Planning

GRHAM is a CCIH initiative, in collaboration with numerous partners, to increase the awareness of Faith-based Organizations (FBOs) in providing essential health services around the world. GRHAM strives to put FBOs and Christian Health Associations (CHAs) “on the map” to improve networking, including collaboration with and between christian health associations, medical missions, ministries of health and multilateral donors. [from website description]

The African Church Health Associations’ Human Resources for Health Mini-Forum was held to re-energize the CHA’s human resources working group. The objectives of the forum were to: expand the HRH knowledge base; help develop a critical mass of faith-based HRH advocates; clarify the “Terms of Reference” for an HRH working group and plan for sustainability and next steps; and to generate action plans for HRH practices and identify technical assistance needs. [adapted from author]

Using Tanzania as a case study, this report advocates that the only effective means of really addressing the HRH challenge inpoor countries is to begin to immediately scale up training capacity, and that approach is relatively inexpensive when compared to its long-term benefits. [adapted from author]

Ethiopia is currently one of the countries most seriously affected by HIV/AIDS, with the sixth highest number of infections in the world. This paper discusses how to combat this epidemic. As the country scales up HIV/AIDS services, increased attention is focused on identifying constraints to program expansion. One of the most important constraints is that of human resources. [from publisher’s abstract]

The tools and guidelines collected in this book will assist health program managers, policymakers, and leaders to assess the impact of HIV/AIDS on the health workforce and its capacity to deliver and scale up HIV/AIDS services. The book provides materials to help decision-makers develop a strategy to mitigate the impact of HIV/AIDS, for both a short-term emergency response and a longer-term plan to strengthen HRM systems. This compilation also includes a tool developed by the World Health Organization to help HIV/AIDS programs to achieve a more sustainable workforce appropriately trained to provide ART.

World Health Statistics 2006 presents the most recent statistics since 1997 of 50 health indicators for WHO’s 192 Member States. This second edition of World Health Statistics includes an expanded set of statistics, with a particular focus on equity between and within countries. It also introduces a section with 10 highlights in global health statistics for the past year. [publisher’s description]

The report includes a chapter on Health Systems which provides key HRH statistical data.

Imbalance in the cadre mix, number, distribution, and quality of health personnel are major concerns for health planners and policy makers. Many methods were developed and used to project future supply and requirement for health personnel. This paper modified the population-to-physician ratio method, by taking into account the specific characteristics of the Thai health care system, and of the future economic scenarios to project requirements of Thai physicians over the next twenty-five years. [from abstract]

Most human resources for health in developing countries are produced by highly subsidized public institutes. Due to inequity in basic education most health science students are from wealthier urban families. They tend to remain in urban areas after graduation, creating inequitable distribution of health personnel. At the same time the public education institutes are subject to strong bureaucratic inefficiency and usually no systematic quality control system. This paper analyses this situation in Thailand. [adapted from abstract]

The objective of this study is to present and analyze different issues relating to the existing workforce in the health services of Bangladesh under the Ministry of Health. [from abstract]

A roundtable discussion of the following questions: 1) Why attempt HRH planning? 2) What should be the objectives for HRH planning? 3) Why has HRH planning had limited success in the past? 4) Will these reasons for limited success continue in the future? 5) Even if HRH planning might be useful, why wouldn’t market forces be a better guide to policy? 6) If both HRH planning and market forces have their use, when should we choose one and when the other? [From author]

Developing countries that have to cope with pressures to reform their bureaucracies have to contend with increasing health worker benefits and salaries that are often intended to retain these health workers in government service. In the Philippines, national and local efforts in health have been forced to focus on guaranteeing some of these benefits, and local governments are feeling the financial limitations of their local funds. [from abstract]

This publication provides an overview of some of the key challenges for policy-makers in addressing the linkages between migration, health and human rights.The first section explains why we are addressing the issue of migration and health and what is meant by doing this through a human rights framework. It then explores some of the terminology used. The second section links the reasons why people migrate with the health and human rights implications of moving on the populations left behind. The third section considers the health implications for those on the move both in the context of public health as well as in relation to the health of the individual.

A human rights framework provides a formal and explicit way to examine the different social, political and economic problems that both give rise to, and result from, international migration, in particular inequality. It also allows clear and explicit articulation of where the obligation to do something about these human rights impacts lies under international human rights law, together with migration of health workers; and ensures that any improvements in the right to health are achieved without any express limitation of any other rights, including freedom of movement and rights in work.

This workbook has been designed to help you produce a workforce plan. The workbook is set out as the draft of workforce plan for Department of Health of a mythical small island country, Planania. Your task is to make changes in the content of this draft so as to produce a draft plan for your health authority. Although the workbook was designed for use at national level in small countries, it has been used in preparing workforce plans for health systems serving populations of several million people. It can be used for planning at district, regional or national level.

This rapid-assessment guide is designed to help users arrive at a global overview of a country’s HRH situation. The guide is designed to help users assess current HRH constraints and challenges to “scaling up” health interventions. HRH main issues include: Policy, regulation and planning; Management and performance improvement; Labour market; Education, training and research; HRH and priority health programmes; and Monitoring and evaluation. [author’s description]

The main aim of these guidelines is to support countries in the Human Resource Development and management process of assessing the human resource for health situation, policy and plan development with the view of achieving some level of comprehensiveness and consistency country level. The guidelines will discuss HRH processes, situation analysis, policy and plan development with reference to the overall context of national health policies and strategies. These guidelines describe how to formulate, develop, review HRH situations, policies and plans with the flexibility necessary for each country context.

The objective of this study was to assess the supply of physicians in Lebanon in 1998, with an assessment of their practice patterns and capacity building. [from abstract]

Human resources management in health often encounters problems related to workforce geographical distribution. The aim of this study was to investigate the internship workplace preferences of final-year medical students and the reasons associated with their choices. [from abstract]

An honest and critical examination of the role of Health Care Professionals (HCPs) during communicable disease outbreaks is needed in order to provide guidelines regarding professional rights and responsibilities, as well as ethical duties and obligations. With this paper, we hope to open the social dialogue and advance the public debate on this increasingly urgent issue. [summary]

There have been reported shortages in both the regulated and unregulated workforce in New Zealand, in particular of medical practitioners, nurses in primary care, mental health professionals, allied and primary health professionals, Māori and Pacific practitioners, and support workers. There is also an ongoing issue of a maldistribution of workers between rural and urban locations. In the future, the constraints on labour supply in New Zealand will necessitate a much greater focus on growing the health workforce and improving the performance and productivity of the available workforce.

Australia is experiencing workforce shortages across a number of health professions despite a significant and growing reliance on overseas trained health workers. The shortages are even more acute in rural and remote areas. It is critical to increase the efficiency and effectiveness of the available health workforce, and to improve its distribution. This report describes the Australian government’s objectives of developing a more sustainable and responsive health workforce while maintaining a commitment to high quality and safe health outcomes. A set of national workforce objectives are also proposed.

Shortages of skilled health workers occur in most countries in the world, and most significantly in countries where education levels are relatively high. Migration has tended to be at some cost to relatively poor countries where the costs of production are considerable and losses are not compensated. The costs of global mobility are thus unevenly borne by the poorer source countries and the benefits are concentrated in the recipient countries. Since migration cannot be ended, and source countries have only limited scope for substantial policy change that will improve the number and status of health workers in the home countries, the onus has increasingly shifted towards the role of recipient countries in ensuring that, if migration is to continue, then it be more equitable and that there be adequate compensation for losses incurred in source countries.

Evidence from Colombia and Chile suggests that decentralization, under certain conditions and with some specific policy mechanisms, can improve equity of resource allocation. In these countries, equitable levels of per capita financial allocations at the municipal level were achieved through different forms of decentralization — the use of allocation formulae, adequate local funding choices and horizontal equity funds. Findings on equity of utilization of services were less consistent, but they did show that increased levels of funding were associated with increased utilization. This suggests that improved equity of funding over time might reduce inequities of service utilization.

This comparative study evaluates the implementation of decentralization of health systems in three Latin American countries: Chile, Bolivia, and Colombia. In terms of the relationship between decentralization and system performance in general, the findings support the conclusion that both the die-hard detractors and the fervent advocates for decentralization are wrong. Decentralization appears to be improving some indicators of equity, such as a tendency toward similar per capita expenditures for wealthier and poorer municipalities, and to be associated with increased and more equitable per capita spending on promotion and prevention.

As a key contribution toward increasing human capacity in national health systems, the Capacity Project is hosting a series of Human Resources for Health (HRH) Action Workshops. The initial workshop—held in Johannesburg in partnership with the United Nations Development Programme/Southern Africa Capacity Initiative (UNDP/SACI)—facilitated the exchange of knowledge and best practices in planning, developing and supporting the health workforce. The three and one-half day workshop brought together 38 HRH leaders from 11 countries (Kenya, Lesotho, Malawi, Namibia, Rwanda, Sudan, South Africa, Swaziland, Tanzania, Uganda and Zambia). Almost all of the participants are senior HRH directors or practitioners working at the operational level within the Ministry of Health in their respective countries. Two representatives from faith-based organizations also attended.

This paper looks at the successes and failures of today’s health care workforce. Hargadon and Plsek argue that our current solutions to the problems in the health workforce are insufficient. To overcome these insufficiencies, they believe that we need to better understand the complexities of the workforce. However, this is not an easy feat, because these problems challenge our traditional mental models of how things should work. [abstract]

The overall aim of the workshop was to identify and agree on priorities for coordinated action in improving human resources for health (HRH) policy and practice, based on a timetable for strategic work involving the agreed participation of different stakeholders. Specific objectives were to improve the performance of health workers/health workforce by: improving understanding of the determinants of successful approaches to workforce development and HRH; developing strategies and the evidence base in relation to the first point; and achieving consensus among stakeholders on a strategy for research, development of knowledge tools, and implementation mechanisms for HRH.

As a key contribution toward increasing human capacity in national health systems, the Capacity Project is hosting a series of Human Resources for Health (HRH) Action Workshops. The initial workshop—held in Johannesburg in partnership with the United Nations Development Programme/Southern Africa Capacity Initiative (UNDP/SACI)—facilitated the exchange of knowledge and best practices in planning, developing and supporting the health workforce.

The three and one-half day workshop brought together 38 HRH leaders from 11 countries (Kenya, Lesotho, Malawi, Namibia, Rwanda, Sudan, South Africa, Swaziland, Tanzania, Uganda and Zambia).

The National Human Resource Plan is a national guideline for all stakeholders. It outlines broad issues whilst taking the lead in some areas in order to facilitate the resolution of some of the chronic systemic challenges facing the health system. In implementing this plan, all stakeholders will be required to adapt to the guidelines expressed here. It is envisaged that there will be a measure of variation between the provinces, because each province must take into consideration the prevailing conditions and demands on its human resource capacity to plan objectively.

Many countries are using the strategy of international recruitment to make up for shortages of health professionals. This is often to the detriment of health systems in the poorest parts of the world. Codes of practice on ethical international recruitment or similar instruments are beginning to be introduced at both national and international levels to protect the health systems of vulnerable countries. This study was designed to review the potential impact of existing instruments. [from executive summary]