Harvard School of Public Health
Department of Global Health and Population
665 Huntington Ave.
Boston, MA 02115
NBER Working Papers and Publications
|November 2009||A Mathematical Model for Estimating the Number of Health Workers Required for Universal Antiretroviral Treatment|
with David E. Bloom, Salal Humair: w15517
Despite recent international efforts to increase antiretroviral treatment (ART) coverage, it is estimated that more than 5 million people who need ART in developing countries do not receive such treatment. Shortages of human resources to treat HIV/AIDS (HRHA) are one of the main constraints to scaling up ART. We develop a discrete-time Markovian model to project the numbers of HRHA required to achieve universal ART coverage, taking into account the positive feedback from HRHA numbers to future HRHA need. Feedback occurs because ART is effective in prolonging the lives of HIV-positive people who need treatment, so that an increase in the number of people receiving treatment leads to an increase in the number of people needing it in future periods. We investigate the steady-state behavior ...
|July 2009||Changing Research Perspectives on the Global Health Workforce|
with David E. Bloom: w15168
Past research on the health workforce can be structured into three perspectives - "health workforce planning" (1960 through 1970s); "the health worker as economic actor" (1980s through 1990s); and "the health worker as necessary resource" (1990s through 2000s). During the first phase, shortages of health workers in developed countries triggered the development of four approaches to project future health worker requirements. We discuss each approach and show that modified versions are experiencing a resurgence in current studies estimating health worker requirements to meet population health goals, such as the United Nations' health-related Millennium Development Goals. A perceived "cost explosion" in many health systems shifted the focus to the study of the effect of health workers' behav...
|September 2007||"Conditional scholarships" for HIV/AIDS Health Workers: Educating and Retaining the Workforce to Provide Antiretroviral Treatment in Sub-Saharan Africa|
with David E. Bloom: w13396
Without large increases in the number of health workers to treat HIV/AIDS (HAHW), most developing countries will be unable to achieve universal coverage with antiretroviral treatment (ART), leading to large numbers of potentially avoidable deaths among people living with HIV/AIDS. We use Markov Monte Carlo microsimulation to estimate the expected net present value (eNPV) of a scholarship for health care education that is conditional on the recipient entering into a contract to work for a number of years after graduation delivering ART in sub-Saharan Africa. Such a scholarship could increase the number of health workers educated in the region and decrease the probability of HAHW emigration. "Conditional scholarships" for a team of health workers sufficient to provide ART for 500 patients ...
Published: Till Bärnighausen & David E. Bloom, 2009. "“Conditional scholarships” for HIV/AIDS health workers: Educating and retaining the workforce to provide antiretroviral treatment in sub-Saharan Africa," Social Science & Medicine, vol 68(3), pages 544-551. citation courtesy of