Publication: The Nurse Workforce in the Eastern Caribbean: Meeting the Challenges of Noncommunicable Diseases
Loading...
Files in English
981 downloads
Date
2016-06-07
ISSN
Published
2016-06-07
Author(s)
Fuller-Wimbush, Danielle
Editor(s)
Abstract
The health workforce must be able to cope with shifts in the pattern of causes of death and disease that are being seen worldwide—particularly with the rise in noncommunicable diseases (NCDs). This requires health personnel to have a set of skills and competencies that can adapt to meet the population’s growing and changing health needs. This report examines the status of the nurse workforce in the Eastern Caribbean, assessing how best to strengthen its capacity to respond to the growing burden of NCDs. The report is based on four Eastern Caribbean case studies conducted in Dominica, Grenada, St. Lucia, and St. Vincent and the Grenadines. The case studies showed that, although overall nurse staffing levels seem to be sufficient across the four countries in terms of numbers, there are nurse shortages at hospitals and health clinics, as well as in the availability of specialists. Better management of the nurse workforce is needed to ensure adequate coverage at the hospitals and clinics is maintained. In terms of specialists, while the quality of education is generally reported to be good, there are barriers to accessing specialized training which include the high-cost of seeking specialized training due to non-existing or very limited local options and the lack of built-in incentives for completing additional education. To help address the capacity constraints faced by the nurse workforce in the Eastern Caribbean to respond to NCDs, the report generated knowledge in support of two critical areas: (i) provide an understanding of the educational and training opportunities available to nurses to strengthen their capacity to meet the NCD challenges, and (ii) assess whether there is a supportive policy environment in place for nurses to play a role in addressing NCDs. As part of the study, a toolkit was developed, which can be used to strengthen the capacity for HRH planning and management with respect to NCDs.
Link to Data Set
Citation
“Fuller-Wimbush, Danielle; Carpio, Carmen. 2016. The Nurse Workforce in the Eastern Caribbean: Meeting the Challenges of Noncommunicable Diseases. Directions in Development--Human Development;. © World Bank. http://hdl.handle.net/10986/24452 License: CC BY 3.0 IGO.”
Associated URLs
Associated content
Other publications in this report series
Publication Democratic Republic of Congo Urbanization Review(Washington, DC: World Bank, 2018)The Democratic Republic of Congo has the third largest urban population in sub-Saharan Africa (estimated at 43% in 2016) after South Africa and Nigeria. It is expected to grow at a rate of 4.1% per year, which corresponds to an additional 1 million residents moving to cities every year. If this trend continues, the urban population could double in just 15 years. Thus, with a population of 12 million and a growth rate of 5.1% per year, Kinshasa is poised to become the most populous city in Africa by 2030. Such strong urban growth comes with two main challenges – the need to make cities livable and inclusive by meeting the high demand for social services, infrastructure, education, health, and other basic services; and the need to make cities more productive by addressing the lack of concentrated economic activity. The Urbanization Review of the Democratic Republic of Congo argues that the country is urbanizing at different rates and identifies five regions (East, South, Central, West and Congo Basin) that present specific challenges and opportunities. The Urbanization Review proposes policy options based on three sets of instruments, known as the three 'I's – Institutions, Infrastructures and Interventions – to help each region respond to its specific needs while reaping the benefits of economic agglomeration The Democratic Republic of the Congo is at a crossroads. The recent decline in commodity prices could constitute an opportunity for the country to diversify its economy and invest in the manufacturing sector. Now is an opportune time for Congolese decision-makers to invest in cities that can lead the country's structural transformation and facilitate greater integration with African and global markets. Such action would position the country well on the path to emergence.Publication Entrepreneurship Education and Training Programs around the World : Dimensions for Success(Washington, DC: World Bank, 2014-04-23)Entrepreneurship has attracted global interest for its potential to catalyze economic and social development. Research suggesting that certain entrepreneurial mindsets and skills can be learned has given rise to the field of entrepreneurship education and training (EET). Despite the growth of EET, global knowledge about these programs and their impact remains thin. In response, this study surveys the available literature and program evaluations to propose a Conceptual Framework for understanding the EET program landscape. The study finds that EET today consists of a heterogeneous mix of programs that can be broken into two groups: entrepreneurship education and entrepreneurship training. These programs target a range of participants: secondary and post-secondary education students, as well as potential and practicing entrepreneurs. The outcomes measured by program evaluations are equally diverse but generally fall under the domains of entrepreneurial mindsets and capabilities, entrepreneurial status, and entrepreneurial performance. The dimensions of EET programs vary according the particular target group. Programs targeting secondary education students focus on the development of foundational skills linked to entrepreneurship, while post-secondary education programs emphasize skills related to strategic business planning. Programs targeting potential entrepreneurs generally are embedded within broader support programs and tend to target vulnerable populations for whom employment alternatives may be limited. While programs serving practicing entrepreneurs focus on strengthening entrepreneurs’ knowledge, skills and business practices, which while unlikely to transform an enterprise in the near term, may accrue benefits to entrepreneurs over time. The study also offers implications for policy and program implementation, emphasizing the importance of clarity about target groups and desired outcomes when making program choices, and sound understanding of extent to which publicly-supported programs offer a broader public good, and compare favorably to policy alternatives for supporting the targeted individuals as well as the overall economic and social objectives.Publication At a Crossroads(World Bank, Washington, DC, 2017-05-02)Higher education (HE) has expanded dramatically in Latin America and the Caribbean (LAC) since 2000. While access became more equitable, quality concerns remain. This volume studies the expansion, as well as HE quality, variety and equity in LAC. It investigates the expansion’s demand and supply drivers, and outlines policy implications.Publication Options for Aged Care in China(Washington, DC: World Bank, 2018-11-20)China is aging at an unprecedented rate. Improvements in life expectancy and the consequences of the decades-old family planning policy have led to a rapid increase in the elderly population. According to the United Nations World Population Prospects, the proportion of older people age 65 and over will increase by about one-fourth by 2030, and the elderly will account for about one quarter of the total population by 2050. Population aging will not only pose challenges for elder care but also have an impact on the economy and all aspects of society (World Bank, 2016a). The government is aware of the need to develop an efficient and sustainable approach to aged care. To this end, the General Office of the State Council issued the 12th Five-Year Plan for the Development of Aged Care Services in China and the Development Plan for a System of Social Services for the Aged (2011-2015). It is now in the process of formulating the 13th Five-Year National Plan on Aging, which will further elaborate and finalize the reform roadmap for 2016 to 2020. The Plan is expected to be finalized and launched by June 2016. The National Development and Reform Commission (NDRC) helped draft these plans and is now leading the development of policy measures for the provision of social services for the elderly. This volume has been prepared to support the translation of the broad ideas on aged care provision expressed in the 12th and 13th Five-Year Plans and other government plans into reality and to help the government tackle the challenges described above. It strives to identify a policy framework that fits the Chinese context and can be put in place gradually. Specifically, it aims to provide an up-to-date understanding of the evolving aged care landscape in China; review international experiences in long-term care provision, financing, and quality assurance and assess their relevance to China’s current situation; discuss implications of current developments and trends for the future of aged care in China; and propose policy options based on available evidence and best practices.Publication An Investment Framework for Nutrition(Washington, DC: World Bank, 2017-04-12)The report estimates the costs, impacts and financing scenarios to achieve the World Health Assembly global nutrition targets for stunting, anemia in women, exclusive breastfeeding and the scaling up of the treatment of severe wasting among young children. To reach these four targets, the world needs $70 billion over 10 years to invest in high-impact nutrition-specific interventions. This investment would have enormous benefits: 65 million cases of stunting and 265 million cases of anemia in women would be prevented in 2025 as compared with the 2015 baseline. In addition, at least 91 million more children would be treated for severe wasting and 105 million additional babies would be exclusively breastfed during the first six months of life over 10 years. Altogether, achieving these targets would avert at least 3.7 million child deaths. Every dollar invested in this package of interventions would yield between $4 and $35 in economic returns, making investing in early nutrition one of the best value-for-money development actions. Although some of the targets—especially those for reducing stunting in children and anemia in women—are ambitious and will require concerted efforts in financing, scale-up, and sustained commitment, recent experience from several countries suggests that meeting these targets is feasible. These investments in the critical 1000 day window of early childhood are inalienable and portable and will pay lifelong dividends – not only for children directly affected but also for us all in the form of more robust societies – that will drive future economies.
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication Towards a Regional Strategy to Strengthen the Nurse Workforce of the English-speaking CARICOM : International Legal Instruments, Agreements and Obligations(World Bank, Washington, DC, 2012-01)The supply of nurses in the English-Speaking Caribbean is insufficient to meet the demand with growing shortages fuelled by the health needs of a rapidly aging population and tremendous losses of human capital occurring at multiple points in the markets. In defining the scope of commitments of a regional legal agreement, English-Speaking Caribbean Community (ES CARICOM) states will have to ascertain whether states would commit to actions to strengthen the nurse workforce or the health workforce more broadly. While the challenges of strengthening the nurse workforce have been systematically assessed, information about other groups of health professionals remains patchy. In 2008, at the request of the Ministers of Health, the World Bank initiated a stream of work to strengthen the nurse workforce in the English-speaking Caribbean. The study estimated the stock of nurses in the ES CARICOM at approximately 7,800 in 2007 with growing shortages under existing policies at 3,400 in 2007 increasing to 10,700 nurses in 2025 due to the health needs of a rapidly aging population. There are two types of international legal instruments: legally binding instruments or treaties; and non-legally binding instruments.Publication The Health Workforce in Latin America and the Caribbean(Washington, DC: World Bank, 2015-06-04)This report provides a status update on the human resources for health (HRH) sub-system in six Latin American and Caribbean countries: Colombia, Costa Rica, Jamaica, Panama, Peru, and Uruguay. The report structures its discussion around how the health workforce is financed, organized, managed, regulated, and performing. In the area of financing, the study presents the variety of contracting mechanisms, salary levels, and financial incentives offered across the countries and their role in being able to attract and retain health workers. On the organization of the HRH sub-system, the report looks at the skill-mix, training, and distribution of health care workers concluding that although the countries have made progress towards achieving key HRH targets and in making education more accessible, there continues to be limited absorption capacity for graduates, the Primary Health Care focus of training programs needs to be strengthened, and strategies to encourage rural service have not been able to fully address the gap in the distribution of health workers. In reviewing management strategies for HRH, the report presents how all countries have adopted the WHO Global Code of Practice on the International Recruitment of Health Personnel to recognize foreign-trained professionals to help address shortages and fill gaps of health worker presence in rural, remote areas. However, the countries continue to struggle with putting self-sufficiency policies in place to meet HRH needs such as the lack of promotion plans, limited non-monetary incentives, and the shortage of personnel for recruitment and eventual placement. In the area of regulation, the report presents the countries’ efforts to reduce precarious employment and introduce HRH safety policies and legislation to regulate disputes and negotiations. On performance, the report found mixed results in the areas of access/availability to health workers and quality of care, factors discouraging dual practice, and unjustified absenteeism of health workers.Publication New Insights into the Provision of Health Services in Indonesia : A Health Workforce Study(World Bank, 2010)Indonesia has made improving the access to health workers, especially in rural areas, and improving the quality of health provider's key priority areas of its next five-year development plan. Significant steps and policy changes were taken to improve the distribution of the health workforce, in particular the contracted doctors program and later the contracted midwives program, but few studies have been undertaken to measure the actual impact of these policies and programs. This book is part of the inputs prepared at the request of the government of Indonesia's national development agency, Bappenas, to inform the development of the next national development plan 2010-14. Other inputs include reports on health financing, fiscal space for health, health public expenditure review, and assessments of maternal health and pharmaceuticals. Study findings highlight the importance not only of improving the supply of health care, but also of improving quality, so as to improve health outcomes. Over the period studied, important gains in the determinants of health outcomes have occurred in Indonesia. At the same time, however, the study shows that Indonesia, despite the significant gains, continues to suffer from serious challenges in the number and distribution, and in particular the quality, of its health workers.Publication Indonesia's Doctors, Midwives and Nurses : Current Stock, Increasing Needs, Future Challenges and Options(World Bank, 2009)This paper is one of several inputs prepared for a comprehensive Health Sector Review that the Government of Indonesia is currently conducting. It compiles, analyzes and interprets available information on Indonesia's health service providers; doctors, midwives and nurses. Within the limitations imposed by questions about the accuracy and timeliness of current workforce data, the paper describes the stock and distribution of health workers. The paper draws attention to weaknesses in the workforce planning methods in use, and then reviews the human resource policies, including governance structures and the regulatory framework, that affect health workers. It concludes by describing future challenges and some suggested ways of addressing these challenges. In brief, this paper identifies a number of main challenges in the health workforce in Indonesia. These are: (i) there is a shortage and inequitable distribution of medical doctors and specialists; (ii) the education of health professionals is of poor quality and the accreditation and certification system is weak; (iii) health workforce policy development and planning are not based on evidence or demand, but rather on standard norms that do not reflect real need or take into account the contribution of the private health sector; nor have they adapted to a decentralized paradigm, and finally; (iv) the growing and changing demand for health care due to demographic and epidemiological changes will increase the burden on the already ineffective health system. The final section of this paper makes nine suggestions designed to address these main challenges.Publication World Bank-Financed HIV Projects in the Caribbean(World Bank, Washington, DC, 2010-10)This paper summarizes the key findings of an 'After Action Review' (AAR) that reflects a decade of experience in designing and implementing ten HIV/AIDS projects in the Caribbean, financed by the World Bank. The objective is to identify what worked (and what didn't) in the project approach, design and implementation, distilling useful lessons for other projects in small states.
Users also downloaded
Showing related downloaded files
Publication Business Ready 2024(Washington, DC: World Bank, 2024-10-03)Business Ready (B-READY) is a new World Bank Group corporate flagship report that evaluates the business and investment climate worldwide. It replaces and improves upon the Doing Business project. B-READY provides a comprehensive data set and description of the factors that strengthen the private sector, not only by advancing the interests of individual firms but also by elevating the interests of workers, consumers, potential new enterprises, and the natural environment. This 2024 report introduces a new analytical framework that benchmarks economies based on three pillars: Regulatory Framework, Public Services, and Operational Efficiency. The analysis centers on 10 topics essential for private sector development that correspond to various stages of the life cycle of a firm. The report also offers insights into three cross-cutting themes that are relevant for modern economies: digital adoption, environmental sustainability, and gender. B-READY draws on a robust data collection process that includes specially tailored expert questionnaires and firm-level surveys. The 2024 report, which covers 50 economies, serves as the first in a series that will expand in geographical coverage and refine its methodology over time, supporting reform advocacy, policy guidance, and further analysis and research.Publication Global Economic Prospects, January 2025(Washington, DC: World Bank, 2025-01-16)Global growth is expected to hold steady at 2.7 percent in 2025-26. However, the global economy appears to be settling at a low growth rate that will be insufficient to foster sustained economic development—with the possibility of further headwinds from heightened policy uncertainty and adverse trade policy shifts, geopolitical tensions, persistent inflation, and climate-related natural disasters. Against this backdrop, emerging market and developing economies are set to enter the second quarter of the twenty-first century with per capita incomes on a trajectory that implies substantially slower catch-up toward advanced-economy living standards than they previously experienced. Without course corrections, most low-income countries are unlikely to graduate to middle-income status by the middle of the century. Policy action at both global and national levels is needed to foster a more favorable external environment, enhance macroeconomic stability, reduce structural constraints, address the effects of climate change, and thus accelerate long-term growth and development.Publication Digital Progress and Trends Report 2023(Washington, DC: World Bank, 2024-03-05)Digitalization is the transformational opportunity of our time. The digital sector has become a powerhouse of innovation, economic growth, and job creation. Value added in the IT services sector grew at 8 percent annually during 2000–22, nearly twice as fast as the global economy. Employment growth in IT services reached 7 percent annually, six times higher than total employment growth. The diffusion and adoption of digital technologies are just as critical as their invention. Digital uptake has accelerated since the COVID-19 pandemic, with 1.5 billion new internet users added from 2018 to 2022. The share of firms investing in digital solutions around the world has more than doubled from 2020 to 2022. Low-income countries, vulnerable populations, and small firms, however, have been falling behind, while transformative digital innovations such as artificial intelligence (AI) have been accelerating in higher-income countries. Although more than 90 percent of the population in high-income countries was online in 2022, only one in four people in low-income countries used the internet, and the speed of their connection was typically only a small fraction of that in wealthier countries. As businesses in technologically advanced countries integrate generative AI into their products and services, less than half of the businesses in many low- and middle-income countries have an internet connection. The growing digital divide is exacerbating the poverty and productivity gaps between richer and poorer economies. The Digital Progress and Trends Report series will track global digitalization progress and highlight policy trends, debates, and implications for low- and middle-income countries. The series adds to the global efforts to study the progress and trends of digitalization in two main ways: · By compiling, curating, and analyzing data from diverse sources to present a comprehensive picture of digitalization in low- and middle-income countries, including in-depth analyses on understudied topics. · By developing insights on policy opportunities, challenges, and debates and reflecting the perspectives of various stakeholders and the World Bank’s operational experiences. This report, the first in the series, aims to inform evidence-based policy making and motivate action among internal and external audiences and stakeholders. The report will bring global attention to high-performing countries that have valuable experience to share as well as to areas where efforts will need to be redoubled.Publication State and Trends of Carbon Pricing 2024(Washington, DC: World Bank, 2024-05-21)This report provides an up-to-date overview of existing and emerging carbon pricing instruments around the world, including international, national, and subnational initiatives. It also investigates trends surrounding the development and implementation of carbon pricing instruments and some of the drivers seen over the past year. Specifically, this report covers carbon taxes, emissions trading systems (ETSs), and crediting mechanisms. Key topics covered in the 2024 report include uptake of ETSs and carbon taxes in low- and middle- income economies, sectoral coverage of ETSs and carbon taxes, and the use of crediting mechanisms as part of the policy mix.Publication The Container Port Performance Index 2023(Washington, DC: World Bank, 2024-07-18)The Container Port Performance Index (CPPI) measures the time container ships spend in port, making it an important point of reference for stakeholders in the global economy. These stakeholders include port authorities and operators, national governments, supranational organizations, development agencies, and other public and private players in trade and logistics. The index highlights where vessel time in container ports could be improved. Streamlining these processes would benefit all parties involved, including shipping lines, national governments, and consumers. This fourth edition of the CPPI relies on data from 405 container ports with at least 24 container ship port calls in the calendar year 2023. As in earlier editions of the CPPI, the ranking employs two different methodological approaches: an administrative (technical) approach and a statistical approach (using matrix factorization). Combining these two approaches ensures that the overall ranking of container ports reflects actual port performance as closely as possible while also being statistically robust. The CPPI methodology assesses the sequential steps of a container ship port call. ‘Total port hours’ refers to the total time elapsed from the moment a ship arrives at the port until the vessel leaves the berth after completing its cargo operations. The CPPI uses time as an indicator because time is very important to shipping lines, ports, and the entire logistics chain. However, time, as captured by the CPPI, is not the only way to measure port efficiency, so it does not tell the entire story of a port’s performance. Factors that can influence the time vessels spend in ports can be location-specific and under the port’s control (endogenous) or external and beyond the control of the port (exogenous). The CPPI measures time spent in container ports, strictly based on quantitative data only, which do not reveal the underlying factors or root causes of extended port times. A detailed port-specific diagnostic would be required to assess the contribution of underlying factors to the time a vessel spends in port. A very low ranking or a significant change in ranking may warrant special attention, for which the World Bank generally recommends a detailed diagnostic.