Planning

Department of Health Annual Report 2003/2004 (South Africa)

An annual review done against the priorities set in the South Africa Health Sector Strategic Framework, 1999 to 2004, and in the Strategic Plan of the National Department for 2003/04 to 2005/06. Section 2 is devoted to Human Resource Management Data.

Strengthening Health Systems to Improve HIV/AIDS Programs in the Europe and Eurasia Region Using Global Fund Resources

Countries in the Europe and Eurasia region are facing a significant and expanding HIV/AIDS epidemic that is largely concentrated among particularly vulnerable populations. A window of opportunity exists to respond effectively to the epidemic and to halt its spread, both within and beyond vulnerable populations. However, available evidence indicates that this opportunity is being missed. One explanation for this is that significant barriers exist within the region’s health systems that prevent rapid scale–up of effective HIV/AIDS programs.

This study seeks to examine these barriers and ways they can be overcome.

Primary Health Care in Mozambique: Service Delivery in a Complex Hierarchy

This report presents findings from a nationwide Expenditure Tracking and Service Delivery Survey implemented in Mozambique between August and October 2002. The study focuses on the primary health care system, which is frequently the only source of health care for most Mozambicans. The report covers a broad set of issues, including institutional context, budget management, cost recovery, allocation and distribution of drugs, human resources, infrastructure and equipment, and service outputs. [from abstract]

Human Resources Impact Assessment

For decades, discussions on human resources in health have ended with a ritual call for more and better manpower planning. But this traditional wisdom has been discredited by unrealistic or vague targets, based all too often on information that was inaccurate, outdated and unrelated to the policy agenda… Policy-makers and donors concerned with human resources problems may want to request those proposing a major new project or policy to make a systematic and formal human resource impact assessment during its preparation. Such assessments would examine the likely effects of the proposed project or policy on the health workforce.

Determining Skill Mix: Practical Guidelines for Managers and Health Professionals

This paper provides practical guidelines for managers and health professionals looking to skill mix as a potential solution to health service delivery problems. These guidelines emphasise the need to evaluate the problem, and examine the context, before deciding if skill mix is the answer. The guidelines are provided in the knowledge that skill mix is rarely examined in a pure theoretical sense by organisations. They have to adopt a pragmatic approach which takes account of the day-to-day realities of their priorities and resources. [abstract]

Human Resources for Health: Models for Projecting Workforce Supply and Requirements, Version 3.0

This document describes two microcomputer spreadsheet models for developing 10 to 30+ year projection scenarios for the supply of and requirements for human resources for health, and for studying the interactions between personnel policies, health sector costs and productivity. The models are designed for use at the national or subnational level, and users may define their projection period in the requirements model according to their needs. [from introduction]

Contemporary Specificities of Labour in the Health Care Sector: Introductory Notes for Discussion

This paper combines the literature on public health, on economics of health and on economics of technological innovation to discuss the peculiarities of labour in the health care sector. The health care system has a distinctive characteristic from other economic sectors: it is the intersection between social welfare and innovation systems. The relationship between technological innovation and cost in the health care sector is surveyed. Finally, the Brazilian case is discussed as an example of a developing country. The peculiarities of labour in the health care sector suggest the need to recognize the worth of sectoral labour and to cease to treat it separately.

Integrating Workforce Planning, Human Resources, and Service Planning

This paper provides an analysis of how labour market indicators can be integrated into service planning, discusses whether planning is sufficiently responsive and flexible to retain relevance and validity in rapidly changing health systems, describes different models and approaches to linking and integrating workforce planning and service planning, discusses methodological approaches to integrating planning, and examines effective approaches to the use of computer based scenario modeling to support assessment of current and future planning options. [from abstract]

Commonwealth Code of Practice for the International Recruitment of Health Workers

The Code develops a consensus approach to dealing with the problem of international recruitment of health workers, while remaining sensitive to the needs of recipient countries and the migratory rights of individual health professionals. The Code covers issues of transparency, fairness, mutuality of benefits, compensation/reparation/restitution, selection procedures, and registration. [Description from author]

Whose Charity? Africa's Aid to the NHS

Health services in the UK are benefiting from the collapse of health services in some of the poorest countries of the world due to the widespread and increasing migration of health professionals. Children in these countries are unable to obtain the most basic health services and many die as a consequence. Research summarised in this briefing reveals that current UK policy in this area is ineffective in tackling this inequality. Using Ghana as a case study, it sets out a range of practical suggestions for how the UK Government should respond. [From author]

Better Health Outcomes from Limited Resources: Focusing on Priority Services in Malawi

The present report deals with health financing issues in Malawi and analyzes trends in health expenditures in the 1990s, along with the prospects for improving resource mobilization, allocation and use in the health sector of that country. This review highlights the need to further prioritize the activities under the Malawi National Health Plan so that the plan will be a basis for government policy and budgetary commitments and also an instrument to marshal and orchestrate donor support to the sector. [from foreword]

Ethical Issues in Health Workforce Development

Increasing the numbers of health workers and improving their skills requires that countries confront a number of ethical dilemmas. The ethical considerations in answering five important questions on enabling health workers to deal appropriately with the circumstances in which they must work are described.

Zambia HIV/AIDS Workforce Study: Preparing for Scale-up

This report presents the findings of a study conducted at 16 healthcare sites in Zambia offering voluntary counseling and testing (VCT), prevention of mother-to-child transmission of HIV (P-MTCT), and antiretroviral (ARV) therapy. The study period, including design, implementation, and data analysis, was April to June 2003. The purpose of the study was to assist the Government of Zambia in determining whether it will have sufficient staff to be able to scale up VCT, P-MTCT, and ARV treatment to reach its targeted numbers of clients.

Mauritania Health System and Implementation of the Poverty Reduction Strategy: Medium-Term Expenditure Framework (2002-04) for Improving the Efficiency and Equity of Public Health Expenditure

Provides an overview of a new budgeting approach in Mauritania, developed by the Ministry of Health on the basis of an analysis of the health problems of poor people, their difficulties in accessing health care, and the shortcomings of the health systems in serving them. The document shows how such analysis can inform the budgeting process and reorient public expenditures in the health sector. Budgeting health services in Mauritania have shifted from a line item approach towards performance based programs with specific indicators of success identified both program and region wide. [from author

Private Sector, Human Resources and Health Franchising in Africa

In much of the developing world, private health care providers and pharmacies are the most important sources of medicine and medical care and yet these providers are frequently not considered in planning for public health. This paper presents the available evidence, by socioeconomic status, on which strata of society benefit from publicly provided care and which strata use private health care. [from abstract]

Intervention Complexity: A Conceptual Framework to Inform Priority-Setting in Health

This article proposes a conceptual framework for the analysis of human resources for health interventions according to their degree of technical complexity; this complements the notion of institutional capacity in considering the feasibility of implementing an intervention.

HIV/AIDS, Equity and Health Sector Personnel in Southern Africa

This paper discusses the implications for health personnel of the HIV epidemic, and health sector responses to it, in southern Africa, using Malawi as a case study. Published and grey literature has been consulted to assess the situation and its implications for equity. [author’s description]

Gender: A Missing Dimension in Human Resource Policy and Planning for Health Reforms

This article takes up the relatively neglected issue of gender in human resources policy and planning (HRPP), with particular reference to the health sector in developing countries.

Tackling the Crisis in Human Capacity Development for Health Services

This issue of The Manager provides a comprehensive framework for addressing human capacity development. It presents steps for developing a strategy that will help managers sustain a supply of adequately trained health staff. It examines four components of planning and managing the workforce: policy and financial requirements, human resource management, partnerships, and leadership. The issue also suggests actions managers and policymakers can take to address issues in these areas so that appropriately trained staff are available in the right places at the right time. [editors’ description]

Policy Brief Two: Rehabilitating the Workforce: The Key to Scaling up MNCH (World Health Report 2005: Making Every Mother and Child Count)

This policy brief from the World Health Report 2005 argues that it will not be possible to effectively scale up Maternal, Newborn and Child Health (MNCH) care without confronting the global health workforce crisis. It highlights how lack of managerial autonomy, gender discrimination and violence in the workplace, dwindling salaries, poor working conditions and some donor interventions have all contributed to a lack of productivity, as well as the rural to urban, public to private and poor to rich country brain drain and migration. The brief argues the need to plan the expansion of the workforce while implementing corrective measures to rehabilitate productivity and morale.

Human Resources and the Success of Health Sector Reform

Though reforms in the health sector have recently been common around the world, their success has, for a variety of reasons, been mixed. The paper aims to examine and explain the importance of human resources (HR) to the success or failure of health reforms using case studies from Russia, Zambia and the United Kingdom. [from abstract]

Cost Estimates: Doubling the Health Workforce in Sub-Saharan Africa by 2010

An initial investment of an estimated $2.0 billion in 2006, rising to an estimated $7.7 billion annually by 2010, is needed from African governments and the collective donor community to double sub-Saharan Africa’s health workforce while increasing its effectiveness, thus making significant progress towards developing the workforces required for countries in sub-Saharan Africa to achieve national and global health goals. [author’s description]

Equity, Equal Opportunities, Gender and Organization Performance

This review highlighted the fact that employment equity debates and policies largely refer to high-income countries. Even in these countries, there is more rhetorical commitment than hard evidence of successful outcomes. Evaluations have been mainly post hoc and many initiatives have not been evaluated at all. There is a continuing debate about what is the appropriate kind of intervention, a number of competing models being advocated. The most noticeable trend seems to be away from reliance on targeting by numbers (particularly for recruitment) and towards more comprehensive approaches across a range of inter- and intra-organizational interventions and over the whole career of the employee.

Development and Strengthening of Human Resources Management in the Health Services

This document summarizes the human resources management situation in the region, its determinants, and the projects for its development. To promote improvements in the human resources management function as part of the sectoral changes under way at the national and regional level, the Pan American Health Organization is proposing a series of strategies, actions, and operational tools through the Observatory of Human Resources in Health Sector Reform initiative. [adapted from author]

HIV/AIDS and the Workforce Crisis in Health in Africa: Issues for Discussion

This paper summarizes the key issues confronting human resources (HR) in the health sector in sub-Saharan Africa and the role that HIV/AIDS has played in exacerbating this crisis. Section I reviews the causes and consequences of this crisis. Section II focuses on the effects of the HIV/AIDS epidemic on the crisis. Section III analyzes the constraints faced by recent health initiatives in addressing HR issues. Finally, Section IV provides recommendations on how donors and other partners can address HR issues in a more intensive, sustained, and concerted manner. [summary]