BY: Shanna Tun MPH (HRH, MOH, Belize)
Shanna Tun MPH (HRH MOH Belize)
Natalia Castillo‐Rodriguez MD, MPH (Social Security, Belize)
National health system for HRH Planning in BELIZE
y To ensure Universal Access and population based
services as a result
l off health
h l h sector reform
f
y The Administrative authority of health services were
decentralized giving Four (4) health regions that cover
the entire country:
y the Northern Region
g
which encompasses
p
the northern
districts of Corozal and Orange Walk,
y the Southern Region which covers Toledo and Stann
C k
Creek,
y the Western Region which covers the Cayo District and
y the Central Region,
Region which covers the Belize District.
District
includes
y Hospital based care in these four regions includes:
y inpatient and outpatient care, including
y
yA
accident
and
emergency,
paediatrics,
obstetrics and gynaecology, internal medicine
andsurgical care.
network of clinics, permanently staffed health
centres and un‐ manned health p
posts is available to
address the primary health care needs of the
population. These are supplemented by mobile
health
ea t
services,
se
v ces, co
community
u ty nursing
u s g aaides,
des,
community health workers and traditional birth
attendants working throughout the rural
communities of the country.
country
National System
y Minister
y Chief Executive Officer
y Director of Health Services
y Directors: Planning and Policy; Health; Epidemiology
y Of which HRH is housed in the Planning and Policy unit
Educational Environment
y Belize has no medical faculty where physicians are trained. However various categories of nurses are trained at Belize’s national university
trained at Belize
s national university, the University of the University of Belize. y Graduation rates appear to be abysmally low
Graduation rates appear to be abysmally low.
HRH Plan for Belize
¾ Themes that are addressed in HRH plans:
9 Strengthen leadership in the public health sector.
9 Increase the investment into the development and improvement of health human resources.
9 Coordination, consensus‐building, and integration of Coordination consensus building and integration of actions throughout all levels: national, sub‐regional, and regional.
9 Ensuring continuity of policies and interventions
9 Improving the collection and management of relevant i f
information on which to base decisions.
ti hi h t b d i i
HRH Plans are in Alignment with the 20 regional goals for HRH 2007 – 2015 at the 27th Pan American Conference in July 2007.
Conference in July 2007
Critical areas that require planning in the
q
p
g
Country
y Belize’s health system is challenged by the increasing burden of
chronic
and
h i non‐communicable
i bl diseases
di
d lifestyle
lif t l ailments.
il
t
y Diabetes, Homicides & Injury purposely inflicted, Ischaemic
Heart disease, HIV/AIDS and Cerebrovascular disease are
l di causes off deaths.
leading
d th
y International Diabetes Foundation reveal that in the age cohort
20 to 79 years, there are some 45,000 Belizeans living with
diabetes.
diabetes
y cost of treating violence and related injuries. On a per capita
basis, Belize has one of the highest homicide rates on the world
and most of the victims are as a result of gunshots.
gunshots
This Leads to burden on the Country’s referral hospital, KHMH.
Prevention programs are now the emphasis of the newly launched
NCD Strategic
S
i plans
l
2014‐2024.
HRH
ACHIEVEMENTS
2009 2014
2009‐2014
WHERE WE ARE TODAY?
¾ MOH Strategic plan
¾ MOH HRH Unit (on the process)
¾ Steering Committee
¾ Observatory
¾ Sub‐committees
¾ MOH HRH Strategic plan 2010‐2014
MOH HRH St t i l ¾ The Operational Plan
¾ Policy Analysis and Planning Unit personnel y
y
g
p
recruitment of HRH Focal Point.
¾ National Health Insurance coverage includes South side Belize City and Southern Region
Improvements towards increasing health professionals to provide health services:
professionals to provide health services:
y Belize approved the CSME freedom of movement, the
movementt off health
h lth professionals
f i
l to
t CSME can be
b
traced since they must apply for a CARICOM Skills
Certificate.
y Cuban Brigade at Primary health Care level is being
phased out to accommodate returning trained
Belizean GP’s from Cuba. (Cuban Brigade assistants
are focused on Specialists. Belize relies on
international healthcare volunteers to shore up health
workforce shortages most especially in the rural areas.
Notable among the healthcare volunteers in Belize are
the Cuban Medical Brigades and the Nigerian
Technical Aids Corps.
First and Second Measurement of the Core Data and Basic d
indicators
And Evaluation of the Community HealthWorkers
Program
The Belize Code of Practice on The International RECRUITMENT
o ea t e so e
of Health Personnel
(Government of Belize / Ministry of ea t / Ju e 0 )
Health / June 2012)
DRAFT
HRH Obersvatory
HRH Observatory Steering Committee
Working Group Subcommittee:
People in the Right Places
9 Committee Members
Working Group Subcommittee:
HRH Training
9 Committee Members
Working Group Subcommittee:
Policy and Planning
10 Committee Members
Working Group Subcommittee:
Working Group Subcommittee: Migration
Working Environment
9 Committee Members
7 Committee Members
Belize
B li
CHALLENGES
1.
2.
3.
4.
5.
6.
High Turnover of HRH (Focal Point) personnel within the Ministry
Lack of Training in HRH
Limited Budget (PAPU)
Technical Difficulties (Long wait time, Contacting the Proper Personnel) in Coordinating with other Ministries p
)
g
for Data and Information
Time availability from representatives of stake holders to p
participate in planning
p
p
g
BHIS HRH Module Information system requires strengthening – coordination between Clinical version and HRH module
NEXT STEPS
• Orientation of MOH HRH Technical Advisor.
• Develop a recruitment and retention plan for HR l
d
l f
and formulate policies and reforms. Increase in salaries and benefits of nurses and doctors, and community health workers.
•
Improve HRH module of the BHIS
Improve HRH module of the BHIS
•
Continue the dialogue with the University of Belize to respond to the issues and concerns that have d
h i
d
h h
been identified.
R l f HRH l
i
d U i
lh l h
Role of HRH planning towards Universal health coverage
REACTIVATE Sub‐Committees • Revise Operational Plan for Implementation for HRH.
• Devise a Reporting mechanism for sub‐committees:
Devise a Reporting mechanism for sub committees:
M&E/Reporting system:
y
Periodicity
y
R
Responsibilities
ibili i
y
Sources of information
•
y Expansion of NHI to cover more regions of the country.
y Strengthening of the Community Health Workers program to be the base of Belize’s primary health care system.