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Swiss Centre for International Health Health Systems Support Unit

Swiss Centre for International Health Health Systems Support Unit. SDC Health network Face 2 Face Meeting 7-11 April 2014 Human resources for PHC Market place Tuesday 8 April 2014 Kaspar Wyss, Swiss Centre for International Health, Swiss TPH.

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Swiss Centre for International Health Health Systems Support Unit

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  1. Swiss Centre for International HealthHealth Systems Support Unit SDC Health network Face 2 Face Meeting 7-11 April 2014 Human resources for PHC Market place Tuesday 8 April 2014 Kaspar Wyss, Swiss Centre for International Health, Swiss TPH

  2. Relations between functions and objectives of a health system Source: WHO, 2007 Human resources for PHC

  3. Source: http://www.capacityproject.org/framework/ Human resources for PHC

  4. HR ‘bundles’ concept • ‘Bundles’ concept • No single magic bullet for a sustainable solution • Coordinated set of HR strategies ('internal fit') have greater impact that individual strategies • Avoid ‘deadly combinations’ of HR practices • Effectiveness of the bundles depends on organisational context • Other health systems strategies • Mixed HR/HS strategies Human resources for PHC

  5. Examples of HR bundles Zambia to address rural staffing shortage (ZHWRS 2005) • agree to serve a fixed period of 3 years in the rural area • additional rural hardship allowance (depending on category of district) • education allowance for children • renovate/upgrade the accommodation • eligible for post graduate training at the expiry of the contract. • 3 monthly rural hardship allowance per contract year worked, after a minimum of 3 years deployed on rural district. • annual appraisal of performance and identification of training needs for capacity building. • loan (for e.g. a car or a house), maximum of 90% of the 3 years rural hardship allowance and eligibility will be after 6 months of service under the contract. Human resources for PHC

  6. Examples of ‘menus’ of HR practices: Patterson et al 2010 Human resources for PHC

  7. Examples of ‘menus’ of HR practices: Martineau and Martinez (1997) Human resources for PHC

  8. Examples of ‘menus’ of HR practices: Positive practice environments http://www.ppecampaign.org/ Human resources for PHC

  9. Examples of ‘menus’ of HR practices: Levers to workforce performance WHO 2006 p71 Human resources for PHC

  10. Examples of ‘menus’ of HR practices: WHO retention guidelines (2010) Human resources for PHC

  11. HR/HS bundles: Tyolo example A number of innovative approaches to enable rapid scale-up: • task shifting to increase the number of health workers engaged in HIV care and improve efficiency; • decentralization of care to health centres and community sites to spread the workload across multiple sites and increase access; • simplification of protocols for testing and treatment; • community engagement to increase capacity and support programme sustainability; • strengthening the health system Bemelmans, M., T. Van Den Akker, et al. (2010). "Providing universal access to antiretroviral therapy in Thyolo, Malawi through task shifting and decentralization of HIV/AIDS care." Tropical Medicine & International Health 15(12): 1413-1420. Human resources for PHC

  12. Effectiveness/outcome Health workforce Retention • turnover rate (stability index) • attrition Distribution • vacancy rates by cadre, geographic location, facility type Effectiveness • skills mix • levels of absence • quantity of work output • quality of work output Health services • Xxx • Yyy Human resources for PHC

  13. Source of HR tools • HRH action framework (click on relevant bubbles) www.capacityproject.org/framework • WHO HRH tools and guidelines pages http://www.who.int/hrh/tools/en/index.html • HRH Global Resource Center – tools and guides http://www.hrhresourcecenter.org/taxonomy_menu/3/131 • Global Health Workforce Alliance – tools and guides http://www.who.int/workforcealliance/knowledge/en/ Human resources for PHC

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