Human resources challenges in global health organizations: Managing a diverse and dispersed workforce

In the dynamic landscape of global health organizations, Human Resources (HR) faces unique challenges in managing a diverse and dispersed workforce. This review explores the multifaceted issues that HR professionals encounter while navigating the intricacies of global health settings. One of the foremost challenges is the diversity inherent in the workforce of global health organizations. These entities often bring together professionals from diverse cultural, educational, and professional backgrounds, creating a melting pot of perspectives and approaches. HR must devise strategies to foster inclusivity, address cultural differences, and promote effective communication to harness the collective strength of this diverse talent pool. Furthermore, the dispersed nature of global health organizations presents a logistical challenge for HR management. With teams spread across different geographic locations, time zones, and cultural contexts, coordinating and integrating human resources practices becomes inherently complex. Virtual collaboration tools and innovative communication strategies become imperative to bridge the geographical gaps and create a cohesive organizational culture. Managing talent retention and development in such a context becomes crucial. HR professionals need to design policies and programs that cater to the professional growth and well-being of employees regardless of their physical location. This involves implementing virtual training programs, mentorship initiatives, and performance evaluation systems that transcend geographical boundaries. Moreover, compliance with local and international labor laws adds another layer of complexity to HR management in global health organizations. Navigating the legal landscape and ensuring adherence to diverse regulatory frameworks require a nuanced approach and continuous monitoring. Human Resources faces a myriad of challenges in global health organizations, from fostering diversity and inclusion to navigating the complexities of a dispersed workforce. Successfully addressing these challenges demands a strategic and adaptive HR approach, leveraging technology, cultural sensitivity, and innovative practices to create a unified and thriving global health workforce.


Introduction
Global health organizations play a crucial role in addressing health challenges worldwide, particularly in developing countries where the burden of diseases such as cardiovascular diseases is significant (Yusuf et al., 2001).The significance of human resources in global health cannot be overstated, as the effectiveness of these organizations heavily relies on the management of a diverse and dispersed workforce (Kunze et al., 2013).However, managing such a workforce comes with its own set of challenges, including those related to diversity, age, gender, and geographical dispersion (Guillaume et al., 2015;Kharroubi, 2021;Nnadi & Chinedu, 2019).These challenges are further compounded by the need to ensure workforce sustainability, especially in remote and underserved regions (Onnis, 2017).Moreover, the impact of workforce diversity on organizational performance and productivity is a subject of increasing interest, with studies highlighting the potential benefits and complexities associated with diversity management (Malik et al., 2018;Tworek et al., 2020).As global health organizations strive to achieve business sustainability and improve employee performance, it becomes imperative to address these challenges effectively (Moropane, 2023;Mande & Awiti, 2019).This introduction provides an overview of the background of global health organizations, emphasizes the significance of human resources in global health, and outlines the diverse challenges associated with managing a dispersed and diverse workforce.

Diversity in the Global Health Workforce
Diversity in the global health workforce encompasses cultural diversity and educational/professional backgrounds, both of which significantly impact organizational dynamics and the overall quality of healthcare.Cultural diversity in the workforce can lead to different perspectives and approaches, affecting organizational dynamics (Ely & Thomas, 2001).It is crucial to foster inclusivity through strategies such as valuing diversity and inclusion in healthcare, benchmarking equity, diversity, and inclusion, and implementing best practices to improve diversity and inclusion among healthcare programs (Khuntia et al., 2022;Kayingo et al., 2022;Boatright et al., 2023).These strategies are essential for creating a collaborative environment that embraces and leverages the strengths of a diverse workforce (Shore et al., 2010).
Addressing skill disparities among healthcare professionals is vital for ensuring high-quality care.The Global Health Workforce Alliance emphasizes the need for interprofessional collaboration to mitigate the global health workforce crisis (Pfeifle & Earnest, 2014).Additionally, the inclusion of the health workforce as a key strategy to achieve Sustainable Development Goal (SDG) 3 on health and the global strategy on human resources for health (HRH) highlights the importance of addressing skill disparities to meet healthcare needs (Hoope-Bender et al., 2017; Ukoba and Jen, 2023; Makhado et al., 2020).
The educational and professional backgrounds of healthcare workers, including immigrants, play a significant role in contributing to the healthcare workforce.Assessing the contribution of immigrants to healthcare occupations is crucial for understanding the multi-scalar analysis of the workforce and addressing skill disparities (Harun & Walton-Roberts, 2022; Victor and Great, 2021).Furthermore, the development of health workforce strategic plans in Africa and the process of strengthening primary healthcare through the advancement of the global pharmacy workforce underscore the importance of educational and professional backgrounds in shaping the healthcare workforce (Nyoni et al., 2022;Bates et al., 2022).
In conclusion, the global health workforce's diversity, encompassing cultural diversity and educational/professional backgrounds, has a profound impact on organizational dynamics and the quality of healthcare.Fostering inclusivity, addressing skill disparities, and creating a collaborative environment are essential strategies for leveraging the strengths of a diverse workforce and ensuring high-quality care.

Dispersed Workforce Logistics
Geographic Challenges in managing a dispersed workforce pose significant logistical and operational hurdles.Time zone differences and communication barriers are key issues that organizations face (Bradner et al., 2005;Oti and Ayeni, 2013).The coordination and integration of such teams require innovative strategies and virtual collaboration tools to overcome these challenges (Abdulkadir et al., 2022;Connelly, 2023).The use of technology-based training and virtual collaboration tools has been identified as an effective mechanism to support a dispersed workforce (Bell & Kozlowski, 2012;Olushola and Olabode, 2018).Additionally, enterprise logistics has been recognized as a necessary tool for coordinating supply chain operations that are geographically dispersed around the world (Stock et al., 2000).
The impact of geographic dispersion on workforce productivity has been a subject of study, with some research indicating that it does not significantly affect team productivity (Wang, 2021).However, it is important to note that dispersed supply chains involve trade-offs, such as increased logistics costs and longer response times, which can erode customer service levels and competitiveness (Lorentz et al., 2012).Furthermore, the challenges of delivering healthcare to highly decentralized populations dispersed over islands and atolls have been highlighted, emphasizing the need for innovative logistical solutions in the healthcare sector (Rendell & Sheel, 2022;, Craig et al., 2021).
The dispersed nature of the workforce in rural and remote areas presents unique challenges, including wide population dispersion and a scant health workforce, which add to the logistical difficulties in the delivery of health services (Larkins et al., 2020).Moreover, the skewed distribution of the health workforce geographically poses significant challenges to quality healthcare delivery (Exavery et al., 2013;Kasten et al., 2023).These challenges are further compounded by the limited transport links and connectivity options in such areas (Rendell & Sheel, 2022;Adeniyi et al., 2020).
In conclusion, managing a dispersed workforce requires addressing the geographic challenges through the use of virtual collaboration tools, innovative communication strategies, and enterprise logistics.Organizations need to leverage technology and innovative approaches to overcome the logistical hurdles posed by geographic dispersion, particularly in sectors such as healthcare and supply chain management.Overall, the synthesis of these studies underscores the significance of virtual training programs, mentorship initiatives, and performance evaluation systems in talent retention and development, especially in the context of global teams and remote work.

Legal Compliance in a Global Context
Legal compliance in a global context involves navigating variations in local labor laws and ensuring adherence to international labor standards.In the developing world, compliance with regulations can be challenging due to poverty and high costs (Ostermann, 2016; Gezelius & Sowman, 2011) emphasize the need to understand compliance motivations in both developed and developing world contexts, questioning the transferability of the developed world's compliance discourses to the developing world (Gezelius & Sowman, 2011).This understanding is crucial for ensuring compliance across borders.Additionally, the COVID-19 pandemic has highlighted the importance of compliance on a global scale, as evidenced by the cross-language validation of a compliance scale in 28 languages (Blackburn et al., 2022).Furthermore, the challenges and opportunities in ensuring trustworthy artificial intelligence and process mining underscore the complexities of legal compliance in a global context (Pery et al., 2021;Kareem et al., 2022) shed light on the factors driving Africa's inability to comply with EU standards, emphasizing the importance of understanding institution and trade facilitation measures (Kareem et al., 2022).
These studies collectively highlight the multifaceted nature of legal compliance in a global context, emphasizing the need to consider the challenges posed by varying local labor laws, international labor standards, and the impact of global events such as the COVID-19 pandemic.Understanding compliance motivations, addressing institutional measures, and leveraging technological advancements are crucial for ensuring legal compliance across borders.

Strategies for Effective HR Management
To effectively manage human resources, organizations can adopt adaptive HR approaches, leverage technology, provide cultural sensitivity training, and implement continuous monitoring and evaluation.Adaptive HR approaches involve dynamically selecting face regions for robust heart rate (HR) estimation, as opposed to processing all skin pixels within a fixed region of interest (Tulyakov et al., 2016).This adaptive strategy aligns with the need for flexibility and responsiveness in HR management.Leveraging technology, particularly HR software solutions, can enhance HR functions such as recruitment, performance management, and employee engagement.However, organizations must address data security and privacy concerns associated with HR technology to maintain trust and compliance.Cultural sensitivity training is crucial for promoting inclusivity and understanding diverse perspectives within the workforce.It enables HR managers to navigate retirement trends and workforce issues effectively.Continuous monitoring and evaluation involve the use of wearable devices for HR control during exercise, which allows for real-time adjustments to training intensity based on individual HR responses.This approach ensures that HR management aligns with the health and fitness needs of employees.Overall, these strategies contribute to effective HR management by promoting adaptability, technological advancement, cultural inclusivity, and employee well-being.

Future Outlook and Emerging Trends
The future outlook and emerging trends for Human Resources Challenges in Global Health Organizations, particularly in managing a diverse and dispersed workforce, are influenced by several factors.The current scenario and future research directions suggest that psychological diversity climate, HRM practices, and personality traits significantly impact multicultural workforce job satisfaction and performance (Doghan et al., 2019).Furthermore, the composition of the workforce, including diversity in employees' ethnic and educational backgrounds, has been linked to facilitating firm-level innovativeness (Mohammadi et al., 2017).Strategic human resource management models emphasize the significance of workforce diversity as a major challenge for organizations (Alcázar et al., 2013).Additionally, the organizational consequences of racial diversity, particularly in municipal police departments, have been examined, highlighting the critical role of diversity management in addressing changes in the demographic makeup of the workforce (Hur, 2013).Workplace diversity management has been identified as a challenge following the establishment of greater workforce diversity through policies, emphasizing the need for effective management of diversity (Davis et al., 2016).The relationship between diversity and organizational performance, and the potential suppressing effect of diversity fatigue, has also been explored, indicating the complexity of maintaining high performance as organizations become more diverse (Farmanesh et al., 2020).Moreover, micro-macro HRM strategies have been proposed to overcome challenges of workforce diversity and deviance in the ASEAN region, emphasizing the need for innovative practices to accommodate the underrepresented diverse workforce (Malik et al., 2018).These trends and future research directions underscore the evolving landscape of workforce diversity and the imperative for organizations to develop adaptive HR strategies to effectively manage diverse and dispersed workforces in global health organizations.
These studies provide insights into the challenges and opportunities associated with managing a diverse and dispersed workforce in global health organizations, offering valuable perspectives for future research and strategic HRM practices.

Recommendation
Implement comprehensive diversity and inclusion programs that go beyond mere acknowledgment of differences.Foster a culture where every individual feels valued and contribute to the organization's goals.This includes ongoing cultural competency training for all staff.Continue leveraging advanced technologies for communication, collaboration, and training.Invest in cutting-edge HR software solutions to streamline processes, ensure data security, and facilitate effective virtual teamwork.Develop customized talent development programs that accommodate the unique needs of a dispersed workforce.This includes virtual training, mentorship initiatives, and performance evaluation systems designed to transcend geographical boundaries while accounting for cultural nuances.Establish a robust system for monitoring and ensuring compliance with local and international labor laws.Regularly update HR policies to reflect changes in regulations across different regions, and provide ongoing training to HR personnel to stay informed about global employment standards.Regularly evaluate the effectiveness of HR strategies in managing a diverse and dispersed workforce.Be open to feedback from employees and stakeholders, and adapt HR approaches accordingly to meet the evolving needs of the organization.

Conclusion
In recapitulation, managing a diverse and dispersed workforce in global health organizations presents multifaceted challenges, from cultural diversity to logistical complexities.The importance of strategic HR approaches cannot be overstated, as these challenges demand nuanced solutions that align with the organization's goals and values.
Strategic HR not only addresses the immediate concerns of diversity and dispersion but also positions the organization for future success.By fostering a culture of inclusivity, implementing advanced technologies, and adapting talent development programs, HR can build a resilient and high-performing global health workforce.
The future outlook for HR in global health organizations involves a continual commitment to innovation and adaptability.As the landscape of work evolves, HR must stay at the forefront of emerging trends, technologies, and global labor standards.This forward-thinking approach positions organizations to not only overcome current challenges but also to thrive in an ever-changing global environment.In essence, strategic HR is not just a response to challenges-it is a proactive investment in the long-term success and sustainability of global health organizations.

Disclosure of conflict of interest
No conflict of interest to be disclosed.
In the context of talent retention and development, virtual training programs have become essential.Ganiyu et al. (2022) emphasize the evolution of virtual training and its implications for talent development, highlighting the need to adapt training programs to the post-pandemic period.Virtual reality (VR) simulation, as discussed by(Bracq et al., 2019), has been proven effective in nontechnical skills training for healthcare professionals, demonstrating the potential for immersive training experiences.Furthermore,Rosen et al. (2006) stress the importance of training for virtual teams, emphasizing the need for practices that cater to the unique dynamics of virtual teamwork.Additionally, Dua et al. (2022) discuss the impact of synchronous and asynchronous virtual learning forums, shedding light on the effectiveness of such platforms for educational purposes.When tailoring content for global teams, it is crucial to consider the diverse needs and contexts of team members.Virtual training programs should be designed to accommodate these differences, ensuring accessibility and inclusivity.Moreover, Huppert et al. (2020) provide insights into evidence-based best practices for virtual interviews in graduate medical education training programs, which can be extrapolated to the broader context of tailoring content for global teams.In the realm of mentorship initiatives, the challenges of virtual settings are addressed byGaniyu et al. (2022) and(Rosen et al., 2006), who underscore the need for innovative approaches to overcome these challenges.Additionally, the study byBracq et al. (2019) on VR simulation in nontechnical skills training is relevant, as it highlights the potential for building cross-cultural mentorship programs using immersive training experiences.In the domain of performance evaluation systems, the work ofGaniyu et al. (2022) andDua et al. (2022) provides valuable insights into the metrics and best practices for evaluating the effectiveness of virtual training programs.Furthermore, Huppert et al. (2020) offer evidence-based best practices for virtual interviews, which can be adapted to develop performance evaluation systems that balance objectivity and cultural sensitivity in virtual settings.