Guideline for Regional HRH Country Strategic Planning

1. Guideline for Regional HRH Country Strategic Planning Philippine Consultant Team 2nd AAAH Conference, Beijing, China

2. Philippine Consultant Team F. Marilyn E. Lorenzo Kenneth Ronquillo Co- project team leaders Dr. Rodel Nodora Prof. Esmeralda Silva Co- Consultants 2nd AAAH Conference, Beijing, China

3. Presentation Outline • Process of Development of Regional Guideline for Country Strategic Planning • Situational Analysis Results • Draft Regional Guideline • Next Steps 2nd AAAH Conference, Beijing, China

4. Process of Development of Regional Guideline for Country Strategic Planning 2nd AAAH Conference, Beijing, China

5. Development of Regional Guideline for Country Strategic Planning • Review HRH situation in AAAH member countries and the existence of national HRH strategies or master plans in these countries • Literature review – Peruse existing guidelines on national health workforce strategy development • Drafting regional guideline that can be used as reference for AAAH member countries • Consultation with AAAH member countries through teleconference • Finalize draft guidelines 2nd AAAH Conference, Beijing, China

6. Situational Analysis • Main objective was to review HRH Situation in AAAH member countries and determine the existence of national HRH strategies or master-plans within countries • Requested focal points to assist team in accomplishing five sets of worksheets 2nd AAAH Conference, Beijing, China

7. WORKSHEETS DEVELOPED FOR THE PROJECT SELECTED SOCIO-DEMOGRAPHIC ANDHEALTH PROFILES • TOTAL POPULATION • POPULATION GROWTH RATE, 1980-2006 • UNEMPLOYMENT AND UNDEREMPLOYMENT NUMBER AND RATES: 2000-2006 • INFANT, UNDER-5 & MATERNAL MORTALITY RATES : 2000-2006 • NUMBER OF REGISTERED DEATHS AND CRUDE DEATH RATES : 2000-2006 2nd AAAH Conference, Beijing, China

8. WORKSHEETS DEVELOPED FOR THE PROJECT • SUPPLY SIDE • NUMBER AND DENSITY OF HEALTH WORKERS TO POPULATION • By Priority Professions • 2000-2007 • NUMBER OF HEALTH WORKERS IN GOVERNMENT SERVICE • By Priority Professions • 2000-2007 • NUMBER OF REGISTERED PROFESSIONALS • By Priority Professions including Community Volunteer Health Workers • 1980-2007 • NUMBER OF SCHOOLS AND NUMBER OF FIRST YEAR ENROLLEES • By Priority Professions • 1999-2007 • NUMBER OF NUMBER OF GRADUATES • By Priority Professions • 2000-2007 2nd AAAH Conference, Beijing, China

9. WORKSHEETS DEVELOPED FOR THE PROJECT • DEMAND SIDE • DEMAND FOR HEALTH WORKERS IN ALL NATIONAL GOVERNMENT AGENCIES ( PRIVATE) , INCLUDING THE MINISTRY OF HEALTH • NUMBER OF HEALTH PROFESSIONALS WHO LEFT THE COUNTRY TO WORK ABROAD • AVERAGE MONTHLY SALARIES OF HEALTH PROFESSIONALS IN THE GOVERNMENT AND PRIVATE SECTORS (IN US$) • MONTHLY SALARY OF MIGRANT HEALTH PROFESSIONS IN TOP 5 DESTINATION COUNTRIES (IN US$) • ATTRITION RATE FOR PRIORITY HEALTH PROFESSIONS: 2000-2007 • NUMBER OF HEALTH FACILITIES AND BEDS IN THE GOVERNMENT AND PRIVATE SECTORS • STANDARD REQUIREMENT FOR HUMAN RESOURCES 2nd AAAH Conference, Beijing, China

10. WORKSHEETS DEVELOPED FOR THE PROJECT • HUMAN RESOURCE SYSTEMS • HRH FRAMEWORK • HUMAN RESOURCE PLAN • JOB RELATED RECRUITMENT AND SELECTION • TRAINING AND DEVELOPMENT NEEDS ANALYSIS • HUMAN RESOURCE FOR HEALTH INFORMATION SYSTEM • PERFORMANCE MANAGEMENT SYSTEM • INDIVIDUAL CAREER PLANNING • CAREER PATHING/ CHARTING • SUCCESSION PLANNING • RETENTION PLANNING • COMPENSATION AND BENEFITS • LABOR RELATIONS 2nd AAAH Conference, Beijing, China

11. Summary of Responses to 1 HR System, by country LEGEND C: Complete I: Incomplete 2nd AAAH Conference, Beijing, China

12. Country-specific Responses to HR System worksheets 2nd AAAH Conference, Beijing, China

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15. Results of the Situational Analysis 2nd AAAH Conference, Beijing, China

16. Situational Analysis Results • Country definitions of many HRH elements were not the same • definitions of health workers i.e. what constitute the group of physicians, nurses, community health workers and other HRH classifications • some countries expressed their HRH needs in terms of FTEs required while others specified their requirements in absolute numbers • Understanding of HRH plans is varied ; some think of HRH planning as merely workforce projections while others include in their plans the establishment of systems 2nd AAAH Conference, Beijing, China

17. Situational Analysis Results • Unclear framework models: some frameworks were workforce forecasting models and not planning frameworks; • A number of country plans were not systems based i.e. there was no mention of HRH systems set up except for recruitment and training and development systems. • Consultant team believes HRH systems development need to be basis of optimal utilization and development of HRH to ensure the quantity and quality of HRH in any country. 2nd AAAH Conference, Beijing, China

18. Situational Analysis Results Poor Quality of data on HRH, • Available information seems to still be incomplete, and non-standardized • Current HRH information available identified health workers either to be providing care only in private or public sectors, rather than in both • There is a need for standardized, uniform information available within the region for comparability and forecasting purposes. 2nd AAAH Conference, Beijing, China

19. Situation Analysis Results • Only Thailand, China , Papua New Guinea and the Philippines have formal HRH plans but plans are all different : Some plans are mere workforce projections • Not all plans have systems developed and implemented 2nd AAAH Conference, Beijing, China

20. Situation Analysis Results • Critical systems are planning, training, recruitment and performance management, compensation and benefits. Most country focal points are aware of the systems. The levels of country development cannot be discerned. 2nd AAAH Conference, Beijing, China

21. Situation Analysis Results There is a need for the guidelines to develop common definitions, create uniform understanding of HRH systems and planning, advance standard formulation at country levels and develop HRH systems. 2nd AAAH Conference, Beijing, China

22. Draft Guidelines for Developing Country HRH Master Plans 2nd AAAH Conference, Beijing, China

23. 1. Accomplish a situational Analysis • External Environment Analysis • Labor and Employment environment • Socio-economic context • Political situation • Internal Environment • Health sector systems assessment • Levels of Classification for HRH systems 2nd AAAH Conference, Beijing, China

24. 2. Decide on Goals of the Master Plan • Goals • Recommend the adoption of work of Hornby and Ozcan for Malawi (Hornby and Ozcan,2003). • Designed to ensure that each country’s health services have effective and well-motivated workforce and are appropriately managed. 2nd AAAH Conference, Beijing, China

25. 2. Decide on Goals of the Master Plan Health Services should have: • The right number of people, • The right category, • In the right place, • At the right time, • With the right skills, • With the right motivation and attitudes, • At the right cost, • Doing the right work, • Under the right work conditions. 2nd AAAH Conference, Beijing, China

26. 2. Identify Objectives of the Master Plan Suggested broad objectives: • Specify the direction of country HR development in three planning frames: short term (5 years), medium term ( next 10 years) and long term ( next 10 years) • Determine HRH development objectives, key strategies, activities and evaluation indicators for the above mentioned time frames • Identify short term, medium term and long- term actions, including policy and program actions that are needed to proceed to medium term and long term 2nd AAAH Conference, Beijing, China

27. 3. Decide on a Planning Framework • Overarching vision/mission/goals • Strategies and mandates of the health sector • Ensure that all aspects of HRH development from production and planning, utilization, placement and development are given the necessary attention. • Identify planning frames, assumptions, and context of plans 2nd AAAH Conference, Beijing, China

28. 3. Decide on a Planning Framework • Recommend the adoption of a modified version of the WHO Framework for sustainable HRH Development (WHO-Dayrit, 2006) • Framework contains common technical framework for human resources to help national governments and national planners understand the myriad and complex problems of human resources for health – and find feasible solutions. 2nd AAAH Conference, Beijing, China

29. 3. Decide on a Planning Framework • define key dimensions of technical competencies needed to develop and implement a strategy for human resources; • help inform the growing number of groups interested in the health workforce and prevent the simplistic and limited views on what is involved; and • provide a common reference point for all health workforce stakeholders and save policy-makers, implementers, donors, the academe, and others the effort to “reinvent the wheel” (WHO-Dayrit, 2006). 2nd AAAH Conference, Beijing, China

30. WHO Framework (2006) 2nd AAAH Conference, Beijing, China

31. c ANALYSIS • OTHER HEALTH SYSTEM COMPONENTS & IMPLICATIONS ON HRD • Financial Management • Quality Management System • Strategic Management System • Organizational Information System • Audit and Risk Management System IMPLEMENTATION COUNTRY SPECIFIC CONTEXT (Issues,Culture and Behavior) HEALTH SERVICES CHARACTERISTICS Equity Effectiveness Efficiency Quality Accessibility Acceptability Appropriateness • HEALTH SECTOR PERFORMANCE IMPROVEMENT & HRD • Quality of staff Mix of staff cadres Number of staff • Staff distributedStaff productivity Education & Training • HR Management 2nd AAAH Conference, Beijing, China BETTER HEALTH OUTCOMES

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33. 4. Identify Key Issues that needs to be addressed by Master Plan • Results of the situational analysis to identify key issues • Utilize decision making models i.e. decision tree problem trees • Utilize Algorithms • Problem Tree and Core Problems : Philippine Example 2nd AAAH Conference, Beijing, China

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35. 5. Identify Key Result Areas of the Plan • Key result areas are focused on key issues that have been identified • Need to be measurable • Will include workforce projections • Will require projection models • Philippines used simple workforce projection model commissioned by WPRO 2nd AAAH Conference, Beijing, China

36. 6. Craft effective and appropriate strategies • Strategies have to be planned for different phases: • Short term – Most detailed with clear indicators • Medium term- Directional plan based on accomplishment of short term objectives • Long term- Directional plan • Strategies include systems development 2nd AAAH Conference, Beijing, China

37. 7. Accomplish Operational Plan • Log Frame Analysis • Verifiable Indicators • Identification of risks and assumptions • Identification of key activities, tasks and responsible persons • Timelines • Budget 2nd AAAH Conference, Beijing, China

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39. 8. Identify Key Policies and Programs to support Master Plan • There are key policies that need to be reviewed, updated • New policies that need to be instituted • Programs that need to be prioritized, emphasized or designed 2nd AAAH Conference, Beijing, China

40. 9. Craft Monitoring and Evaluation Scheme • Monitoring and Evaluation to start in short term • Drive the refinement of the Master Plan • Based on HRH information system established • Review and revise Master Plan over periods of time 2nd AAAH Conference, Beijing, China

41. 10.Plan for Annual Plan Review and Replanning • Annual Strategic Planning Review to evaluate accomplishments and re align plans, activities and tasks for given year • Detailed annual planning and readjustment of strategic directions 2nd AAAH Conference, Beijing, China

42. Summary of Guideline Steps • Do situational Analysis • Decide on Goals of the Master Plan • Decide on a Planning Framework • Identify Key Issues that needs to be addressed by master-plan 5. Identify Key Result Areas of the Plan 6. Craft effective and appropriate strategies 7. Accomplish Operational Plan 8. Identify Key Policies and Programs to support plan 9. Craft Monitoring and Evaluation Scheme 10. Plan for Annual Plan Review 2nd AAAH Conference, Beijing, China

43. Next Steps • Organize a country team - The team should be multidisciplinary and inter-sectoral • Staff from the Human Resource Department within the Department/Ministry of Health and other key stakeholders • Other agencies such as education, finance, planning as well as professional regulatory bodies, professional organizations, academe, and development partners. • Team leader - someone that can provide immediate guidance on issues at hand and has a network among various departments/ministries and other relevant agencies. 2nd AAAH Conference, Beijing, China

44. The Philippine HRH Implementing Organization DTI Domestic Deployment DOLE & League of Municipalities and Cities Funding PHIC/ International Donors like WHO NGOs DOF Planning, Resource Mgmt, Coordination , Champion DOH BLHD, HHRDB,,IMS, HPDPB, BIHC, BHFS, NCFHD Regulation PRC, Professional Regulatory Boards, CHED, TESDA & PHIC Int’l Deployment POEA, DFA & OWWA Data source: LGU’s DILG Retention, Compensa- tion & Career Dev’t DBM, PHA & LGUs Production Academe & Accredited Professional Organizations CSC NEDA Partners Proposed Implementers of thePlan Support & coordinating agencies 2nd AAAH Conference, Beijing, China 44

45. Next Steps • Ensure adoption of HRH Master Plan by government as the official HRH development strategy • Ensure buy-in by various stakeholders in HRH development 2nd AAAH Conference, Beijing, China

46. Next Steps • Commit roles and responsibilities–terms of reference clear and well understood by everyone. A work plan should be developed to include specific tasks and assignments, timelines, budgets, and responsible persons. • Hold discussions with key informants - Interviews, meetings, focus group discussions and other approaches for further information should be done to validate existing strategies,programs 2nd AAAH Conference, Beijing, China

47. MABUHAY!Xie Xie! 2nd AAAH Conference, Beijing, China