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Approximately 2 million people worldwide receive chronic dialysis treatment for end-stage kidney disease with annual direct healthcare costs that exceed USD 60 billion. 1 The global dialysis population is expanding rapidly in the context of constrained workforce and financial resources.
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The renewed interest in these programmes can be traced, in part, to an increased focus on the achievement of universal health coverage in LMICs, which is constrained by persistent health workforce challenges in countries with weak health systems, particularly those in sub-Saharan Africa [ 4– 8].
Finally, the health workforce is also constrained by its human capital.
Furthermore, it became rapidly clear that weak health systems, for instance through health workforce deficits, severely constrained the effectiveness of many high impact interventions [ 2].
The health workforce is severely constrained across Africa, yet numerous HIV/AIDS programs have demonstrated how task-shifting from physicians to other health providers and community health workers can be effective in treating this particularly human resource-intensive chronic disease [ 65].
The 'smoke-free policies' theme occurred most frequently as opportunity but infrequently as challenge while 'health workforce capacity' occurred most frequently as challenge but less frequently as opportunity, suggesting that policy implementation is constrained by lack of a skilled workforce.
Inevitably the economy, which is constrained by crumbling infrastructure, a dwindling workforce and pervasive corruption, could not absorb this amount of money.
Concurrently, the supply of medical doctors (MDs) is constrained in most countries, leading to workforce shortages [ 1].
Operations of the Health service commission, charged with the responsibility of establishing an efficient health workforce continue to be constrained[ 18].
But a deeper problem is that rising consumer and investment demand cannot be satisfied by an economy that is constrained by corruption, Soviet-era infrastructure and an inadequate and immobile workforce.Rising prices are now ordinary Russians' biggest concern, although they have not yet translated into protests.
Bruton et al. (2003) broaden the analysis to East Asian companies in general and argue that cultural differences, operationalized by the power of a firm's owner managers and their relationship to their colleagues, constrain the applicability of workforce reduction.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com