The Governance, Policy, Process, and Capacity of Health Workforce Regulation and Accreditation: Qualitative Policy Analysis and Evidence from Palestine
Bibliographic record
Abstract
Mohammed Alkhaldi,1– 5 Shahenaz Najjar,6– 8 Aisha Al Basuoni,9 Hassan Abu Obaid,10 Ibrahim Mughnnamin,11 Hiba Falana,12 Haya Omran Sultan,12 Yousef Ibrahim Aljeesh13 1Faculty of Communication, Arts and Sciences, Department of Public Health, Canadian University Dubai, Dubai, United Arab Emirates; 2School of Physical and Occupational Therapy, McGill University, Faculty of Medicine, Montreal, Canada; 3Health System Impact Fellowship, Canadian Institutes of Health Research (CIHR), Montreal, Canada; 4Swiss Tropical and Public Health Institute (Swiss TPH), University of Basel, Basel, Switzerland; 5Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine The University of Oxford, Oxford, UK; 6Health Sciences Department, Arab American University, Jenin, Palestine; 7Institute for HealthCare Policy, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; 8UBI Business School, Brussels, Belgium; 9Unit of Projects, Gaza Community Mental Health Programme (GCMHP), Gaza, Palestine; 10Indonesian General Hospital, Ministry of Health, Gaza, Palestine; 11Yatta General Hospital, Ministry of Health, Hebron, Palestine; 12Nursing and Health Professions, Department of Pharmacy, Birzeit University, Ramallah, Palestine; 13Deanship of Scientific Research and Postgraduate Studies, Islamic University of Gaza, Gaza, PalestineCorrespondence: Mohammed Alkhaldi, Email mohammed.alkhaldi@mail.mcgill.caBackground: The significant health development achieved in Palestine last decades has been lost, in Gaza particularly. This requires fundamental health system reform and rebuilding, including health workforces. Strengthening health workforces involves essential elements: leadership, finance, policy, education, partnership, and management. The current unprecedented catastrophe in Gaza and overall instability in Palestine show the utmost necessity for rethinking and reforming all pillars of the already collapsed health system, including the workforce. Health Workforce Accreditation and Regulation (HWAR) standardizes healthcare evaluations, representing a critical research area in Palestine due to limited existing knowledge.Objective: This study aims to enhance understanding of the HWAR in Palestine, and identify gaps and weaknesses, thereby enhancing the HWAR’s development and optimization.Methods: This qualitative study used an inductive approach to explore the landscape of HWAR. Data were collected from October to November 2019, when 22 semi-structured in-depth interviews - were conducted with experts, academics, leaders, and policymakers purposely selected from government, academia, and non-governmental organization sectors. Data analysis, namely, thematic and ground theory, was performed using Excel and MS programs.Findings: The study revealed an absence of transparent governance and ineffective communication within HWAR systems. National policies and guidelines are problematic, with HWAR mechanisms fractured and needing reform. Licensing for healthcare workers hinges on local education, while monitoring and evaluation of HWAR are deficient. Some institutions adhere to HWAR standards, yet widespread updates and applications are necessary. Coordination among educational, accreditation, and practice sectors is non-systematic. Adequate human resources exist, but we need to improve HWAR management. Operational and political challenges limit HWAR, leading to a focus on immediate responses over sustainable system integration.Conclusion: Boosting HWAR is critical for Palestine, especially after the ongoing conflict and humanitarian crisis that led to the dysfunction of the entire health system facilities. A collaborative strategy across sectors is needed to improve governance and outcomes. It is essential to foster strategic dialogue among academia, regulatory entities, and healthcare providers to enhance the HWAR system. Further study on HWAR’s effectiveness is recommended.Keywords: governance and policy landscape, health workforce, accreditation and regulation, Palestine
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.097 | 0.107 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.010 |
| Science and technology studies | 0.009 | 0.015 |
| Scholarly communication | 0.008 | 0.008 |
| Open science | 0.003 | 0.012 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".