Peer-reviewed article
Health workforce implications of integrating NCD prevention, screening and treatment into hospital-based MNCH services: perspectives from Kyrgyzstan, Tajikistan and Viet Nam.
Collins TE, Karapici A, Maliqi B, Berlina D, Akselrod S et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This paper examines how three countries integrate non-communicable disease services into maternal, newborn and child health programs. The authors identify workforce challenges including staff shortages, skills gaps, and uneven distribution of health workers. The paper uses a quality improvement framework to analyse structural and process barriers. It calls for more research on strengthening the health workforce for integrated services.
Key points
- Health workforce shortages, skills gaps, limited training capacity and uneven distribution are major barriers to integrating NCD services into MNCH
- The paper applies Donabedian's quality improvement model focusing on outcome, process and structure
- Practical experiences from low- and middle-income countries on operationalising this integration remain limited
- A systemic perspective is needed to address health workforce issues and improve care quality
- Additional research is needed to strengthen the health workforce for effective NCD-MNCH integration and primary healthcare
Limitations
This is a synthesis of programme learning and perspectives rather than an empirical evaluation of a specific intervention. It does not measure child health outcomes or assess the effectiveness of any particular integration model on children's well-being.
Abstract
Integration of non-communicable diseases (NCDs) prevention, screening and treatment into maternal, newborn and child healthcare (MNCH) services has become increasingly important as countries address the dual burden of communicable and NCDs. While global policy attention has grown, practical experiences from low- and middle-income countries on how to operationalise this integration, particularly its implications for the health workforce, remain limited.This practice paper synthesises programme learning from Kyrgyzstan, Tajikistan and Viet Nam, drawing on WHO-supported country assessments, programme reports and practitioner perspectives, with a particular focus on workforce challenges. Health workforce shortages, skills gaps, limited training capacity and uneven distribution remain major barriers to service integration in these countries. We apply Donabedian's quality improvement model, encompassing outcome, process and structure, to elaborate on these challenges. We emphasise the importance of taking a systemic perspective in addressing health workforce issues and improving the quality of care. We recognise the need for additional research in key areas that are instrumental for strengthening the health workforce, particularly for the effective integration of NCD services into MNCH and strengthening primary healthcare. Our insights aim to assist in the development of integrated programmes and to promote advancements in the research agenda for the health workforce.