Estrategia de cooperación para la
segunda medición de Metas
Regionales y Análisis de Políticas de
Recursos Humanos para la Salud
Taller de expertos
Lima, Perú, 14-16 de noviembre 2012
Charles Godue
Coordinador
Recursos Humanos
para la Salud
Ámbito regional
Principales marcos internacionales de políticas de recursos humanos para la salud
Observatorio de RHS
1999
Reforma sectorial
Joint Learning Initiative
2003
Llamado a la Accion de TOR
2005
Renovación de la APS
Informe Mundial de la Salud 2006
Informe Mundial de la Salud 2008
20 Metas Regionales de RHS 2007‐2015
RISS
Declaracion de Kampala
2008
Informe Mundial de la Salud 2010
Estamos en buen camino para alcanzar 3er Foro Global las Metas?
de RHS Recife 2013
Cual será la nueva agenda de RHS post 2015?
20 Metas Regionales de RHS
•Desarrollo de indicadores
•Desarrollo de una metodología
•1era medición y línea basal en 24 países
•Informe de progreso para la CSPA
•Medición en niveles descentralizados y 2nda medición
Proponemos a los países una 2nda medición? (medición intermedia)
Si proponemos una medición intermedia para documentar avances y retrocesos, como podemos evaluar la contribución de las políticas, estrategias y programas diseñados para alcanzarlas?
Un proceso de evaluación de políticas podría generar los insumos críticos al desarrollo de una nueva agenda de RHS post 2015?
Un proceso de evaluación de políticas de RHS puede informar:
Las Metas Regionales de RHS?
Los objetivos y prioridades nacionales de RHS?
Los objetivos sub‐regionales de RHS?
Búsqueda de un denominador común, relacionado con la APS y la cobertura universal en salud, priorizando la disponibilidad de un personal de salud suficiente, competente, motivado y apoyado en el primer nivel de atención
Resultados esperados (outcomes):
La propuesta de evaluación de política debe ser:
•Relativamente simple
•Relevante, atractiva, con “tracción” política
•Flexible y adaptable a contextos y realidades diversos (países de ingreso bajo / medio)
•Articulada a iniciativas existentes (ej: Road Map en el CAR)
•Introducción de ajustes y mejoría de las políticas, estrategias y programas en marcha
•Diseño de nuevas iniciativas
•Identificación de los principales obstáculos
•Fortalecimiento de las capacidades de planificación
•Cultura de monitoreo y evaluación •Aprendizaje colectivo
•Insumos para una nueva agenda de RHS post 2015
La estrategia de cooperación propuesta
Mónica Padilla
CAM
Benjamín Puertas
Sur América
Mario Dal Poz CC UERJ
Margarita Velazco, Observatorio Social
Expertos
M. Nunez, R. Cameron
Don Ferguson
CAR
Gail Tomblin, CC DU
Consultores Regionales
OPS
Las expectativas del taller….
LOS INSUMOS
•Marco conceptual
•Metodología
•Tool kit
•Glosario
•Guías
•Capacitación
•Templates
LOS PROCESOS
LOS PRODUCTOS
•Identificación y preparación del grupo conductor
•Participantes
•Actividades (encuesta, estudios, grupos focales etc.)
•Coaching
•Informes de análisis de políticas
•Inventario de políticas
•Estudios de caso
•Publicaciones
•Buenas practicas, policy briefs
•Curso de planificación
•otros
Red de Observatorios de RHS / Red de Aprendizaje (CVSP)
Los tiempos disponibles…
Reunión regional de RHS
SEP 13?
Preparación y diseño
NOV12 –ENE13
2nda medición y análisis de políticas en los país
FEB ‐ AGO
2012
2013
3er Foro Mundial de RHS
Recife
10‐13 NOV 13
t
2014
Observatoriorh.org
Gracias! Merci!
Thanks!
HHR Observatory: core ideas
PRINCIPLES AND
VALUES
HRH
POLICIES
STAKEHOLDER’S
INTERESTS
INFORMATIO
N AND
EVIDENCE
Evidence-based Healthcare Muir-Gray, J (1998)
THE HRH OBSERVATORY
EVIDENCE FOR DECISION MAKING
HRH Core Data Set
Comparative studies
Case Studies
National
Inter‐institutional
Inter‐sectoral
Group
Cooperation between countries
Information Clearinghouse
Training
Institutional Development
HRH STEWARDSHIP
HRH POLICIES
PLANNING
REGULATION
EDUCATION
HRH MANAGEMENT
Direct Technical Cooperation
ANALYSIS
NEGOTIATION
AGREEMENT
HRH STRATEGIC INTERVENTIONS MISSION
To lead strategic collaborative efforts
among Member States and other partners to
promote equity in health, combat disease,
and improve the quality of, and lengthen, the
lives of the peoples of the Americas.
Pan American Health Organization
World Health Organization
2008
PAHO MEMBER STATES and
PAHO’s PRESENCE IN THE REGION
Guatemala
Haiti
Honduras
Jamaica
Mexico
Nicaragua
Panama
Paraguay
Peru
Dominican
Republic
Saint Kitts and
Nevis
Saint Lucia
Saint Vincent and
the Grenadines
Suriname
Trinidad & Tobago
Uruguay
USA
Venezuela
Pan American Health Organization
Antigua &
Barbuda
Argentina
Bahamas
Barbados
Belize
Bolivia
Brazil
Canada
Chile
Colombia
Costa Rica
Cuba
Dominica
Ecuador
El Salvador
Grenada
Guyana
World Health Organization
Participating States
France
Netherlands
United Kingdom
Associate
Member
Puerto Rico
Observer States
Spain
Portugal
Headquarters
Country Offices
2008
HUMAN RESOURCES FOR HEALTH: THE REGIONAL APROACH Integration processes between countries •NAFTA
•SICA
•CARICOM •CAN •MERCOSUR PAHO HSS/HR
Technical Cooperation
Four official languages:
•English
•French
•Portuguese
•Spanish
Laying the Foundation
RROAD MAP IMPLEMENTATION, Road Map Implementation, 2012‐17
2012‐17
High Level Meeting, Caribbean HRH Road Map (2012)
Kampala Declaration (2008) CARICOM CCH III (2008)
The Health Agenda for the Americas (2008)
HRH Data Management Project (2007) Regional Goals for HHR (2007) WHO World Health Report (2006)
Global Health Workforce Alliance (2006)
Joint Learning Initiative (2004) Toronto Call to Action (2005) Joint Learning HHR Road Map – The Journey
Context
Components/Milestones
Population
Health Issues
Epidemiology
Aging Population
Child Health
Mental Health
Education
Poverty/Education
Violence/Crime
Health System
Issues
Inefficiency
Costs & Capacity
Poor Access
Service Quality
Leadership
Management
2012
HRH
Database
Outcomes
Health
Learning
Network
HRH
Observatory
Rural Supply
EFFICIENCY of
Service Delivery
EFFECTIVENESS of
Health Outcomes
HRH Issues
HRH Shortages
STABILITY of
Health Workforce
GOVERNANCE
EDUCATION & TRAINING
Develop & Implement
Managerial Skills
Growing Needs
HRH Plans
HIS Training
Attrition
HRH Policies
Policy Development
Emigration
Workplace Improvements
Staff Management
Legislation
Health & Safety
HRH Inventories
Provider Competence
Programs
ENABLERS
Policies
Training
Impacts
WORKFORCE
Optimal
Competent
Aligned with
Needs
Stable
Distributed
Flexible
Accountable
HEALTH SYSTEM
Efficiency
Quality
Equity
Access
Administration
Sustainability
Management
Productivity
Funding
Planning
Partnerships
HRH PLANS
Community Based Integrated PHC Teams – Enhanced Skills – Task Shifting – Competency Based
Deployment – Needs Based Planning – Health Promotion – Disease Prevention – Chronic Care
2013-2017
Communications
Evaluation/
Monitoring
POPULATION
Improved Access
Appropriate
Access
Better Quality
Better Informed
Better Health
2020+
HRH Capacity & Skills Development
EDUCATION
E
D
U
TRAINING
HRH Planners
‐ Legislation & regulation
‐ Policies & programs
‐ Data systems & monitoring
‐ Communications & partnerships
‐ Research & evaluation
‐ Evidence‐based planning
‐ Funding Health
‐
H R H
Facilities Managers
‐ Health, safety & security
INFORMATION
SUPPORT
‐ Labour relations
‐ Assessment & deployment
‐ Professional development
‐ Performance management
‐ Succession planning
‐ Incentives & compensation
‐ Recruitment & retention
Care Providers
‐ Primary health care
‐ Public health
‐ Chronic care
‐ Health promotion
‐ Disease prevention
‐ Community‐based
‐ Integrated teams
‐ Task‐shifting
‐ Competency‐based
deployment
GOVERNANCE
G
O
E
R
MANAGEMENT
N
A
N
C
SERVICE E
PROVISION
OBSERVATORY MODEL (AMRO)
eg
b‐r
Su
al
i on
National Observatory
MO
H
P. A.
UN
I
Other
Regional Observatory
PAHO
Sub‐regional
The HHR Observatory: definition
It is a regional network of governments,
academic institutions, health services and
social organizations, promoted by the Pan
American Health Organization, for the
generation, analysis, access and
exchange of information, knowledge and
experiences to support decision-making
and the formulation and implementation of
public policies, in response to national
HHR priorities and the Regional Goals for
HHR 2007-15
Mission
Through collaborative networking,
contribute to the generation of information
and knowledge aimed at strengthening the
response capacity of the national health
authority and to the formulation and
management of HHR policies, plans and
strategies designed to achieve universal
coverage and the development of health
systems based on Primary Health Care
Objectives
• To produce evidence in HHR, through
systematic and critical analysis and from
different perspectives, based on a country’s
needs
• To generate standardized information on HHR
• To evaluate and monitor situations and trends
of HHR related to the 20 HHR regional goals
and the 5 challenges of the Toronto Call to
Action
Objectives
• To improve the quality of information and
strengthen information systems on HHR
• To identify information gaps and research
needs on HHR
• To design communication and dissemination
strategies of information, evidence and
concerted action
Observatoriorh.org
Observatoriorh.org
TORONTO CALL FOR ACTION
2005
1. Long term policies and plans
2. The right people at the right place
3. Appropriate education and competencies
4. Working conditions and performance
5. Migration of health personnel
• 20 REGIONAL GOALS FOR HHR 2007 – 2015
• HEALTH AGENDA OF THE AMERICAS
• PAHO STRATEGIC OBJECTIVE 13
• Capacity for HHR planning • Planning HHR for Ageing and NCDs
• How to introduce more flexibility in the regulation of professional practice
• Reform of GME
• Coordination with ministry of education
• Indigenous Peoples, cultural diversity and HHR
• Salaries, modes of remuneration, financial incentives to performance
• Health and safety of health workers
Red Regional
CVSP
Nodos de Países
(10)
139 Instituciones
* Nodo OPS
Cuba
*
Mexico*
*
Chile
Costa
Rica
Colombia*
Ecuador* * Brasil
Peru* * Paraguay
Chile* *
Argentina
(21)
(10)
Actores claves
• Ministerios de Salud
• Oficinas OPS
• Universidades
• Asociaciones
(9)
(13)
(34)
(8)
(10)
(7)
(6)
(21)
28
E‐learning Platform
THE NEED FOR AN HHR OBERVATORY IN CANADA?
• Highly recognized technical expertise
• Health system with values and principles coherent
with universal coverage and PHC strategy
• Research know-how and capacity in HHR / Health
Systems
• The essence: national relevance and contribution
• The concept: technical cooperation (share
knowledge and information resources)
• The way: structured network
• Specific interest: Caribbean Region, Brazil, Chile