Improving collaboration between primary care and mental health services.

Previous guidelines and planning documents have identified the key role primary care providers play in delivering mental health care, including the recommendation from the WHO that meeting the mental health needs of the population in many low and middle income countries will only be achieved through greater integration of mental health services within general medical settings. This position paper aims to build upon this work and present a global framework for enhancing mental health care delivered within primary care. This paper synthesizes previous guidelines, empirical data from the literature and experiences of the authors in varied clinical settings to identify core principles and the key elements of successful collaboration, and organizes these into practical guidelines that can be adapted to any setting.

What explains the distribution of doctors and nurses in different countries, and does it matter for health outcomes?

Aims: To re-examine the form of the relationships between the global distribution of health professionals (physicians and nurses), gross national product per capita, female literacy, and infant and under-5 mortality rates reported in three papers by Robinson and Wharrad using more recent data. The secondary aim was to explore prior assumptions about the quality of the data, the homogeneity of the sample, and the form of the relationship.

Background: The analyses by Robinson and Wharrad did not take account of differences between developing and developed countries.

What are the reasons for high turnover in nursing? A discussion of presumed causal factors and remedies.

Problems with high turnover in nursing and of maintaining adequate numbers of nurses to supply clinical staffing requirements have a long history and have therefore attracted a commensurate literature with time. An overview and discussion of the situation internationally, with an emphasis on Organisation for Economic Co-operation and Development (OECD) countries and the UK, finds that job satisfaction is often a consistent underlying determinant interacting with workplace factors and personal reasons in complex ways. Effective and adaptive retention strategies are required to meet and mitigate the problem as reasons for it may vary over time.