Human Resources in Health Care Keerti Bhusan Pradhan

Human Resources in Health Care Keerti Bhusan Pradhan keerti@aravind. org

Healthcare as Service Sector ¡ ¡ ¡ Healthcare more than any other sector depends on people to carry out its mission HR accounts for a high proportion of budgets assigned to the health sector Globally 35 million persons are employed in health sector (ILO) The economic and human costs of poor HR are high in the health sector Health services mission, strategic plans and quality improvement initiatives are useless unless there is appropriate policies and procedures for managing people Health care key stakeholders are people and despite changes in the way care is provided people are always central in the provision of care whether the care is preventive, promotive, diagnostic, curative, chronic or rehabilitative

Healthcare-Science or Art The Science of Healthcare That is achieving and delivering high quality health care products and services through use of scientific and innovative technology ¡ The Art of Healthcare Managing the human beings who provide the services and improve the products ¡

Challenge for health systems Physical Infrastructure ¡ Governance ¡ Financing ¡ ¡ Human Resources (Work Force)

Insufficient Human Capacity In many developing countries there is insufficient human capacity to make use of the newly available resources ¡ New Opportunities are due to: Scientific Advances (Vaccines…) Infusion of new money New drugs Without a motivated, competent, well distributed and well supported workforce-Waste/Misuse of resources ¡

Dimensions of HRH performance ¡ ¡ ¡ Coverage: the extent to which the allocation of the workforce corresponds to needed services in terms of type of services and geographical access Productivity: the ratio of outputs relative to inputs Technical quality: the extent to which services have a positive impact on health status Sociocultural quality: the extent to which services are acceptable to users and meet their expectations Organisation stability: the use of the workforce so as to guarantee the viability of services and their capacity to adapt to changing needs

Challenge of HSR on HR Changes ¡ ¡ ¡ Cost Reduction Improvement in Performance Improvement of Equity of access to services Decentralization of services Changes in the health model Implications for WF ¡ ¡ ¡ Staff planning, Staff distribution, Working conditions Incentive System, Work organization, Professional Development Process, Training Deployment of personnel, Methods of recruiting and retaining staff Transfer of authority, Skills needed Redefinition of professional roles, Integration of services

Workforce Imbalances ¡ Imbalances between HR management practices and national policy objectives. Ex: Where Health Policies aim at developing PHCare while training programs continue to prioritize the training of specialized doctors ¡ Mismatches of numbers: ¡ Qualitative disparity: ¡ Unequal distribution of workforce: Shortages/surpluses resulting from gaps between the training programs and the requirements of the country’s health policy b/w Geographical areas, professions and categories, health establishments and specialities

Characteristics of HR activities in the health sector ¡ ¡ ¡ ¡ The Intersectoral nature of Health Services The time-lag between decision making and outcome Strong Professional Dominance Interdependence of the different professional categories The role of the state as the principal employer The high proportion of the women employed in health services (Thai study) The ambiguity of the relationship b/w health needs, service requirements and resource needs in the supply of these services Deficiencies of the market

Policy Issues Link between effectiveness of health workforce and improved performance of health system ¡ Nature of Health workforce Size, composition, skills, training needs, current functions and performance, appropriate roles, adaptation to changing priorities ¡ Lack of data for evidence ¡ Evidence on the effectiveness of HR training ¡ Framework for assisting countries for HR planning and development ¡

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