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Capacity Workshop on Health System Development: Human Resources Development : 

22 September 2010 1 Capacity Workshop on Health System Development: Human Resources Development Alexandria, 8-12 June 2008 Ghanim Alsheikh, WHO/EMRO alsheikhg@emro.who.int

Outline : 

22 September 2010 2 Outline HR and H System HR and Health Outcomes HRD Sub-system HR Policy framework Main messages for future directions

Slide 3: 

HRH and Health system

Message 1: As a cross-cutting function, HRH is the ENGINE of any Health System : 

22 September 2010 4 Message 1: As a cross-cutting function, HRH is the ENGINE of any Health System HR HR HR HR HR HR

Slide 5: 

HRH and Health Outcome

Worker Density & Service Coverage : 

22 September 2010 6 Worker Density & Service Coverage From: JLI 2004.

Slide 7: 

22 September 2010 7 Worker Density and Mortality (Data from 117 country) Source: Anand & Baernighausen- 2004 (JLI)

HR “Numbers Game” : 

22 September 2010 8 HR “Numbers Game” Message 2: Number essential but NOT ENOUGH Performing HS and its HRH

Slide 9: 

HRH Mal-distribution

Slide 10: 

22 September 2010 10 Health Worker Density Comparisons by World’s Regions From: JLI 2004.

Slide 11: 

Regional mal-distribution: Physicians

Regional mal-distribution: nurses : 

Regional mal-distribution: nurses

Deceiving Surplus : 

22 September 2010 13 Deceiving Surplus Unregistered out-migration; Dual practice Poor absorption of HS: only 60/135K employed in public National/Foreign workforce: 2%

: 

Hospitals Health Centers Physicians Nurses and midwives National mal-distribution: Geographic & facility maldistribution Densities per population of Drs & nurses in Hospitals & Health Centers by governorates

Different mal-distribution: Skill Mix: 14 EMR countries : 

22 September 2010 15 Different mal-distribution: Skill Mix: 14 EMR countries

What standards?Ratio of Nurse/Physician in OECD (1) & EMR (2) : 

22 September 2010 16 What standards?Ratio of Nurse/Physician in OECD (1) & EMR (2) Message 3: Averages are misleading, close M&E for different kinds of mal-distribution is essential, HRH regional & national observatories

Slide 17: 

Human Resources Development Sub-system

Generic Framework for National HRH dynamics : 

18 Production of Health Inflow Education In-migration Retirement Death Out-migration Outflow Coverage Motivation Competence Generic Framework for National HRH dynamics Stock Health Workers Source: JLI 2004.

The Human Resources Development Sub-system : 

19 The Human Resources Development Sub-system Message 4: HRD intervention should be systematic to address 3 stages: HR planning, HR production and HR utilization

National HRD subsystem Stakeholders : 

20 National HRD subsystem Stakeholders Health services Professionalassociations continuingeducation CPD MOH HRD Units University HPE Vocational education Universitynon-HPE National Planning Coucil Health planning Message 5: Wide membership of a National Coordinating mechanism to address all stages of HRD system

Slide 21: 

21 Message 6: A Nanal HRH Policy should address all HRD subsystem to meet demands of health system development

Conclusion: main messages: : 

22 September 2010 22 Conclusion: main messages: As a cross-cutting function, HRH is a priority for efficient Health System to achieve health outcomes HRD should address both number, quality and performance Sound information and close M&E of different kinds of mal-distribution is essential. HRD interventions should be systematic to address 3 stages of HRD subsystem Wide membership of a National Coordinating mechanism is essential to address all stages of HRD system and ecosystems. A Nanal HRH Policy should address all HRD subsystem aiming at meeting demands of health system development.

Thank you : 

22 September 2010 23 Thank you