Human resources for health--challenges for the 21st century.

A quality health workforce is critical for the development of health systems and the delivery of health services. Although significant resources have been devoted to this area, imbalances persist in most countries. There is a growing recognition that to address current demographic, epidemiological, technological and socioeconomic changes, approaches to human resources for health development must be more comprehensive. While education and training of health personnel is a crucial element, the areas of policy development, planning and management of human resources must receive appropriate attention. Health sector reform initiatives have not included human resources development as an integral part in their processes, which has led to failures of reforms in some cases. Human resources for health must have a more prominent place on the political agenda of countries. It is apparent that to meet current and future challenges, partnerships between the many actors must be established.

Changes in the healthfulness of life of the elderly population: an empirical approach.

This paper presents an empirical approach to measuring the healthfulness of life of the elderly population. It discusses information related to trends in disability-free and quality-adjusted life expectancy in the context of the current debate concerning prospects for a possible future compression of morbidity. Trends in each of the components underlying health expectancy are examined: survivorship and remaining life expectancy in each state of health, rates of institutionalization, as well as incidence of disability and prevalence of activity restriction in the household population. The effects on health expectancy of changes in these components are noted.

Health expectancy in Canada, late 1970s: demographic, regional, and social dimensions.

Based on estimates of activity restriction from the Canada Health Survey, institutional data on long-term care, and survival data from vital statistics, we have calculated an index of health expectancy (life expectancy in each state of health), and a summary of these indices which we have called quality-adjusted life expectancy. At birth, expected years of long-term institutionalization were 0.8 for men and 1.5 for women. Expected years of activity restriction not involving long-term institutionalization were 10.8 for men and 14.0 for women; 3.0 of the expected years of activity restriction for men and 1.3 of these years for women were in the most severe category of restriction (unable to do major activity). For both sexes together, quality-adjusted life expectancy was 1.4 years greater in Ontario and the Prairies than in the Atlantic region, 3.2 years greater in Canada's three largest cities than in rural areas and small towns, and 7.7 years greater among persons from high-income families than among persons from low-income families.