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Human Resources for Scaling Up HIV/AIDS Interventions

Human Resources for Scaling Up HIV/AIDS Interventions. Evidence and Information for Policy. Barbara Stilwell, Coordinator, Dept. of Human Resources for Health, Geneva. The size of the problem. HRH challenges for achieving HIV/AIDS interventions.

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Human Resources for Scaling Up HIV/AIDS Interventions

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  1. Human Resources for Scaling Up HIV/AIDS Interventions Evidence and Information for Policy Barbara Stilwell, Coordinator, Dept. of Human Resources for Health, Geneva

  2. The size of the problem

  3. HRH challenges for achieving HIV/AIDS interventions Inadequate number of HRH and inadequate distribution

  4. HRH challenges for achieving HIV/AIDS interventions Qualification of HRH Stigma attached to HIV/AIDS “Stigma will follow me, and my brothers and sisters for the rest of our lives. Sometimes it even accompanies us into death” (South Africa, PLWA)

  5. Migration Sources: General Medical Council, 2002; Nursing and midwifery council, 2002; Migration Research Unit, 2002

  6. Intention to migrate from Nigeria: Main reasons Source: MoH, 2003

  7. Health workforce distribution Distribution of countries by stock of HRH, according to region Source: WHO database on health personnel, late 1990s Source: HRH data base, WHO, 2000

  8. Labour market Source: HRH 6 country study, WHO, 2003

  9. HIV/AIDS specific HR issues countries are struggling with : • Difficulty to plan the required number of staff in the ART care flow • What skills should be taught to which level of staff? • Impact of HIV/AIDS on staffing - absenteeism due to morbidity, mortality, time lost due to funeral attendance and caring for sick family members

  10. HIV/AIDS and HRH models Gathering evidence and information to identify ART delivery systems and HRH inputs from: • Community projects • Employer-based schemes • Public hospital PMTCT • Developing national systems of care institutions from various sectors • National expansion programme based on • PLWA input at clinic and community level • Research sites delivering care Site visits (41) + Country HR assessments

  11. Adjusted service targets method for HRH requirements Service Targets Services Skills required Demographics Tasks Needs Time requirements Incidence and prevalence of diseases Productivity /efficiency gains HRH requirements (FTEs)

  12. The way forward with the highest level of political support • Short term • Transfer of tasks to community members, including involvement of PLWA • Combination of tasks: review all clinical/preventive tasks at all levels for all programmes • Emergency response resources - volunteers • Short period training • Develop stigma reduction strategies

  13. The way forward with the highest level of political support • Medium term • Changes in legislation to maximize HRH use • Review regulations governing health providers’ diagnostic and treatment authority • New cadres of health care workers that can be trained quickly • New HRH skill mix • Policies addressing HRH retention problems • Public /private partnerships • Health worker substitution • Develop stigma reduction strategies

  14. The way forward with the highest level of political support • Long term • Strengthening capacity of health systems at regional and national level - including HRH development plans and migration • Building supportive infrastructures • Increasing the stock of HRH (training) • Review fiscal policies to overcome public sector employment constraints • Develop stigma reduction strategies

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