HUMAN RESOURCES PLANING AND MANAGEMENT
Sub-regional Experience
Central America and Dominican Republic
Mónica Padilla
HR ADVISOR
PAHO/ WHO
There are shortages of health workers worldwide
Distribution of the global health workforce
Source: WHO (2006). The World Health Report 2006 – Working Together for Health. Geneva, World Health Organization
2|
Global Perspectives on the Health Workforce
What must be done to lower maternal mortality?
Maternal mortality ratio per 100 000 live births in 2000
Source: WHO (2005). The World Health Report 2005 – Make Every Mother and Child Count. Geneva, World Health Organization
3|
Global Perspectives on the Health Workforce
Health workers save lives … but we need enough of them
High
Probability of survival
Maternal Survival
Child Survival
Infant Survival
Low
Low
Proportion of health workers per population
High
Source: WHO (2006). The World Health Report 2006 – Working Together for Health. Geneva, World Health Organization
4|
Global Perspectives on the Health Workforce
HUMAN RESOURCES PLANING AND
MANAGEMENT
- Social – Political Context
- Health Care system - organization – services –
- Citizen rights
- HRH Action Framework
- Information and knowledge for better decisions
- Common Agenda
Framework of action of health systems
FUNDAMENTAL ELEMENTS OF THE SYSTEM
DELIVERY OF SERVICES
HEALTH WORKFORCE /HR
What is the situation and
Process in Belize ?
INFORMATION
DRUGS AND TECHNOLOGY
FINANCING
LEADERSHIP/GOVERNANCE
BETTER HEALTH FOR
THE POPULATION
HR AS A CORNERSTONE
OF HEALTH SYSTEMS
HRH Action Framework
tools for an effective and sustainable health workforce
Preparation
& Planning
Critical
Success
Factors
country
specific context
including
labour market
Policy
Leadership
Situation
analysis
HRM
Systems
Finance
Implementation
Improved
Health
Workforce
Outcomes
Partnership Education
M&E
BETTER
HEALTH
SERVICES
Equity
Effectiveness
Efficiency
Accessibility
BETTER
HEALTH
OUTCOMES
other health
system
components
Go to CD-Rom / Internet [http://www.capacityproject.org/framework/]
7|
Global Perspectives on the Health Workforce
Information and knowledge for better decisions
ENTRY:
Preparing the
workforce
Planning
Education
Recruitment
EXIT:
Managing attrition
Migration
Career choice
Health and safety
Retirement
WORKFORCE
PERFORMANCE
WORKFORCE:
Enhancing worker
performance
Supervision
Compensation
Systems support
Lifelong learning
Availability
Competence
Responsiveness
Productivity
Do we have integrated national data ?
Source: WHO (2006). The World Health Report 2006 – Working Together for Health.
Geneva, World Health Organization
Human Resources Unit
Health Systems Strengthening Area
Toronto Call To Action:
Answers the Challenges
Human Resources Unit
Health Systems Strengthening Area
COMMON AGENDA: A SUB – REGIONAL APROACH
INTEGRATION
PROCESSES
BETWEEN
COUNTRIES
•SICA
•CARICOM
•CAN
•MERCOSUR
PAHO
HR TECHNICAL COOPERATION
2005
Central America and Dominican Republic
Human Resources Development Agenda
8 COUNTRY TEAMS -
SICA /COMISCA -
PAHO
IMPLEMENTATION
26 AUGUST 2010
HR TECHNICAL COMISSION
COMMON AGENDA 2010-2012
•BASED ON NATIONAL PRIORITIES
•PARTICIPATIVE PROCESS
• BUILD ON A CONSENSUS
•LED BY THE NATIONAL HEALTH
AUTHORITIES
Country Teams working ………..
COMMON
AGENDA
Central America and Dominican Republic
N
Human Resources Development Agenda
A
8 COUNTRY TEAMS -
SICA /COMISCA -
PAHO
COMMON AGENDA
2011
•Establish team and a joint working mechanism
•Establish a Baseline of Regional HR Goals in the Sub region
2012
•Implement national observatories based RHUS Regional
Observatory
•Strengthening the production of information and knowledge
in HRS
•Professional migration in CA and DOR regional study Health education and training
2013
•Integrated Panel of Information HR
•International Diploma for HRH Managers
•II measurement Regional Goals
•HR Program Evaluation – HR Global Forum Brasil
•HR Development Plan CA / DOR 2013 - 2015
C
I
O
N
A
L
A
G
E
N
D
A
1
THE PROCESS …..
BASE LINE REGIONAL RH GOALS NATIONAL TEAMS
• Ministry of Health
•Social Security
•PAHO
SUBREGIONAL GOAL
Step 1: Start monitoring Invitation
Step 2: Standardization
Step 3: Verification of information sources
Step 4: Data collection, calculation of indicators, state balance
measuring and preparation of the Baseline
Step 5: Presentation and discussion of the measurement of
goals
Step 6: Planning and preparing action plans
Step 7: Balance measurement RHUS Regional Goals
Step 8: Presentation of Regional Baseline to Health Ministries /
COMISCA
To become a team that produces
results
A
2
G
HR OBSERVATORY SUBREGIONAL AND NATIONAL NETWORK
E
N
NATIONAL TEAMS
•MOH : HR Direction / Technology and computers
•Social Security
•University •PAHO D
A
N
A
COACHING PROCESS C
SUBREGIONAL GOAL I
O
To become units with the best and most
updated HRS information on each country
N
A
L
Challenge: lack of technology, technical capability, the fragmentation of the HR data sources http://apps.who.int/globalatlas/autologin
/hrh_login.asp
THE HRH OBSERVATORY
1998 - 2012
Political
conditions
Technical
basis
Advocacy Priority
HR
MEETING,
BARGAINING,
AGREEMENT
+
EVIDENCE
THE HRH OBSERVATORY
EVIDENCE FOR DECISION MAKING
HRH Core Data Set
Comparative studies
Case Studies
National
Interinstitution
Intersector
Group
Cooperation between countries
Information Clearinghouse
Training
Institutional Development
HRH
STEWARDSHIP
HRH POLICIES
PLANNING
REGULATION
EDUCATION
HRH MANAGEMENT
Direct Technical Cooperation
ANALYSIS
BARGAINING
AGREEMENT
HRH STRATEGIC
INTERVENTIONS
HRH observatories development coaching process: CA /
March 27th - Jun 15th 2012
OBJECTIVES AND PRODUCTS
UNIT
OBJECTIVE
PRODUCTS
Observatories structure and
functions
Identify functions and
Structures required
Functions discussed
Commissions convened
Installation and
management of HRS web
sites
Identify requirements of
networking and virtual
communication technology
Regional and national web
portals designed and
operating
Teams trained in DRUPAL
CMS
Generating strategic
information
National teams update
information systems RHS
Regional and national core
data defined
Feeding and use online
software to process data
(health education and
measurement of regional
goals HRS)
Teams trained in HR
information systems
HR Observatory software
(Regional Goals / Health
Education) in use
Coaching material:
http://www.observatoriorh.org/centro/?q=node/75
GROUP 1: Guatemala, Nicaragua, Honduras y Costa Rica
GROUP 2: República Dominicana, Panamá, Belice y El Salvador
8 Virtual sessions 3 H
1 final meeting
No homework ….
Need for political
support as a
requirement for
participation in the
sub regional
closing meeting
EQUIPOS DE PAÍS
1. HR OBSERVATORIES
ESTRUCTURE
AND OPERACIÓN
•
National commissions
• Institutionalization
• Network
Nicaragua
BELICE
2. Regional and national web portals designed and
operating
Multisite System / CMS Drupal
Observatorio Centroamericano
MOH
HR professionals
Social Security
Computer and
technology
professionals
University
PAHO/ country
•
Each country manages its own portal
• Leadership of the health authority
• decentralized management responsibility
Nacional Observatories
Observatorios Nacionales
3. Strategic Information Generation production
integrated information panel
En desarrollo
Software available on line on page RHUS Observatory for the use of
countries in the region of the Americas (need to translate into English)
Each country can record and graph
information from training institutions,
geographic distribution, offering cadres.
Can offer a national data of enrollments
and graduates
• Call and commitment to the
institutions of each country to report
the information annually
• Example agreement signed by the
deans of medical schools in Ecuador
Challenges for a National Plan
and Agenda
•
•
•
•
Mechanism to work together (Network)
Select priority problems to address
Produce relevant useful information and knowledge
Monitoring actions and evaluating results
0
0
8.0
8.0
7.8
7.8
7.0
7.0
4.8
4.8
4.2
4.2
MORAZAN
MORAZAN
5
4.9
4.9
LA UNION
LA UNION
5.8
5.8
CABAÑAS
CABAÑAS
LA PAZ
LA PAZ
8.1
8.1
CUSCATLAN
CUSCATLAN
9.7
9.7
AHUACHAPAN
AHUACHAPAN
10
10
SAN VICENTE
SAN VICENTE
11.0
11.0
CHALATENANGO
CHALATENANGO
15
15
SONSONATE
SONSONATE
20
20
USULUTAN
USULUTAN
21.3
21.3
SANTA ANA
SANTA ANA
5
22.0
22.0
SAN MIGUEL
SAN MIGUEL
25
25
PAÍS
PAÍS
30
30
LA LIBERTAD
LA LIBERTAD
45
45
SAN SALVADOR
SAN SALVADOR
Densidad de Recursos Humanos
Médicos y Enfermeras por 10,000 habitantes.
El Salvador
42.7
42.7
40
40
35
35
29.9
29.9
20.8
20.8
URBAN - RURAL DISTRIBUTION
Physician Density Latin American countries
120
105
100
80
60
40
20
0.6
0
19.5
17.7
15
N ICARAGUA
5.3
1.3
BOLIVIA
14.7
3.3
PERU
URBAN DENSITY
6.03
10.4
1.2
COLOMBIA
ARGENTINA
PARAGUAY
RURAL DENSITY
Colombia
Cuando se comparan las tareas que realiza el personal en
la actualidad con los currículos académicos de su
formación se observa la NO PERTINENCIA del
mismo.
Se muestra el caso de medicina
1.80
1.66
1.60
1.60
1.40
1.20
1.00
0.80
0.60
0.40
0.20
0.07
0.00
Clinical
Fuente: Cálculo CENDEX
Teorical - Practical
Escenario of
practice
Subsecretaría de Innovación y Calidad
Dirección General de Calidad y Educación en Salud
Dirección de Políticas y Desarrollos Educativos en Salud
Especialidad de pediatría y oferta laboral de
Correlación (1991-1999-2001) proyección 2010
pediatras.
3,500
Demanda de insc ripc ión al ENARM
Tendenc ia en la demanda de insc ripc ión al ENARM
Oferta de bec as para la espec ialidad de pediatría
Tendenc ia de la oferta de bec as para la espec ialidad de pediatría
Oferta Laboral para Médic os Pediatras
Tendenc ia de la oferta Laboral para Médic os Pediatras
Poblac ión de 0 a 15 años CONAPO
Población de 0 a 15
años1
(millones)
37
36
3,000
Sumatoria 19,070
2,500
35
34
2,000
33
1,500
32
1,000
500
Sumatoria 6,230
Sumatoria 2,596
30
29
0
-500
31
1991
1993
1995
1997
1999
2001
2003
2005
2007
2009
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
Fuente: Comisión Interinstitucional para la Formación de Recursos Humanos en Salud. Boletín de Información Estadística (Recursos y Servicios) de la
DGEI. Proyecciones de población CONAPO Censo 2000.
Mapa proporcional de la distribución de enfermeras
Fuente: http://www.worldmapper.org/images/largepng/216.png
Mapa proporcional de la distribución de médicos
Fuente: http://www.worldmapper.org/images/largepng/216.png
Decitions …..
SOCIAL RURAL SERVICE IN PERU TRANFORMATION 2005 ‐ 2008 HEALTH FACILITIES WITH
SOCIAL SERVICE PROFESIONALS
SERUMS ‐ 2005
SOCIAL RURAL SERVICE IN PERU TRANFORMATION 2005 ‐ 2008 HEALTH FACILITIES WITH
SOCIAL SERVICE PROFESIONALS
SERUMS ‐ 2008
http://dev.observatoriorh.org/sites/default/files/w
ebfiles/informacion/reubraoct2011/per_moscoso
&suarez.pdf
Human Resources Observatory CA / DOR
http://www.observatoriorh.org/centro/
Muchas Gracias !!!