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Human Resources for Health
Published in: Human Resources for Health 1/2021

01-12-2021 | Review

A systematic review of the profile and density of the maternal and child health workforce in China

Authors: Huan Zhang, Xiaoyun Liu, Loveday Penn-Kekana, Carine Ronsmans

Published in: Human Resources for Health | Issue 1/2021

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Abstract

Background

To track progress in maternal and child health (MCH), understanding the health workforce is important. This study seeks to systematically review evidence on the profile and density of MCH workers in China.

Methods

We searched 6 English and 2 Chinese databases for studies published between 1 October 1949 and 20 July 2020. We included studies that reported on the level of education or the certification status of all the MCH workers in one or more health facilities and studies reporting the density of MCH workers per 100 000 population or per 1000 births. MCH workers were defined as those who provided MCH services in mainland China and had been trained formally or informally.

Results

Meta-analysis of 35 studies found that only two-thirds of obstetricians and paediatricians (67%, 95% CI: 59.6–74.3%) had a bachelor or higher degree. This proportion was lower in primary-level facilities (28% (1.5–53.9%)). For nurses involved in MCH care the proportions with a bachelor or higher degree were lower (20.0% (12.0–30.0%) in any health facility and 1% (0.0–5.0%) in primary care facilities). Based on 18 studies, the average density of MCH doctors and nurses was 11.8 (95% CI: 7.5–16.2) and 11.4 (7.6–15.2) per 100 000 population, respectively. The average density of obstetricians was 9.0 (7.9–10.2) per 1000 births and that of obstetric nurses 16.0 (14.8–17.2) per 1000 births. The density of MCH workers is much higher than what has been recommended internationally (three doctors and 20 midwives per 3600 births).

Conclusions

Our review suggests that the high density of MCH workers in China is achieved through a mix of workers with high and low educational profiles. Many workers labelled as “obstetricians” or “paediatrician” have lower qualifications than expected. China compensates for these low educational levels through task-shifting, in-service training and supervision.
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Metadata
Title
A systematic review of the profile and density of the maternal and child health workforce in China
Authors
Huan Zhang
Xiaoyun Liu
Loveday Penn-Kekana
Carine Ronsmans
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Human Resources for Health / Issue 1/2021
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/s12960-021-00662-4

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