escola de Governo em Saúde - Fiocruz Brasília, no período de 2006-2015. Metodologia: A pesquisa consistiu em um estudo analítico-descritivo, de caráter quali-quantitativo, baseado em pesquisa documental secundária. Foram analisados os relatórios acadêmicos e o questionário de avaliação pedagógica, realizada com os egressos. Resultados: As análises evidenciaram que houve crescimento pela procura de vagas nos processos seletivos, assim como a participação de egressos oriundos da área tanto do Direito como da Saúde. Conclusão: A implantação do curso se deu de forma exitosa, e que a especialização oferece relevantes contribuições para a qualificação de profissionais da área da saúde e demais interessadas.

KNOWLEDGE, ATTITUDES AND PRACTICES OF HEALTH PROFESSIONALS TOWARDS ANTIBIOTIC USE IN PREGNANCY: A CROSS-SECTIONAL SURVEY

ABSTRACTOBJECTIVES:To evaluate the knowledge, attitudes and practices of health professionals (HPs) towards the use of antibiotic in pregnancy.To compare the knowledge, attitudes and practices of HPs towards the use of antibiotic in pregnancy on the basis of their area of practice and qualification.METHODS: This cross-sectional study was performed at district Faisalabad of Pakistan. Out of 250 HPs approached, 210 HPs responded and filled the questionnaire. Data after collection was divided and analyzed on the basis of three categories: (i) based on overall response of the HPs (ii) based on area of practice of the HPs (urban & rural) and (iii) based on qualification of the HPs (consultants, postgraduate trainees, general practitioners & paramedics). RESULTS: HPs having sound knowledge regarding antibiotic use in pregnancy were 88% in urban and 58.5% in rural areas. Attitude was good in 83.5% urban and 67.8% of rural HPs. Practices of HPs were good in 71% of urban and 48.1% of rural areas. Results of the comparison based on the qualification of HPs were as follows; 99% consultants, 91.4% post graduate trainees, 87.6% general practitioners and 46.6% paramedics were good in knowledge; 94.2% consultants, 86.8% post graduate trainees, 87.9% general practitioners and 57.7% paramedics were found to be good in attitudes; 83.1% consultants, 71% post graduate trainees, 61% general practitioners and 29.6% paramedics were good in practices. CONCLUSION: Health professionals practicing in urban areas and more qualified HPs (consultants) were much better in knowledge, attitudes and practices of prescribing antibiotics in pregnancy.KEYWORDS: Pregnancy (MeSH); Antibiotic (MeSH); Knowledge (MeSH); Attitude (MeSH); Fetus (MeSH)

Knowledge, attitude, and behaviors of health professionals towards smoking cessation in primary healthcare settings.

This study aimed to assess the behaviors of multiple health professionals in primary healthcare settings in Jordan towards smoking cessation counseling and to determine the barriers to effective smoking cessation behaviors. A survey of 456 health professionals in primary healthcare settings was conducted. A self-administrated questionnaire was used to collect the data. About half of health professionals reported that they usually ask patients about smoking status and advise them to stop smoking (51.4% and 50.5%, respectively). Only 23.7% reported assessing the willingness of the patients to quit smoking and 17.9% reported discussing counseling options with smokers. Considerably fewer percentages of health professionals reported preparing their patients for withdrawal symptoms (6.0%), discussing pharmacotherapies (3.8%), and prescribing nicotine patches (6.4%). Key barriers to smoking cessation counseling, as reported by health professionals, included: insufficient resources and organizational support, limited coverage of cessation interventions, and lack of motivation to quit. Smoking cessation counseling was not routinely implemented by Jordanian health professionals. Barriers to effective delivery of smoking cessation counseling need to be integrated within relevant strategies aiming at enhancing the frequency and quality of health professionals' engagement in smoking cessation.

A mobile health technology platform for quality assurance and quality improvement of malaria diagnosis by community health workers.

BackgroundCommunity health workers (CHWs) play an important role in improving access to services in areas with limited health infrastructure or workforce. Supervision of CHWs by qualified health professionals is the main link between this lay workforce and the formal health system. The quality of services provided by lay health workers is dependent on adequate supportive supervision. It is however one of the weakest links in CHW programs due to logistical and resource constraints, especially in large scale programs. Interventions such as point of care testing using malaria rapid diagnostic tests (RDTs) require real time monitoring to ensure diagnostic accuracy. In this study, we evaluated the utility of a mobile health technology platform to remotely monitor malaria RDT (mRDT) testing by CHWs for quality improvement.MethodsAs part of a large implementation trial involving mRDT testing by CHWs, we introduced the Fionet system composed of a mobile device (Deki Reader, DR) to assist in processing and automated interpretation of mRDTs, which connects to a cloud-based database which captures reports from the field in real time, displaying results in a custom dashboard of key performance indicators. A random sample of 100 CHWs were trained and provided with the Deki Readers and instructed to use it on 10 successive patients. The CHWs interpretation was compared with the Deki Reader’s automatic interpretation, with the errors in processing and interpreting the RDTs recorded. After the CHW entered their interpretation on the DR, the DR provided immediate, automated feedback and interpretation based on its reading of the same cassette. The study team monitored the CHW performance remotely and provided additional support.ResultsA total of 1251 primary and 113 repeat tests were performed by the 97 CHWs who used the DR. 91.6% of the tests had agreement between the DR and the CHWs. There were 61 (4.9%) processing and 52 (4.2%) interpretation errors among the primary tests. There was a tendency towards lower odds of errors with increasing number and frequency of tests, though not statistically significant. Of the 62 tests that were repeated due to errors, 79% achieved concordance between the CHW and the DR. Satisfaction with the use of the DR by the CHWs was high.ConclusionsUse of innovative mHealth strategies for monitoring and quality control can ensure quality within a large scale implementation of community level testing by lay health workers.

Critical Care Medicine: Bangladesh Perspective.

Bangladesh became an independent and sovereign country in 1971 following a nine-month blood shedding liberation war. Bangladesh has a population of about 152.25 million, making it one of the most populous countries in the world. Intensive care is an emerging but less emphasized concept in Bangladesh. The first intensive care unit (ICU) in Bangladesh was established in the National Institute of Cardiovascular Diseases (NICVD) in 1980. Since then many ICUs have been established. In Bangladesh there is no governing body like Bangladesh Medical and Dental Council (BMDC) that can set the standard of such units. There are no reliable statistics regarding the number of both governmental and private ICUs, bed capacities, no. of patients getting admitted per month, services offered, equipment, qualification of health professionals, cost/benefits and mortality rates of these ICUs.

For a public policy of surveillance of suicidal behavior.

The object is to reflect on the need for effective implementation of a surveillance program of suicidal behavior and of the causal and intervening factors of suicide, as well as to training and qualification of health professionals about this topic, and the profile of the individual with suicidal behavior. Suicidal behavior is public health serious, global problem and it should be faced in a consensual way by public administrators, professionals and population. Suicide is a real, current catastrophe and a kind of death that can be avoided.

Human resources for health in Peru: recent trends (2007\u20132013) in the labour market for physicians, nurses and midwives

BackgroundMost analyses of gaps in human resources for health (HRH) do not consider training and the transition of graduates into the labour market. This study aims to explore the labour market for Peru’s recent medical, nursing, and midwifery graduates as well as their transition into employment in the Ministry of Health’s (MOH) system.MethodsData from four different datasets, covering 2007–2013, was used to characterize the patterns of recently trained physicians, nurses, midwives, and postgraduate-trained physicians that enter employment in the MOH system, and scenario analyses were used to describe how this rate of entry needs to adapt in order to fill current HRH shortages.ResultsHRH graduates have been increasing from 2007 to 2011, but the proportions that enter employment in the MOH system 2 years later range from 8 to 45% and less than 10% of newly trained medical specialists. Scenario analyses indicate that the gap for physicians and nurses will be met in 2027 and 2024, respectively, while midwives in 2017. However, if the number of HRH graduates entering the MOH system doubles, these gaps could be filled as early as 2020 for physicians and 2019 for nurses. In this latter scenario, the MOH system would still only utilize 56% of newly qualified physicians, 74% of nurses, and 66% of midwives available in the labour market.ConclusionAt 2013 training rates, Peru has the number of physicians, nurses, and midwives it needs to address HRH shortages and meet estimated HRH gaps in the national MOH system during the next decade. However, a significant number of newly qualified health professionals do not work for the MOH system within 2 years of graduation. These analyses highlight the importance of building adequate incentive structures to improve the entry and retention of HRH into the public sector.