# Interventions that strengthen the care workforce: a realist synthesis review

## TL;DR

This review explores interventions that improve the care workforce, emphasizing training and better working conditions to support growing health system needs.

## Contribution

The study provides a realist synthesis of interventions to strengthen the care workforce, highlighting multi-faceted approaches for policy and practice.

## Key findings

- Training programs for care workers are a key intervention for workforce strengthening.
- Improving scheduling and pay can significantly enhance care worker retention and satisfaction.
- Legislative and educational reforms are recommended to support care workers across different contexts.

## Abstract

Health systems depend on care workers to provide “hands-on” direct care with eating, dressing, and other needs, as well as indirect care with household tasks, meals, and transport. Care workers are in high demand to support growing populations who need help in daily life, yet they often fall outside of health human resource planning. Recruiting, supporting, and retaining the care workforce are urgent priorities for health workforce planners.

This realist synthesis review asks: Which interventions strengthen the care workforce? We systematically identified 7396 peer-reviewed sources and 481 gray literature sources, with 151 included in the review.

The sources document a variety of interventions that strengthen the care workforce, with an emphasis on pre-service and ongoing training for care workers. There were ambitious interventions that aimed to support the care workforce on multiple fronts.

Policy makers and researchers are encouraged to implement complex interventions that cover multiple factors simultaneously. We recommend focusing on legislative structures, educational oversight, and material working conditions, such as scheduling and pay, as highly promising avenues for strengthening the care workforce across multiple contexts.