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Human Resources for Health Results Addis Ababa May 11, 2009

Health Workforce Production for Results. Human Resources for Health Results Addis Ababa May 11, 2009. Andr é -Jacques Neusy, Executive Director THEnet : Training for Health Equity Network. The Production Problem in Africa. Deficit of “well-trained” health workers due to:

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Human Resources for Health Results Addis Ababa May 11, 2009

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  1. Health Workforce Production for Results Human Resources for Health ResultsAddis AbabaMay 11, 2009 André-Jacques Neusy, Executive DirectorTHEnet: Training for Health Equity Network

  2. The Production Problem in Africa Deficit of “well-trained” health workers due to: • Low # produced through pre-service training • Quality & relevance of training inadequate • Migration out of the country • Migration out of the health field • Morbidity and pre-mature mortality • Poorly performing and funded health systems

  3. Scaling Up  Skilling Up?

  4. “persistent ambiguity of our goals even as we perfect the means to achieve them” Albert Einstein

  5. Scaling Up to What End? • To meet health system needs? • To meet priority health needs? • To meet specific goals such as MDG’s? • To satisfy labor market demand?

  6. Consider the Trade-offs

  7. Before Setting Production Goals • What do we know? Establish baseline data • What do we have? Evaluate • country financial resource • existing institutional training capacities and outcomes • What is out there? Benchmark RelevantBest Practices

  8. Defining Relevant Production Models • Are Planning, Production & Evaluation Streamlined to ensure alignment with system, labor market & health needs? • Are Current Models producing the desired Outcome and Impact? Quality, performance, distribution, financing • Is there Adequate Capacity and Resources to meet Production Goals?

  9. THEnet Schools The Northern Ontario School of Medicine (Canada) The Latin America School of Medicine (Cuba) The University of the Philippines-Leyte School of Health Sciences (Leyte, Philippines) The Medical School of the Ateneo University of Zamboanga (Philippines) The Comprehensive Community Physician Training Program (Venezuela) The Medical School of Walter Sisulu University (S- Africa) The Medical School of Flinders University (Australia) The Medical School of James Cook University (Australia)

  10. The Social Accountability Production Model Performance Measures: Quality Equity Relevance Cost Effectiveness

  11. Production Elements:WHO to train? What is the Current Evidence on: • Social, Demographic & Geographic Background USA PSAP (1979) dramatic increase PHC practice in rural area Australia JCU (2000) & Flinders (1997) Philippines AZU (1994) & SHS Leyte (1976) Venezuela BAU (2005) • Training of Mid-level & Frontline workers • Task shifting

  12. Step-ladder curriculum:Community and Competency-based Case Study: School of Health Sciences University Philippines Physicians Licensure Examination Doctor of Medicine (MD) Service leave Bachelor of Science in Community Health (BSCH) Service leave & National Licensure Examination Bachelor of Science inNursing (BSN) Service leave & National Licensure Examination Certificate in Community Health Work (Midwifery)

  13. Production Elements: WHAT – Content of Training • Priority Health Needs • Primary Care Focus • Competency-Based • Balance individual & population health

  14. Production Elements: HOW • Where should Learning take Place? • Tertiary CarePrimary Care Setting • UniversityPractice Setting • UrbanRural • Which Learning Methodologies fit the context? • Learner centered methodologies • Service based learning • Distributed Learning • IT as support structure or mainstay

  15. Production Element: HOW? • Who should Teach? • TOT integrated into Health Worker Education • Health Workers trained as Facilitators • Mentors in Practice Setting • How to Maximize Scarce Resources with Collaboration? • Regional approaches • Multi-professional learning platforms • Networking and Resource Pooling

  16. Case Study: Northern Ontario School of Medicine • Inter-professional • Integrated • Community Oriented • Distributed Community Engaged Learning • Patient Centered Case Based Learning • Primary Care – Generalist Oriented • Diversity through recruitment from Underserved Communities

  17. More Evidence Needed • Need for Context Specific Evidence Base (requires academic infrastructure in rural & remote communities) • Cross-Disciplinary Research Collaborations • Strengthen Policy Research and Analysis • Document Processes and Benchmark Strategies that are Successful across Contexts • Context Driven Common Performance Standards and Evaluation Tools

  18. THEnetCommunity of Practice Mapping the Landscape and identifying Gaps: from Secondary School to Post-graduate Medical Education Develop Common Standards & Taxonomy to Measure Process, Outcomes & Impact Cross-Institutional and Cross-Disciplinary Research & Evaluation Community of Practice & Capacity Development Advocacy for Socially Accountable Education

  19. André-Jacques Neusy THEnet: Training for Health Equity Network Email: AJ.Neusy@med.nyu.edu

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