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2
Second Global Forum on Human Resources for Health 25 - 29 January 2011 | Bangkok, Thailand | Empower he
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alth workers for health outcomes | Reviewing progress, renewing commitments to health workers towards MDGs and beyond
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Ethiopia has seen high economic growth over the last decade, but remains a poor country with a high burden of disease. It has made considerable health gains in recent years, mainly by having
...
health policies that focus on extending primary healthcare, using health extension workers. It has made good use of existing resources,but has a low health expenditure (of around US$21 per capita, and totalling 4per centof GDP). It has a federal system with devolved healthcare financing, whereby block grants are allocated to sectors at regional and woreda(district) level. The challenge now,with the epidemiological transition (and a sense that the ‘low-hanging fruits’have already been gathered in relation to public health), is how Ethiopia, still poor, continuesto invest in health improvements?Human resources for health (HRH) are a critical pillar within any health system –the health staff combine inputs to provide the services, thus affecting how all other resources are used, and they make frontline (and back-office) decisions thatare importantdeterminants of servicequality,effectiveness and equity. HRH is usually the most resource-intensive element within the health system –commonly absorbing 50–70per centof public expenditure onhealth, although the proportions are very varied by individual countries and across regions. As they are commonly part of the public administration, reforms to HRH are also part of a complex political economy in most countries.Assessing value for money (VfM) in relation to HRH is correspondingly complex;across the value chain, manyfactors influence the conversion of inputs into outputs and outcomes (see Figure 1).A more detailed description of the HRH value chain can be found in Annex1.
more
Background: Investing in the health workforce is key to achieving the health-related Sustainable Development Goals. However, achieving these Goals requires addressing a projected global shortage of
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18 million health workers (mostly in low- and middle-income countries). Within that context, in 2016, the World Health Assembly adopted the WHO Global Strategy on Human Resources for Health: Workforce 2030. In the Strategy, the role of official development assistance to support the health workforce is an area of interest. The objective of this study is to examine progress on implementing the Global Strategy by updating previous analyses that estimated and examined official development assistance targeted towards human resources for health. Methods: We leveraged data from IHME’s Development Assistance for Health database, COVID development assistance database and the OECD’s Creditor Reporting System online database. We utilized an updated keyword list to identify the relevant human resources for health-related activities from the project databases. When possible, we also estimated the fraction of human resources for health projects that considered and/or focused on gender as a key factor. We described trends, examined changes in the availability of human resources for health-related development assistance since the adoption of the Global Strategy and compared disease burden and availability of donor resources.
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The WHO Global strategy on human resources for health: workforce 2030 encourages development partners and global
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health initiatives to leverage their support to health systems in countries to sustainably strengthen the health workforce. To assess the impact of these investments, a methodology was developed and pilot tested by WHO.
The impact assessment tool (consisting of an MS Excel calculator with two subsets) supports users to:
• assess and quantify the health impact of HRH investments made in the context of HIV, tuberculosis (TB) and malaria programmes through their modelled effect on health service coverage of these three diseases; and
• provide aggregate indicative estimates of the range of health workers required to attain high coverage of selected health services.
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The overview of findings from five Latin American countries
The Ministry of Health and Social Services (MOHSS) undertook a situation analysis in respect of human resources for
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health in order to improve health and social services outcomes following varios sector targeted interventions. The situation analysis report covers the period up to December 2018 and results from this situation analysis were presented at various forums for broader discussion and input.
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Handbook on Monitoring and Evaluation of Human Resources for Health with special applications for low- and middle-income countries
Mario R Dal Poz, Neeru Gupta, Estelle Quain and Agnes LB Soucat
World Health Organization (WHO); USAID; The World Bank
(2009)
Background: At the MDG Summit in September 2010, the UN Secretary-General launched the Global Strategy for
Women’s and Children’s Health. Central within the Global Strategy are the ambitions of “more money for
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health”
and “more health for the money”. These aim to leverage more resources for health financing whilst simultaneously
generating more results from existing resources - core tenets of public expenditure management and governance.
This paper considers these ambitions from a human resources for health (HRH) perspective
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Health Systems for Outcomes Publication | This report summarizes the findings of a qualitative study on health workers’ performance and career in Rwanda to identify bottlenecks, strengths and shor
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tcomings for human resources in the health sector, as perceived by both health workers and users of health services.
more
Health Systems for Outcomes Publication | The government of Rwanda has identified human resources for h
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ealth as one of its policy priorities. This study aims to contribute to building a better understanding of health worker choice and behaviour, and to improve evidence based polcies.
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Health Systems for Outcomes Publication | Using qualitative data from Rwanda, this study focuses on four institutional factors that affect health worker performance and career choice: incentives, mo
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nitoring arrangements, professional norms and health workers’ intrinsic motivation. It also provides illustrations of three institutional innovations that work, at least in the context of Rwanda: performance pay, the establishment of community health workers and increased attention to the training of health workers.
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Supportive supervision is considered critical to community health worker programme performance, but there is relatively little understanding of how it can be sustainably done at scale. Supportive supervision is a holistic concept that encompasses th
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ree key functions: management (ensuring performance), education (promoting development) and support (responding to needs and problems). Drawing on the experiences of the ward-based outreach team (WBOT) strategy, South Africa’s national community health worker (CHW) programme, this paper explores and describes approaches to supportive supervision in policy and programme guidelines and how these are implemented in supervision practices in the North West Province, an early adopter of the WBOT strategy. Outreach teams typically consist of six CHWs plus a nurse outreach team leader (OTL).
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Community health worker teams are potential game-changers in ensuring access to care in vulnerable communities. Who are they? What do they actually do? Can they help South Africa realize universal health
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coverage? As the proactive arm of the health services, community health workers teams provide household and community education, early screening, tracing and referrals for a range of health and social services. There is little local or global evidence on the household services provided by such teams, beyond specific disease-oriented activities such as for HIV and TB. This paper seeks to address this gap.
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This study highlights the challenges and areas in need of improvement as perceived by CHWs and beneficiaries, in regards to a nationwide scale-up of CHW interventions in a resource-challenged country. Identifying and understanding these barriers, and addressing them accordingly, particularly within
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the context of performance-based financing, will serve to strengthen the current CHW system and provide key guidance for the continuing evolution of the CHW system in Rwanda.
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Identifying characteristics associated with performing recommended practices in maternal and newborn care among health facilities in Rwanda: a cross-sectional study
Sipsma, H.L., Curry, L.A., Kakoma, J.P., Linnander, E.L., & Bradley, E.H.
Human Resources for Health
(2012)
CC
This study examined the quality of facility-based maternal and newborn health care by describing the implementation of recommended practices for maternal and newborn care among health care facilitie
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s to determine whether increased training, supervision, and incentives for health workers were associated with implementing these recommended practices.
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This article reexamines a set of study findings that directly relate to the influence of gender on workplace violence, synthesizes these findings with other research from Rwanda, and examines the subsequent impact of the study on Rwanda’s policy environment.