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OVERVIEW: RESOURCE REQUIREMENT TOOL (RRT) FOR HUMAN RESOURCES FOR HEALTH

OVERVIEW: RESOURCE REQUIREMENT TOOL (RRT) FOR HUMAN RESOURCES FOR HEALTH. Overview of the RRT functionalities July 13, 2009. GHWA Financing Task Force (FTF). Alberto Carrasquilla, Former Minister of Finance, Colombia Sanjeev Gupta, Senior Advisor, International Monetary Fund

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OVERVIEW: RESOURCE REQUIREMENT TOOL (RRT) FOR HUMAN RESOURCES FOR HEALTH

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  1. OVERVIEW: RESOURCE REQUIREMENT TOOL (RRT) FOR HUMAN RESOURCES FOR HEALTH Overview of the RRT functionalities July 13, 2009

  2. GHWA Financing Task Force (FTF) • Alberto Carrasquilla, Former Minister of Finance, Colombia • Sanjeev Gupta, Senior Advisor, International Monetary Fund • Eyitayo Lambo, Former Minister of Health, Nigeria • Mamadou Lamine Loum, Former Prime Minister, Senegal • K. Srinath Reddy, Head of the India Public Health Foundation • Rick Rowden, ActionAid • Julian Schweitzer, World Bank • Netsanet Walelign, UNICEF • Hong Wang, Abt Associates Inc. • Ex-officio members

  3. Discussion Topics • RRT overview • Description of RRT components • Employment component • Pre-service training component • Affordability component

  4. Purpose of the tool 4 • Estimate/project cost to (i) hire and (ii) train planned HRH • Analyze affordability of the HRH plan • Conduct “what if” analyses of (i) policies; (ii) plans; (iii) assumptions • Produce specific information for advocacy • Monitor implementation of HRH plan • Provide input into human resource information systems (HRIS) design related to costs and financing

  5. RRT audience and users • Ministries of Health • Ministries of Education • Ministries of Finance • Development partners • Advocacy Groups

  6. RRT structure: three components RESOURCE REQUIREMENT TOOL EMPLOYMENT • How much would it cost to hire, retain and deploy HRH? • Estimates public sector HRH employment and HRM costs • Accounts for private sector employment 1 ABILITY TO FUND 3 PRE-SERVICE TRAINING • How much would it cost to train HRH? • Estimates resource requirements for public sector HRH pre-service training • Accounts for private sector PST capacity • Can it be afforded? • Estimates gap between required and available resources for government HRH plans 2

  7. Discussion Topics • RRT overview • Description of RRT components • Employment component • Pre-service training component • Affordability component

  8. Employment component: Inputs (1/2) • Basic Country information • Employment-specific information • Public sector HRH (by cadre and by geographic areas) • Resources dedicated to public sector HRH by cadre, by geographic area • Salary and benefits • Deployment cash and non-cash bonuses • Performance-related cash and non-cash bonuses • Assumed productivity improvements due to performance-based financing • In-service training costs • HR Management (HRM) staff and related costs • Private sector HRH, accounting for “moonlighting” RESOURCE REQUIREMENT TOOL Country HRH Scale up Plans EMPLOYMENT 1 ABILITY TO FUND 3 PRE-SERVICE TRAINING 2

  9. Employment component: Scenarios (1/2) RESOURCE REQUIREMENT TOOL • Scenarios: • Vary the number of projected pubic sector HRH • Vary resources for public sector HRH by cadre by geographic area • Salary and benefits • Deployment cash and non-cash bonuses • Performance-related cash and non-cash bonuses • Vary potential performance savings • In-service training costs • Vary resources dedicated to HRM • HRM salaries and benefits • HRM recurrent costs • HRM capital investments Country HRH Scale up Plans EMPLOYMENT 1 ABILITY TO FUND 3 PRE-SERVICE TRAINING 2

  10. Discussion Topics • RRT overview • RRT description • Employment component • Pre-service training component • Affordability component

  11. PST component: Inputs (1/2) • Inputs are listed by 1) ministry and 2) by type of cadre that is trained • Names of publictraining institutions and years of training for this cadre • Total students in the university • HRH graduates in the current year (by region urban/rural) and total HRH graduates • Total capacity for HRH students per graduating year • Number of years to reach capacity • HRH student average drop out rate • Weighted average variable cost per HRH student • Weighted average fixed cost per HRH student • Total capital costs RESOURCE REQUIREMENT TOOL Country HRH Scale up Plans EMPLOYMENT 1 ABILITY TO FUND 3 PRE-SERVICE TRAINING 2

  12. Scenarios that can be created for pre-service training RESOURCE REQUIREMENT TOOL Country HRH Scale up Plans • Scenarios: • Vary • HRH attrition rate • HRH rate of re-entry into the sector • Costs of education • Capital investment requirements • Expected revenues • Private competition for grads EMPLOYMENT 1 ABILITY TO FUND 3 PRE-SERVICE TRAINING 2

  13. Discussion Topics • RRT overview • RRT description • Employment component • Pre-service training component • Affordability component

  14. Likely Affordability: Inputs RESOURCE REQUIREMENT TOOL • Inputs: • Total GDP/GNI • Share of GDP/GNI captured by government • Share of public spending allocated to health • Share of health spending for HRH • Share of public spending on education • Share of education spending on HRH pre-service training via MOE • Donor funds committed/expected for HRH employment or training • Revenues from public universities Country HRH Scale up Plans EMPLOYMENT 1 ABILITY TO FUND 3 PRE-SERVICE TRAINING 2

  15. Likely Affordability: Scenarios RESOURCE REQUIREMENT TOOL • Scenarios: • Vary: • Growth of GDP • Government capture of GDP • Government allocations for health and education • Health allocation for HRH • Education allocation for HRH • Donor commitments for HRH Country HRH Scale up Plans EMPLOYMENT 1 ABILITY TO FUND 3 PRE-SERVICE TRAINING 2

  16. Based on gaps countries can adjust HRH plans RESOURCE REQUIREMENT TOOL Country HRH Scale up Plans Inputs Scenarios Inputs Scenarios EMPLOYMENT Outputs 1 ABILITY TO FUND 3 PRE-SERVICE TRAINING Outputs 2 Outputs Inputs Scenarios Feedback

  17. Countries can monitor implementation of plans over time 17 RESOURCE REQUIREMENT TOOL RESOURCE REQUIREMENT TOOL RESOURCE REQUIREMENT TOOL YEAR 1 Country HRH Scale up Plans Country HRH Scale up Plans Country HRH Scale up Plans EMPLOYMENT EMPLOYMENT EMPLOYMENT YEAR 2 1 1 1 ABILITY TO FUND ABILITY TO FUND ABILITY TO FUND 3 3 3 PRE-SERVICE TRAINING PRE-SERVICE TRAINING PRE-SERVICE TRAINING YEAR 3 2 2 2

  18. Sample Outputs: West African Country RRT application 18 18 • Gaps that can be used for advocacy or for reconsideration of HRH plans Gap Dollars Year

  19. Questions?

  20. What RRT is not… • RRT notJUST a costing tool: • It estimates projected resource requirements including costs and expenditures and compares resource requirements to availability • RRT not a tool for projecting and planning HRH numbers (i.e., number of HRH is taken as input) • It can inform HRH planning when used interactively • RRT lets users vary number of HRH as feedback to planners who may choose to change planned levels of HRH

  21. What RRT is not… • RRT not a conceptual framework • Builds on ideas from conceptual frameworks and literature on HRH financing • Practical tool ready for use by MOHs • BUT it can be complimented with two papers by the Financing Task Force: 1) Economic and Financing Issues in Scaling Up HRH and What Countries Can Do Now Paper • RRT not a demand forecast for public sector HRH • BUT it is provides a model for estimating private sector demand • RRT does not replicate exiting tools, but builds on them • Content based on WBG Costing Tool (March 2007) and WHO Costing Tool (2002) • Design based on GAVI FSP, Malaria costing tool, etc

  22. Sample output: Employment costs 22 HRH Employment Cost (Dollars in thousands) Dollars for HRH Employment Year

  23. Sample Outputs: Pre-Service Training Costs 23 Costs for Scaling HRH Pre-Service Training Dollars in Thousands Year

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