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HRH in the Diaspora to Support the Health Sector in Sierra Leone

HRH in the Diaspora to Support the Health Sector in Sierra Leone . Dr JF Aguilera, IOM RO Dakar April 1st, 2014. Background. SL has one of the highest MMR and U5MR in the world, although improving since 2000 (DHS, 2008) Maternal mortality: 857/100,000 LB (1,800 in 2000)

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HRH in the Diaspora to Support the Health Sector in Sierra Leone

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  1. HRH in the Diasporato Support the Health Sector in Sierra Leone Dr JF Aguilera, IOM RO Dakar April 1st, 2014

  2. Background • SL has one of the highest MMR and U5MR in the world, although improving since 2000 (DHS, 2008) • Maternal mortality: 857/100,000 LB (1,800 in 2000) • U5 mortality: 140/1,000 LB (286 in 2000) • HRH densities (WHO, 2010) • Nurses/Midwives: 0.17/1,000 • Physicians: 0.02/1,000  WHO threshold to deliver essential maternal and child health care: 2.3/1,000

  3. HRH Gaps in SL(Source: National Health Sector SP 2010–15)

  4. HRH Issues and Challenges in SL • Low production of HRH • Insufficient number of institutions (1 med school, 10 nursing schools) • Poorly equipped training institutions with inadequate tutors • No medical post-graduate training in SL (in planning) • Poor retention of HRH • High attrition rate • Poor conditions of service • Low motivation, especially to work in remote areas • Inadequate accommodation for key facility staff at all levels • Weak HR planning and management • Lack of reliable HRH information systems • Delay in recruitment of staff • Absence of structured career pathway for most cadres

  5. Overview of IOM Intervention on HRH in Sierra Leone • Mapping of HRH in the Diaspora in US/Canada, UK and Germany • Mapping of needs in health-care and training institutions • Development of a Diaspora Engagement Strategy

  6. HRH in the Diaspora

  7. HRH training and HealthcareDeliveryNeeds • 17 HRH training institutions surveyed • All the training institutions seriously lack teaching/learning materials (books, computers, internet access), logistic for clinical placement of students • Insufficient staffing for tutorship (quantitative and qualitative) • Plan to provide facilities for home based postgraduate training in the various health disciplines through the establishment of a Sierra College of Health Specialties and promotion of international partnerships • 30 HFs surveyed • There is an acute shortage of trained and qualified health HRH (e.g. pediatricians, gyn/obst, surgeons) exacerbated by unequal staff distribution • Low moral, mostly due to largely insufficient incentive (salary, top-ups, career paths) to retain qualified staff, especially in the provinces • All of the HFs surveyed provide back-up for training institutions (clinical practice, lecturers)

  8. Perspectives for Diaspora Engagement in SL • Endorsement of the newly developed DES by the ODA • Political leadership at the highest level • Recognition that diaspora engagement is a tool to contribute to improve HRH for training and healthcare delivery • 4 axes were identified: • Establishment of a coordinating mechanism to improve needs assessing, planning and management • Establishment of effective communication mechanisms to promote the DES, identify diaspora skills and facilitate deployment • Sustainable recruitment of 150 HRH Diaspora to be placed (ST, LT, virtual) in prioritized areas health care delivery and training institutions by 2018 • Obstacles to be overcome (cost, mistrust, logistical issues, maintenance of Diaspora database, updated HRH needs, …) • Support to the development of a policy and legal framework to enhance engagement of HRH in the diaspora • Inclusion of diaspora engagement component in the National Health Sector SP

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