Introducing the BMC Series SDG Editorial Board Members: Sarah Hewko

Professor Sarah J Hewko is an Editorial Board Member of BMC Health Services Research, Assistant Professor with the Department of Applied Human Sciences at the University of Prince Edward Island in Canada, and a Registered Dietitian. In this blog post, Sarah tells us more about how her research relates to Sustainable Development Goals 5 and 8.

Welcome to our SDG Editorial Board Members blog collection. We are hearing from the Editorial Board Members of the BMC Series journals whose work aligns with achieving the Sustainable Development Goals. Here you can find other posts in this collection, grouped with the tag ‘SDG editorial board members’. 

I am a Canadian Registered Dietitian (RD) with interdisciplinary training in nutrition and dietetics, health administration, and nursing theory. Through my research program, I create new knowledge that empirically defines the characteristics of work settings that facilitate evidence-based, timely use of allied health services while also supporting allied health professional’s (AHPs) innovative behaviors, career satisfaction, and job satisfaction and enhancing retention of these professionals, both in specific specializations and within organizations. It is clear that the actions and leadership skills of middle managers in health care settings are key to optimal workforce outcomes. Key stakeholders for my research include employment policy-makers, health administrators, and front-line supervisors and managers of AHPs. Commonly included in the classification of allied health professions are physiotherapy, speech-language pathology, occupational therapy, and dietetics.

The majority of Canadian RNs and AHPs retire well before the age of 65, and retaining them for even an average of 6 months longer could have significant impacts on the sustainability of the health workforce.

To date, the results of my research have been most relevant to Sustainable Development Goals number 5: Achieve gender equality and empower all women and girls, and number 8: Promote sustained, inclusive, and sustainable economic growth, full and productive employment and decent work for all. In my doctoral research, I explored retirement decision-making among Registered Nurses (RNs) and AHPs. The results of this study highlighted the importance of structural supports for caregivers, a key factor contributing to achieving gender equality (target 5.4). Also, having broad representation from several female-dominated health professions in my analysis, these findings contribute to support for policy changes that enhance the quality of jobs (for all workers) in the health care sector (target 8.5). The majority of Canadian RNs and AHPs retire well before the age of 65, and retaining them for even an average of 6 months longer could have significant impacts on the sustainability of the health workforce.

Since then, I have focussed my attention on the RD workforce, which is overwhelmingly female. I have completed three studies, one identifying reasons for variations in job turnover within clinical settings, a second (in press) exploring RDs’ capacity for and interest in innovation, and a third (submitted) exploring the experience and motivation of RDs working concurrently in health care and as independent sales consultants for network marketing companies. The results of these studies have highlighted how undervalued RDs feel and how few growth opportunities they encounter in their professional work. Such experiences in the health workforce are likely shared across the allied health professions as there are many similarities in the characteristics of employment for AHPs and many allied health professions are female-dominated. Were health administrators to take actions based on my research findings, such as by supporting and providing opportunities for personal growth and development in the workplace and/or by rewarding individual AHP successes, they would be contributing to women’s full and effective participation in the health workforce (target 5.5) and their full and productive employment (target 8.5). The COVID-19 pandemic has only exacerbated existing shortages of health professionals, including AHPs, particularly in rural and underserved areas; taking action to support the retention of health professionals, such as by effectively addressing SDGs 5 and 8, enhances the sustainability of health services.

There are several challenges I have encountered in building my research program. First, because work in health human resources straddles “work” and “health” research, it can be considered too human resource-oriented for funders of health research and too health-oriented for funders of human resources research. I continue to gain skills in grant-writing and to seek out mentors to help me frame my work optimally for funding opportunities. Second, the COVID-19 pandemic has limited the capacity for research activities within health care settings. As a result, it has been difficult to pursue plans for on-site interventional research that may provide empirical evidence to support practices identified in survey and qualitative research as facilitating improved AHP job retention, innovativeness, job satisfaction, and career satisfaction. This summer, I look forward to conducting a study exploring the process and rationale supporting RD redeployment during the COVID-19 pandemic in Canada.

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