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Innovations for HR challenges in Resource Limited Settings: Lessons from a rural HIV/AIDS program in Mid western Uganda. Dr Richard Mwesigwa Infectious Diseases Institute (IDI)-Uganda 19 th April 2012. Background. Kampala. Expanded Kibaale Kiboga Project.
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Innovations for HR challenges in Resource Limited Settings: Lessons from a rural HIV/AIDS program in Mid western Uganda Dr Richard Mwesigwa Infectious Diseases Institute (IDI)-Uganda 19th April 2012
Background Kampala
Expanded Kibaale Kiboga Project • Capacity building HIV/AIDS project • Focusing on Health systems strengthening • Implemented in Mid western Uganda.
HR for Health Situation • Average Health Worker : population ratio • Medical doctors 1:8,373 ; Nurses 1:1,212 • 70% doctors serve 12% of population • EKKP- Staffing level 47% of MOH standard • Low salaries (Doctors <280USD/month) • Lack of social amenities
Capacity pyramid Default IDI model for capacity Building Tools Skills Staff Facilities Structures Systems Roles requires Cognisance of local context: Policies, trust Enables effective use of *Potter C and Brough R
Capacity pyramid II Easier Tools Skills Staff Facilities Structures Systems Roles Local context: Culture, Policies, Ownership Harder Time to implement change
Local context interventions • District/HW involvement for ownership • Support for comprehensive HR planning and management • Better advocacy facilitated by understanding of HR needs • Stakeholders meetings for coordination
Structures, systems and roles • Integration in existing structures • Task shifting • Helping hands (Volunteers, PHA Network, Interns) • HR boosting (Support recruitment of Critical staff) • Camping strategy & Integrated Static Outreaches (ISOs)
Staff • Motivation to enhance commitment • Facilitation (airtime, motorcycles) • Recognition (frontline- hero programme & Reward for performance) • Support for career development
Facilities (Working environment) • Cleaning and re-arrangement • Remodelling/ Renovations
Imparting Skills • Training focuses on teams and not individuals • Mentorship using Short Term Technical Assistance Teams (STTATs) • IDI/MOH have supported training of District based trainers
Provision of Tools • Equipment • Policy documents and guidelines • Buffer supplies • Supply of data tools
Lessons learnt • Proper planning is key to optimizing outputs with available resources • Cognizance of local context is critical in designing HR for Health interventions. • Non monetary rewards can keep staff motivated
Lessons learnt II • District leadership involvement is key in designing sustainable interventions • Task shifting to lower cadre workers is possible with adequate supervision • Integration in existing structures ensures sustainability