STRATEGIC FRAMEWORK HUMAN RESOURCE DEVELOPMENT IN THE PERIOD OF 2011-2020 (Draft) December 2010

1. STRATEGIC FRAMEWORK HUMAN RESOURCE DEVELOPMENT IN THE PERIOD OF 2011-2020 (Draft) December 2010

2. The necessary role of this framework: • Three biggest challenges of human resource: • Lack of staff numbers • quality is not enough • located unequally among geographical areas, levels and specialties. • Government requested to develop this long-term plan • Provinces/cities have increasing needs on HR, but is not met.

3. CURRENT HUMAN RESOURCE Fig1. Total number of health professionals during 2003 - 2008

4. Table 1. Distribution of health professional (2003 – 2008)

5. Table 2: Basic number on healthprofessional

6. Table 3: Distribution of healthprofessionalbytypes and levels

7. Fig 3: Distribution of health staffs by education level (2009)

8. Fig 4. Distribution of health staffs by working levels

9. Current status of Health professional training

10. Distribution of healthscienceuniversities Khoa Y, ĐH Yersin (2004) Khoa Y, ĐH Yersin (2004) Trường ĐH Y Thái Nguyên (1968) Trường ĐH Y tế công cộng (2001) Trường ĐH KT Y tế Hải Dương (2007) Trường ĐH Dược Hà Nội (1902) Trường ĐH Y Hải Phòng (1979) Trường ĐH Y Hà Nội (1902) Học viện quân Y- BQP Khoa Y ĐH Tây Bắc Trường ĐH Điều dưỡng NĐ(2006) (2004) Khoa Y ĐH QG HN Trường ĐH Y Thái Bình (1968) Học viện Y Dược học Cổ truyền (2003) Trường ĐH Y Dược Huế (1957) Khoa ĐD, Khoa KHSK – ĐH Thăng Long (2006) Khoa ĐD- ĐH Thành Tây Khoa YD-ĐH Đà Nẵng (2007) ĐH Y khoa Vinh Khoa ĐD- ĐH Duy Tân Khoa Y, ĐH Tây Nguyên (1997) Khoa Y-ĐH Quốc gia HCM Trường ĐH Y Dược Cần Thơ (1979) ĐH Y Dược TP Hồ Chí Minh (1947) Trường ĐH Y khoa Phạm Ngọc Thạch (2007) Khoa Y ĐH An Giang Khoa ĐD và KTYH, ĐH Hồng Bàng* (2006) Public school Private school New school

11. - Currently, there are 24 health science universities/schools: • 18 public universities/schools; • 05 private (nursing training) universities/schools; • 01 belong to Ministry of Defence; • - In preparation to establish 2 new training institutes (Tâybắc & An Giang). • Distribution of these schools is unequal among geographic and socio-economic areas

12. There is no coducted research on the quality of teachers/lecturers. • There is no compulsory training program for teachers • There is no comprehensive project on training of trainers, including international support project • Better teachers prefer working at bigger schools in Hanoi and HCM city. (Prof. and A.Prof by 33%) • Some schools have no or just one or two professors

13. Number of Enrollment over years

14. Number of new graduated students

15. Budget for equipment and construction at schools, which belong to MoH, is low. There is no regular budget for upgrading teaching and technical equipment. Most of sources depend on ODA • National program for education system provides to 11 MoH training institutes an amount of 4 to 8 bil VND • Budget for one student/year is 7.5 mil VND • Regular expenditure increases 10-15% annually while number of enrolled students surge into double after every 5-6 years

16. Junior colleges • There are 34 junior colleges. • Onlyonecollegeprovides training onreparingtechnicalequipment • In the last two years, there is a big number of SMS upgraded to junior colleges. However, investment for these schools is very limitted. Many of them received no more infrastructure investment after two years.

17. Secondary medical school • There are 44 public SMS in provinces and cities. • All provinces/cities have either SMS or junior colleges or both, except new established provinces. • - There are some private schools participated in training health professionals at secondary level

18. CHALLENGES IN • HUMAN RESOURCE DEVELOPMENT • Human resource • Training programs do not match with human resource plan, socio-economic development plan • It is difficult to recruit staffs in some areas: anatomy, lab test, metal health, TB, leprosy • In provincial and district levels: lack of health staffs in both quantity and quality. Few MD, who have CKII or master degrees, works in district level • Applying Decree No 43/2006/ND-CP => limit number of health staffs in order to reduce the payment • Wage and income of health staffs is still very low

19. Trainings for staffs • Number of graduated students (medical and pharmacy) do not meet the need of health care system • The training quality has been improved but it doesn’t match with technology development and the need of community • Low capacity in regional training system integration. Face to the risk of falling behind. • Without clear orientation and direction for Training on Technical transformation. • Still many difficulties in training health professionals

20. Training managementisnotsystematic, there are many gaps becausethe roles of MoH and MoET, peoplecommittee and otherministrieshavenotbeendescribedclearyet. • New junior collegeshaven’tgotenoughcapacitytotrainstaffs at collegelevel. • Vocational training in health sector islimitted • Training and recruitingdoesn’t match eachother • GovernmentInvestmentfor trainings islimitted

21. Policy on recruiting and treatment • Insufficient regulations: provinces themselves can not decide number of permanent health stafts. • Retaining policy is not strong enough to attract health staffs, especially in mountain, remote, island areas and in some “not attractive” specialties. • Allowance is too low, not updated, not adequate with the special working condition of health sector.

22. Plan’s OBJECTIVES

23. GENERAL OBJECTIVES To provide enough HR with good quality, appropriate structures and distribution, to contribute in improving health service quality, family planning activities, health protection and health care for people, toward the equity, efficiency and development.

24. SPECIFIC OBJECTIVES • Establish and develop a network of health professional training institutions, which fit with social-economic development in each areas of the country. • Develop an appropriate HR structure fit with health system, to meet with the basic requirements on HR for all specialties in order to implement the tasks of protecting and improving people’s health condition. • Adjust the HR recruitment and retaining policy.

25. 3. Indicators 3.1. Human resource - 41 healthstaffs (allkinds)/10,000 capita in 2015 and 52 healthstaffs/10,000 capita in 2020; - 8 MD/10,000 capita in 2015 and 10/10,000 capita in 2020; - 2 pharmacist/10,000 capita in 2015 and 2,5 pharmacist/10,000 capita in 2020;

26. - 12 nurses/10,000 capita in 2015 and 20 nurses/10,000 capita in 2020; - 5 med. technicians/10,000 capita in 2015 and 8 med. technicians/10,000 capita in 2020; - 14 other staffs /10,000 capita in 2015 and reduce to 11.5 other staffs/10,000 capita in 2020

27. 3.2. Training health staffs - In 2015, strivetobequalifiedtoestablishtwoHealthScienceUniversities in Hanoi and HCM citybasedonthebasisframeworks of Hanoimedicaluniversity, HCM Med and Pharmuniversity and some new establishedschools. Up to 2020, thesetwoUniversitieswilldevelopetothesamescale and emphersizethe training qualitywith popular universities in regional areas; someschools/faculties in theseuniversitieswillbeabletoprovide training courses in foreignlanguagewithinternational training programs.

28. Up to 2015, 03 more medical and pharmacy schools/faculties will be established inside the politechnique universities, in order to provide enough HR for health care and family planning. • - More than 70% (in 2015) and 100% (in 2020) health science universities, junior colleges and SMS will meet the standard criteria of MoH and MoET on infrastructure, professional environment for training.

29. In 2015, ensure that all provinces, cities belonging to national level have public or private junior colleges or SMS, among them 80% are colleges. • In 2015, number of foreign students will be about 0.5 to 1% of total number of undergraduate students. • Up to 2015, all health science schools have renovated their training programs and regularly updated their training programs.

30. In 2020, overcome the lack of HR for health and family planning in grass-root level in difficulty areas; ensure the HR for “low atractive” specialties. • In 2020, health science universities will have their own practical hospitals, ensure the teaching, research and practical conditions, and in the same time to participate in providing health services.

31. In 2020, more than 90% university lecturers and more than 70% college lecturers have postgraduate degrees; more than 75% university lecturer and 20% college lecturer are PhD; more than 50% of SMS teacher have postgraduate degrees. • In 2020, at least 5% undergraduate students and 20% college and SMS students study in private health science schools.

32. SOLUTIONS FOR HRD

33. POLICY AND MECHANISM • Adjust, modify and issue the policy in recruiting health staffs, preferential allowance for them to fit with actual working condition of the health sector, to ensure the attraction and retaining health staffs to work in health sector, especially in low attraction section such as: preventive medicine, grass-root level, difficulty areas, and some specialties,…

34. Curriculum on implementing preferential allowance must be details, accurate and fit with actual condition to ensure that health facilities could implement them easily. • It is necessary to have appropriate financial mechanism (to allocate the government budget to pay for health staffs after having the adjustment) to ensure health staffs will have preferential allowance right after related regulations are issued and valid.

35. TRAINING HEALTH PROFESSIONAL • Develop training institutions, teachers and renovate training methods and programs • University: • - EstablishHealthScienceUniversities in Hanoi and HCM city, HueMed and Pharmschoolswillbecome focal school. • Otherhealthscienceschoolswillprovide training in allkinds of healthstaffswithincreasingnumber of students. • Theseschoolswilldecreasenumber of students in college and secondarylevel, and they are notlimitted in enrollment.

36. Junior colleges • Each socio-economicarea has at leastone focal junior college, providemulti training programs and multi-levelwithnumber of studentsfrom 800 to 1000, amongthem, collegestudents are 80%. • Other junior colleges have number of students from 500 - 800

37. SMS • Onlyexist in some socio-economicdifficultprovinces. Number of students per schoolis 400 to 600. • Privateschools • Havedifferentsizedependingonthe social labor needs and theschools’ capacity. • Haverighttoprovideallkinds of training programwhenevertheschoolsmeettheconditionalrequirements.

38. Types of training • - Regular training • Training undercontracts at specificaddress • Step up training • Nominated training • Training for employees • Second degree training • Certificate training according to the demand of leaners

39. Training projects • Group 1: • Training health professional based on social needs (including contract training for specific address, technology transference training, nominated training) • Project to support Vinh Med and Pharmacy School • Project to establish Taynguyen Med University • Project to establish Med and Pharm faculty in Taybac University • Training project for high skills health professionals, health managers and hospital managers.

40. Group 2: • Project of using government bond to improving infrastructure for 15 universities and 65 junior colleges, SMS in public sector. • ADB project on “Human resource for health development” to develop training system for health sector • Project on developing high quality HR for health in period 2011-2010. • Project on training HR using modern training program (for some training programs)

41. Group 2 (cont): • Project on training of trainers of health science schools, including strengthening their capacity in active teaching methods, how to develop training materials • Project on strengthening health training management and accreditation • Project on renovation training program, textbook and teaching methods

42. Project/program need supports • Projects to improve infrastructure and training equipment for universities • Training of trainer project • Education renovation and accreditation project • Project to cooperate with popular international universities to provide distance learning course • Comprehensive survey on HR for health in the whole country • Pilot study on HR management, coordination models for some difficulty recruitment areas • ….

43. THANK YOU!