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3.
Hum Resour Health ; 22(1): 40, 2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38890630

RESUMO

BACKGROUND: Physician assistants/associates (PAs) provide services in diverse medical specialties globally, including psychiatry. While health professionals in psychiatry have been described for many years, little is known about PAs practicing in this discipline. METHODS: We describe US PAs practicing in psychiatry using robust national data from the National Commission on Certification of Physician Assistants (NCCPA). Analyses included descriptive and inferential statistics comparing PAs in psychiatry to PAs in all other medical and surgical specialties. RESULTS: The percentage of PAs practicing in psychiatry has increased from 1.1% (n = 630) in 2013 to 2.0% (n = 2 262) in 2021. PAs in psychiatry differed from PAs practicing in all other specialties in the following: they identified predominately as female (71.4% vs. 69.1%; p = 0.016), were more racially diverse (Asian [6.6% vs. 6.0%], Black/African American [5.5% vs. 3.4%], multi-race [2.8% vs. 2.1%], and other races [Native Hawaiian/Pacific Islander, American Indian/Alaska Native, or other; 3.7% vs. 3.6%]; p < 0.001), and resided in the South (43.8% vs. 34.1%; p < 0.001). PAs in psychiatry vs. all other specialties were more likely to work in office-based private practice settings (41.6% vs. 37.3%; p < 0.001) and nearly twice as likely to provide telemedicine services for their patients (62.7% vs. 32.9%; p < 0.001). While one-third (31.9%) of PAs in psychiatry experienced one or more burnout symptoms, and 8.1% considered changing their current position, the vast majority of PAs in psychiatry (86.0%) were satisfied with their position. CONCLUSIONS: Understanding the attributes of PAs in psychiatry is essential in medical labor supply and demand research. Our findings suggest that the number of PAs working in psychiatry is steadily increasing. These PAs were predominantly female, exhibited greater racial diversity, and were primarily located in the South and Midwest regions of the US. A striking difference was that PAs in psychiatry were almost twice as likely to provide telemedicine services for their patients. Although nearly a third of PAs in psychiatry acknowledged having one or more symptoms of burnout, few were considering changing their employment, and the vast majority reported high job satisfaction.


Assuntos
Assistentes Médicos , Psiquiatria , Humanos , Feminino , Assistentes Médicos/estatística & dados numéricos , Assistentes Médicos/provisão & distribuição , Masculino , Estados Unidos , Adulto , Pessoa de Meia-Idade , Mão de Obra em Saúde/estatística & dados numéricos , Recursos Humanos
4.
J Public Health Manag Pract ; 30(4): E174-E183, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38870386

RESUMO

CONTEXT: The COVID-19 pandemic highlighted the need for a well-trained public health workforce prior to the public health crisis. Public health training centers regularly assess workforce needs and their pre-pandemic data play vital roles in guiding public health workforce development beyond the crisis. PROGRAM: In 2019, Oklahoma partners of the Region 6 South Central Public Health Training Center (R6SCPHTC) co-conducted an online survey of the public health workforce located in the Health Resources & Services Administration Region 6. IMPLEMENTATION: Between March and April, the R6SCPHTC collected 503 surveys, including 201 surveys from Oklahoma. Questions inquired about demographic and workforce characteristics, work contexts, training needs and interests, training access and logistics, and knowledge of R6SCPHTC online resources. EVALUATION: Key findings included that two-thirds of the pre-pandemic Oklahoma public health workforce consisted of employees age 40 or older with few holding public health or medical degrees. The majority of respondents worked for health departments and Tribes, and almost half were frontline workers. Although at least half of the participants interested in training on public health activities and topics were familiar with them, confidence in their abilities related to these activities and topics was expressed by less than half. Qualitative data provided details on training needs addressed quantitatively and described new training areas. Survey participants expressed interest in diverse training delivery methods and technological devices. Most respondents were not familiar with the free trainings available through the R6SCPHTC. DISCUSSION: Similar to the regional and national public health workforce, Oklahoma's workforce needed training and support already before COVID-19. Time and resources need to be invested into the current and future workforce. While addressing priority public health skills and topics remains important, training on current and emerging topics is needed. Providing accessible trainings with expanded content will prepare Oklahoma's public health workforce for the future.


Assuntos
COVID-19 , Avaliação das Necessidades , Saúde Pública , Humanos , Oklahoma/epidemiologia , COVID-19/epidemiologia , Saúde Pública/métodos , Saúde Pública/estatística & dados numéricos , Saúde Pública/educação , Avaliação das Necessidades/estatística & dados numéricos , Inquéritos e Questionários , Adulto , Pessoa de Meia-Idade , Masculino , Feminino , SARS-CoV-2 , Pandemias , Mão de Obra em Saúde/estatística & dados numéricos , Mão de Obra em Saúde/tendências , Recursos Humanos/estatística & dados numéricos
5.
East Mediterr Health J ; 30(5): 344-349, 2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38874293

RESUMO

Background: Adequate supply of rehabilitation health workforce is a prerequisite for enhancing access to rehabilitation care. However, there is a lack of comprehensive data regarding the supply of rehabilitation health workers in Saudi Arabia. Aims: To determine the need for, and supply of, rehabilitation workforce, and investigate the relationship between rehabilitation workforce supply and rehabilitation needs in Saudi Arabia. Methodology: This cross-sectional study measured the ratio of physiotherapists and occupational therapists per 10 000 population. Data were obtained from the Ministry of Health, family health survey and census data of the General Authority for Statistics and published literature. To assess the need for rehabilitation services, we computed a composite disability index based on 3 variables: count of individuals with physical disabilities, those with chronic diseases, and those aged > 65 years. Determinants of the supply potential were population size, rural population percentage, and physician supply. Data were analysed using descriptive statistics and simple linear regression. Results: The ratios of physiotherapists and occupational therapists working at the Ministry of Health facilities were 0.69 and 0.03 per 10 000 population, respectively. Overall rehabilitation health workforce ratio was 0.73 per 10 000. Supply varied across regions, from 0.4 for Riyadh to 2.5 for Al Jouf. Nine regions exceeded the overall ratio. Rehabilitation need index ranged from 0.144 in Najran to 0.212 in Aseer. No significant associations were found between rehabilitation workforce supply on one hand, and need and other potential determinants on the other hand. Conclusion: The rehabilitation workforce supply in Saudi Arabia surpassed the regional and global averages, but was lower than the average for high-income countries. Workforce distribution varied by region across the country and was not related to need. It is important to consider the need for rehabilitation services and context-specific factors when determining the optimal size and distribution of the rehabilitation health workforce in Saudi Arabia.


Assuntos
Necessidades e Demandas de Serviços de Saúde , Mão de Obra em Saúde , Fisioterapeutas , Arábia Saudita , Humanos , Estudos Transversais , Mão de Obra em Saúde/estatística & dados numéricos , Fisioterapeutas/provisão & distribuição , Fisioterapeutas/estatística & dados numéricos , Terapeutas Ocupacionais/provisão & distribuição , Terapeutas Ocupacionais/estatística & dados numéricos , Masculino , Reabilitação/estatística & dados numéricos , Feminino , Recursos Humanos/estatística & dados numéricos
6.
Rural Remote Health ; 24(2): 8374, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38826141

RESUMO

INTRODUCTION: The purpose of this study was to understand what literature exists to comprehend demographics and predicted trends of rural allied health professionals (AHPs), person factors of rural AHPs, and recruitment and retention of rural AHPs. METHODS: A scoping review was completed and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Articles were analyzed using three a priori categories of recruitment and retention, person factors, and demographics and trends. RESULTS: Eighty articles met inclusion criteria for the review. Most of the literature came from Australia. Most research studies were qualitative or descriptive. A priori coding of the articles revealed overlap of the a priori codes across articles; however, the majority of articles related to recruitment and retention followed by demographics and trends and person factors. Recruitment and retention articles focused on strategies prior to education, during education, and recruitment and retention, with the highest number of articles focused on retention. Overall, there were no specific best strategies. Demographic data most commonly gathered were age, practice location, profession, sex, gender, previous rural placement and number of years in practice. While person factors were not as commonly written about, psychosocial factors of rural AHPs were most commonly discussed, including desire to care for others, appreciation of feeling needed, connectedness to team and community and enjoyment of the rural lifestyle. CONCLUSION: The evidence available provides an understanding of what research exists to understand recruitment and retention of AHPs from a recruitment and retention approach, person factor approach, and demographics and trends approach. Based on this scoping review, there is not a clear road map for predicting or maintaining AHPs in a rural workforce. Further research is needed to support increased recruitment and retention of AHPs in rural areas.


Assuntos
Pessoal Técnico de Saúde , Seleção de Pessoal , Serviços de Saúde Rural , Humanos , Pessoal Técnico de Saúde/estatística & dados numéricos , Pessoal Técnico de Saúde/psicologia , Feminino , Masculino , Austrália , Reorganização de Recursos Humanos/estatística & dados numéricos , Recursos Humanos/estatística & dados numéricos
7.
San José; OPS; 2024-06-14. (OPS/CRI/HSS/24-0001).
em Espanhol | PAHO-IRIS | ID: phr2-60342

RESUMO

En este documento se exponen los resultados del estudio titulado Análisis de la estructura, dinámica y composición de la fuerza de trabajo en salud en Costa Rica, en el contexto de la pandemia de COVID-19. A finales de la década de los noventa e inicios de la primera década del presente siglo, se llevaron a cabo estudios similares que permitieron contar con un panorama claro de la situación de los recursos humanos en el país e identificar las principales tendencias y desafíos. Desde entonces, no se había hecho una investigación similar, por lo cual, el área de Sistemas y Servicios de Salud de la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS) en Costa Rica, en coordinación con la Dirección de Servicios de Salud del Ministerio de Salud, acordaron llevar a cabo la presente investigación. El propósito de etse etsudio es contribuir al conocimiento y debate sobre la situación de la fuerza de trabajo en salud en Costa Rica, los desafíos que enfrenta el país en este campo y avanzar en la formulación de una política y planificación de Recursos Humanos en Salud (RHUS) en el ámbito sectorial. Este tipo de análisis se volvió particularmente relevante en el contexto de la pandemia de COVID-19, que produjo un incremento inesperado en la demanda de profesionales de la salud (especialmente enfermeras, médicos generales y especialistas, entre otros); también, porque permite apoyar la contención de la emergencia y sus secuelas, así como los aspectos relacionados con la salud y seguridad de la fuerza de trabajo en salud. Esto último hace evidente, una vez más, la urgente necesidad de conocer mejor la situación de la fuerza de trabajo en salud y los desafíos para el corto y mediano plazo. La investigación se llevó a cabo en cuatro etapas: conceptualización, caracterización. recolección y sistematización de datos estadísticos. A partir de los datos proporcionados, se hizo una caracterización y análisis de la fuerza de trabajo en salud en el sector público, en relación con aspectos como estructura y composición, dinámica y formación.


Assuntos
Recursos Humanos , Recursos Humanos , Sistemas de Saúde , Serviços de Saúde , COVID-19 , Pandemias , Costa Rica
9.
Health Aff (Millwood) ; 43(6): 831-839, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38830157

RESUMO

Over the course of the past two decades, attrition within the US governmental public health workforce has passed concerning and become dire. The practice sector has struggled to recruit and retain new talent, despite the infusion of considerable federal investment in workforce expansion initiatives. In 2020, Emory University's Rollins School of Public Health partnered with the Georgia Department of Public Health to establish the Rollins Epidemiology Fellowship Program. Initially created to recruit and place early-career master of public health-level epidemiologists into Georgia's public health system for COVID-19 pandemic response, the two-year service-learning program has evolved into an effective and replicable model of direct academic involvement in strengthening the governmental public health workforce. Here we describe the program's structure and early results, spotlighting it for consideration by the federal government and other jurisdictions interested in directly engaging academia in efforts to revitalize the public health workforce.


Assuntos
COVID-19 , Bolsas de Estudo , Humanos , Georgia , COVID-19/epidemiologia , Epidemiologia/educação , Saúde Pública , Mão de Obra em Saúde , Recursos Humanos
10.
Health Aff (Millwood) ; 43(6): 822-830, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38830158

RESUMO

Governmental public health agencies in the US are understaffed, and ongoing shortages will have a detrimental effect on their ability to provide basic public health services and protections. Public Health AmeriCorps was established in 2022 to support efforts to create a stronger and more diverse public health workforce nationwide. The Minnesota Public Health Corps, one of the largest Public Health AmeriCorps models, is a capacity-building program that places AmeriCorps members directly into governmental public health settings across the state. We used data from the first year of the Minnesota Public Health Corps (2022-23) to describe the experiences of thirty-five sites participating in the program. We also examined preliminary findings about how it shaped AmeriCorps members' skills and prospects related to career development in public health. Corps members were younger and more diverse than the current public health workforce in Minnesota, and the majority said that they intended to pursue a public health career. Host sites reported improved capacity to deliver public health services and indicated that corps members helped them reach new populations. Our evaluation demonstrates that this statewide program may be a scalable model to address parts of the acute capacity gaps at public health agencies, as well as long-term efforts to revitalize the workforce.


Assuntos
Fortalecimento Institucional , Saúde Pública , Minnesota , Humanos , Mão de Obra em Saúde , Feminino , Masculino , Recursos Humanos , Adulto
11.
BMC Oral Health ; 24(1): 631, 2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38811920

RESUMO

BACKGROUND: This study involved a scoping review to explore factors influencing dental hygienist demand and supply in high-income countries. METHODS: A six-stage scoping review was conducted with separate search strategies tailored to four databases (MEDLINE, CINAHL, Google Scholar, and Google) plus a targeted scan of dental hygienist organization websites. This yielded 2,117 unique citations, leading to 148 articles included in the review. RESULTS: Nearly half of the articles (47%) focused on the United States, with 11% on Canada. Most articles (91%) were in English, alongside 13 in Korean and one in French. Journal articles comprised 62% of the publications, followed by reports/working papers (11%) and websites (11%). Other types included conference abstracts, policy briefs, and presentation slides. Content-wise, 47% were original research, with analysis articles (14%), commentaries (11%), and reviews (8%) also present. The articles were coded into three main categories: workforce characteristics/projections, factor-specific analyses, and workforce opportunities. The articles on workforce characteristics covered demographic, geographic, and employment aspects of dental hygienists, along with projections for supply and demand using simulation modelling and geospatial analyses. Factor-specific articles investigated the (1) working environment, (2) policy/regulatory/training environment, (3) job/career satisfaction and related human resource issues, and (4) scope of practice. The third key category of articles highlighted opportunities for expanding the workforce through alternative models in different sectors/settings (e.g., public health, primary care, long-term care, hospitals, mobile outreach, and non-clinical roles including research, education and leadership) and for a range of vulnerable or underserved populations (e.g., geriatric and pediatric populations, persons with disabilities, those living in rural/remote areas, Indigenous peoples, and incarcerated people). CONCLUSIONS: This review provides a comprehensive documentation of the current state of the dental hygienist workforce, compiling factors affecting demand and supply, and highlighting opportunities for the dental hygienist workforce in Canada and other high-income countries. The findings offer a foundation for future research, highlighting the need for more focused and rigorous reviews and underscoring the necessity of high-quality studies to verify the effectiveness of various interventions and policies. This is crucial to address dental hygienist workforce challenges and ensure the sustainability and effectiveness of oral health care delivery.


Assuntos
Higienistas Dentários , Higienistas Dentários/provisão & distribuição , Humanos , Necessidades e Demandas de Serviços de Saúde , Recursos Humanos , Países Desenvolvidos
14.
Arch Dermatol Res ; 316(5): 192, 2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38775980

RESUMO

BACKGROUND: There has been a growing imbalance between supply of dermatologists and demand for dermatologic care. To best address physician shortages, it is important to delineate supply and demand patterns in the dermatologic workforce. The goal of this study was to explore dermatology supply and demand over time. METHODS: We conducted a cross-sectional analysis of workforce supply and demand projections for dermatologists from 2021 to 2036 using data from the Health Workforce Simulation Model from the National Center for Health Workforce Analysis. Estimates for total workforce supply and demand were summarized in aggregate and stratified by rurality. Scenarios with status quo demand and improved access were considered. RESULTS: Projected total supply showed a 12.45% increase by 2036. Total demand increased 12.70% by 2036 in the status quo scenario. In the improved access scenario, total supply was inadequate for total demand in any year, lagging by 28% in 2036. Metropolitan areas demonstrated a relative supply surplus up to 2036; nonmetropolitan areas had at least a 157% excess in demand throughout the study period. In 2021 adequacy was 108% and 39% adequacy for metropolitan and nonmetropolitan areas, respectively; these differences were projected to continue through 2036. CONCLUSIONS: The findings suggest that the dermatology physician workforce is inadequate to meet the demand for dermatologic services in nonmetropolitan areas. Furthermore, improved access to dermatologic care would bolster demand and especially exacerbate workforce inadequacy in nonmetropolitan areas. Continued efforts are needed to address health inequities and ensure access to quality dermatologic care for all.


Assuntos
Dermatologistas , Dermatologia , Necessidades e Demandas de Serviços de Saúde , Humanos , Estados Unidos , Estudos Transversais , Dermatologia/estatística & dados numéricos , Dermatologia/tendências , Necessidades e Demandas de Serviços de Saúde/tendências , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Dermatologistas/provisão & distribuição , Dermatologistas/estatística & dados numéricos , Dermatologistas/tendências , Mão de Obra em Saúde/estatística & dados numéricos , Mão de Obra em Saúde/tendências , Recursos Humanos/estatística & dados numéricos , Recursos Humanos/tendências , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/tendências , Previsões
15.
Soc Sci Med ; 351: 116978, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38761455

RESUMO

One-fourth of nursing home residents are diagnosed with anxiety disorders and approximately half live with depression. Nursing homes have long struggled with staffing shortages, and the lack of care has further heightened the risk of poor mental health. A key solution to both problems could be immigration. Prior studies have documented how immigrant labor could strengthen the long-term care workforce. We add to this picture by exploring the impact of immigrant inflows on the mental health outcomes of nursing home residents. Using a nationally representative dataset and a shift-share instrumental variable approach, we find empirical evidence that immigration reduces diagnoses of depression and anxiety, the use of antidepressant and antianxiety drugs, and self-assessed symptoms of depression. The results are robust to several sensitivity tests. We further find that the effect is more substantial in facilities with lower direct care staff hours per resident and with likely more immigrants without citizenship. Language barriers tend to be a minor issue when providing essential care. The findings suggest that creating a policy framework that directs immigrant labor to the long-term care sector can mutually benefit job-seeking immigrants and nursing home residents.


Assuntos
Assistência de Longa Duração , Casas de Saúde , Humanos , Casas de Saúde/estatística & dados numéricos , Feminino , Masculino , Assistência de Longa Duração/estatística & dados numéricos , Emigração e Imigração/estatística & dados numéricos , Idoso , Estados Unidos , Depressão/epidemiologia , Saúde Mental/estatística & dados numéricos , Pessoa de Meia-Idade , Ansiedade , Emigrantes e Imigrantes/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Recursos Humanos/estatística & dados numéricos
16.
Int Anesthesiol Clin ; 62(3): 26-34, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38785107

RESUMO

Increasingly, both healthcare leaders and studies of healthcare outcomes recommend a medical workforce that is representative of the patient population as a method to reduce health disparities and medical costs. Anesthesiology remains a specialty with lower proportions of women and underrepresented in medicine (URiM) physicians as compared to the overall physician workforce, with 26.1% of anesthesiologists identifying as women and 31.3% of anesthesiologists as URiM. Two areas of focus are commonly identified when discussing inadequate representation in the workforce: recruitment into the specialty and retention in the profession. As medical educators, we provide a critical role in the recruitment and retention of women and URiM anesthesiologists, through implementation of processes, programs, and cultural change. Here, we will discuss the current problems of recruitment and retention of women and URiM anesthesiologists and suggest action plans for now and the future to enhance our specialty's diversity.


Assuntos
Anestesiologistas , Anestesiologia , Seleção de Pessoal , Humanos , Anestesiologistas/organização & administração , Seleção de Pessoal/métodos , Feminino , Médicas , Grupos Minoritários , Recursos Humanos
18.
Ann Fam Med ; 22(3): 233-236, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38806269

RESUMO

This study characterized adult primary care medical assistant (MA) staffing. National Survey of Healthcare Organizations and Systems (n = 1,252) data were analyzed to examine primary care practice characteristics associated with MA per primary care clinician (PCC) staffing ratios. In 2021, few practices (11.4%) had ratios of 2 or more MAs per PCCs. Compared with system-owned practices, independent (odds ratio [OR] = 1.76, P <0.05) and medical group-owned (OR = 2.09, P <0.05) practices were more likely to have ratios of 2 or more MAs per PCCs, as were practices with organizational cultures oriented to innovation (P <0.05). Most primary care practices do not have adequate MA staffing.


Assuntos
Atenção Primária à Saúde , Humanos , Atenção Primária à Saúde/organização & administração , Estados Unidos , Admissão e Escalonamento de Pessoal , Recursos Humanos , Assistentes Médicos/provisão & distribuição , Assistentes Médicos/estatística & dados numéricos , Adulto , Cultura Organizacional
19.
World Neurosurg ; 185: e16-e29, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38741324

RESUMO

OBJECTIVE: There has been a modest but progressive increase in the neurosurgical workforce, training, and service delivery in Nigeria in the last 2 decades. However, these resources are unevenly distributed. This study aimed to quantitatively assess the availability and distribution of neurosurgical resources in Nigeria while projecting the needed workforce capacity up to 2050. METHODS: An online survey of Nigerian neurosurgeons and residents assessed the country's neurosurgical infrastructure, workforce, and resources. The results were analyzed descriptively, and geospatial analysis was used to map their distribution. A projection model was fitted to predict workforce targets for 2022-2050. RESULTS: Out of 86 neurosurgery-capable health facilities, 65.1% were public hospitals, with only 17.4% accredited for residency training. Dedicated hospital beds and operating rooms for neurosurgery make up only 4.0% and 15.4% of the total, respectively. The population disease burden is estimated at 50.2 per 100,000, while the operative coverage was 153.2 cases per neurosurgeon. There are currently 132 neurosurgeons and 114 neurosurgery residents for a population of 218 million (ratio 1:1.65 million). There is an annual growth rate of 8.3%, resulting in a projected deficit of 1113 neurosurgeons by 2030 and 1104 by 2050. Timely access to neurosurgical care ranges from 21.6% to 86.7% of the population within different timeframes. CONCLUSIONS: Collaborative interventions are needed to address gaps in Nigeria's neurosurgical capacity. Investments in training, infrastructure, and funding are necessary for sustainable development and optimized outcomes.


Assuntos
Acessibilidade aos Serviços de Saúde , Neurocirurgiões , Neurocirurgia , Nigéria , Humanos , Neurocirurgia/tendências , Neurocirurgia/educação , Acessibilidade aos Serviços de Saúde/tendências , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Neurocirurgiões/provisão & distribuição , Neurocirurgiões/tendências , Mão de Obra em Saúde/tendências , Mão de Obra em Saúde/estatística & dados numéricos , Procedimentos Neurocirúrgicos/tendências , Procedimentos Neurocirúrgicos/estatística & dados numéricos , Recursos Humanos/estatística & dados numéricos , Recursos Humanos/tendências , Internato e Residência/tendências , Inquéritos e Questionários , Previsões
20.
J Perinat Neonatal Nurs ; 38(2): 113-116, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38758262

RESUMO

The American College of Nurse-Midwives (ACNM) represents certified nurse-midwives (CNMs) and certified midwives (CMs) who are graduate-prepared advanced practice providers. They attend educational programs accredited by the American Commission for Midwifery Education (ACME) and are certified by the American Midwifery Certification Board (AMCB). Their scope of practice as defined by ACNM includes primary care, reproductive services beginning with menarche through menopause, gender-affirming services, contraception, abortion, prenatal, birth, postpartum, and care of the newborn. CNMs/CMs attend 10.9% of US births, but other high-income countries have the reverse proportion of midwives to obstetricians. The CNM/CM workforce is growing, but retirements and attrition slow the growth. Research demonstrates good outcomes from care provided by midwives, and ACNM's primary goal is to expand the midwifery workforce and increase consumer access to midwifery care to mitigate the persistent rise in maternal mortality and morbidity. Barriers to workforce expansion include restricted practice at the state level, inability to expand the number of seats in education programs due to lack of clinical preceptors, and a lack of diversity in the workforce. Strategies to address these barriers may allow the workforce to grow, increasing access to high-quality, equitable sexual and reproductive care for people in the United States.


Assuntos
Tocologia , Enfermeiros Obstétricos , Humanos , Estados Unidos , Tocologia/educação , Feminino , Enfermeiros Obstétricos/educação , Gravidez , Certificação , Papel do Profissional de Enfermagem , Recursos Humanos
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