HRH Planning & Management
in the Caribbean Region
Outline of Presentation
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Goal of HRH Planning
Scope and Components of the HRH Planning Process
Highlights of the Caribbean Comparison Report
Approach to HRH Capacity Development
HRH Roadmap: Priorities for Action
Goal of HRH Planning
“To achieve and maintain an optimal and stable
supply and distribution of appropriately trained,
deployed, supported and motivated health
workforce, with the capacity to respond to
current and future population health care needs
in a way that maximizes efficiency and
effectiveness while being affordable and
sustainable…”
The History of HRH Planning
HRH Planning Context
Sustainable Health System Reform
Health
Delivery
CHANGE
MANAGEMENT
Human
Resources
Fiscal Support
Sustainable Health Workforce
Development
HRH
Planning
Management
\ Policy / Education
Finance / Partnership
L
Leadership
Workforce Development
Affordable Healthcare
Health System Outcomes
Health Expenditure & Outcomes
Ranking
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Equity in Healthcare Delivery
Equity for Healthcare Workers
Health System Cost Drivers
Technology Management
Application of Technology
Telemedicine
Primary Health Care Teams
HRH Task Shifting
Competency-Based Deployment
HRH Forecasting
HRH Forecasting
Recruitment & Retention
HRH Management & Development
Governance in Healthcare
Knowledge Translation & Exchange
Non-Communicable Diseases
NCD’s
Injuries
CD’s
Non-Communicable Diseases
Lifestyle Risk Factors
Policy Response
- Primary Health Care
- Public Health
- Health Promotion/Disease Prevention
- Health Education
- Community Health Support
WHAT ARE THE IMPLICATIONS FOR
HUMAN RESOURCES FOR HEALTH
PLANNING ?
Health Outcomes
HRH Reform
ISSUES:
Supply
Demand
Production
Training
Recruitment
Retention
Distribution
Access
Deployment
Health/Safety
Productivity
Migration
Management
Payment
Sustainability
Review of HRH in the Caribbean
Historical Trends
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Only Dominica, Trinidad & Tobago and St. Lucia up in MD supply in last decade
Others record a decline in physician numbers, the greatest in Jamaica
Jamaica and Guyana greatest decline in RN numbers
Jamaica and Grenada the highest health worker emigration
Regional out-migration of 81% RNs and 53% MDs
78% employed in the public sector
Specialists 17% of Dominica’s MD stock; 85% in Anguilla
Trinidad & Tobago recruiting 450 RNs and 119 Medical Specialists
Guyana 300 vacancies, 25% to 50% vacancy rates
Possible surplus of health workers in Guyana in less than five years
Review of HRH in the Caribbean
Regional Goals
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8 of 11 countries achieve the minimum target of 25 per 10,000 population
Jamaica and Belize 25% of goal; Montserrat & Barbados 3.3 times minimum target
Only Belize and Grenada were 40 percent of MDs PHC physicians
5 of 9 countries achieved 90% of required PHC competencies & team coverage
One RN for every MD achieved by all countries; Montserrat & Barbados 8.3 to 1
All countries had an HRH Unit, but the majority were one-person operations
80% of population growth occurring in urban areas
Four countries reached target regarding staff inter-cultural competencies
Jamaica, Dominica & St. Lucia reported upgrading staff skills and competencies
Only four countries recruited PHC workers locally
Only Barbados & Jamaica had adopted recruitment codes of practice
No countries had achieved self-sufficiency in HRH
Review of HRH in the Caribbean
Regional Goals
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29% of health workers were in precarious, unprotected positions
Six countries had worker health and safety practices in place
Four countries had managers with appropriate competencies
All countries had labor dispute mechanisms; 67% essential services legislation
Six countries provided some inter-disciplinary training, the highest in Jamaica (73%)
Only Jamaica & Barbados recruited students from under-serviced areas
Only Barbados, Jamaica & Guyana have nursing attrition rates less than 20%
Six countries have reached the target regarding health program accreditation
Conclusions
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About HALF the Regional Goals are well underway
Continuing support needed for data development, HRH planning capacity, ongoing
skills development and workforce management and retention.
HRH Action Framework
HRH CAPACITY DEVELOPMENT &
SUSTAINABILITY
GOAL : Optimal, Productive, Accessible, Responsive, Motivated & Stable Workforce
ENABLERS
Leadership
Management
Education/Training
Curriculum
Communications
KTE
Leg/Regulation
Programs/Policies
Stds/Guidelines
Partnerships
Finance/Incentives
FACILITATION
PLANNING
CORE FUNCTIONS
MoH LINKAGES
Data Development
Trend Monitoring
Research & Analysis
Supply & Distribution
Needs Identification
Cost-Benefit/Impact
Strategic Planning
Forecasting
Evaluation
Primary Health Care
Public Health
Health Promotion
RHA’s
Finance
Health Institutions
Mental Health
Health & Safety
Health Information
CNO / MOH
Research & Planning
PARTICIPATION
DEVELOPMENT
COORDINATION
IMPLEMENTATION
COLLABORATION
EVALUATION
MODIFICATION
Health Workforce Productivity
Capacity
Development
Education &
Training
Workforce Culture,
Communications &
Expectations
Supply & Mix
Workforce
Optimization
Workplace
Support
Models of Care
Occupational
Health & Safety
Matching
Competencies to
Requirements
Provider Roles &
Deployment
Mix, Numbers &
Distribution
Personnel
Management
Practices
Innovation &
Support
Outcomes
Stability of Workforce
Efficiency in health
services delivery
Effectiveness of
Patient Care, Health
Outcomes &
Population Health
Roadmap: Priorities for Action
Governance
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HRH Database Development
HRH Policy Inventory
HRH Policy Brief Development
(Online) Observatory Development
Processes to Update & Disseminate Information
Hiring Guidelines stipulating Public Health
competencies
• MoH to draft new supporting HRH policies
HRH Roadmap: Priorities for Action
Education & Training
• Build capacity & competencies to meet challenges of NCD’s
• Caribbean Learning Network courses in planning, evaluation
and management
• CLN courses in online in-service training to work in interprofessional teams
• Enroll HR Managers in online HRH Management courses
• Health staff will upgrade competencies as required
• CLN will begin process of course accreditation
• Ongoing commitment to staff training & capacity building
• Improved working conditions through better staff preparation