Policy and Planning

The Seven-Billionth Person: A Global Health Workforce Perspective

This post was originally published on the IntraHealth International blog.

Sara Pacqué-MargolisOn October 31st the world welcomed Danica in the Philippines, Nargis in India, and numerous other babies who symbolize the seven-billionth person on our planet. It’s a timely moment to shine some light on the implications of population growth for the health and well-being of all our children and the generations to come.

Here’s the crux: the global shortage of health workers translates to an estimated billion people with no access to essential health services, according to a 2010 World Health Organization (WHO) report. So exactly how many health workers do we need to address this problem? The WHO has determined that 2.3 doctors, nurses, and midwives per 1,000 people is the minimum threshold needed to cover the population with essential health services. This is commonly referred to as the health worker density ratio.

Now here’s where the issue of population growth comes in. Planning and policy efforts to improve the health worker density ratio have focused on increasing the ratio’s numerator (health workers). Makes sense, right? But they’ve largely ignored the ratio’s denominator (population size). Read more »

Move the Merchandise: An Around-the-Clock Operation to Save a Kenyan Medical Warehouse

Wambua NziokiThis post was originally published on the IntraHealth International blog.

Picture the following scenario: A large warehouse, 13,000 square meters, on the outskirts of Nairobi, Kenya, about 20 kilometers from the city center, is so full of drugs and other medical supplies that there is no space for new deliveries. The warehouse is packed with everything from gauze bandages to malaria pills to antiretroviral drugs—valuable and necessary medical supplies that people need. But the system used to manage and distribute these supplies with less paperwork and greater efficiency, known as the Enterprise Resource Planning system, is not working. This means nothing is moving in or out of the warehouse. Read more »

Creative Approaches to the Global Health Workforce Crisis

Maurice I. MiddlebergFive years ago the World Health Organization told us that 57 countries had a critical shortage of health workers—fewer than 2.3 service providers for every thousand people. Today, all 57 countries are still below this threshold. What’s holding us back from faster progress?

First, the good news: many of these countries have national health workforce plans in place. Forty-four of the 57 crisis countries have a plan, according to the Global Health Workforce Alliance’s recent progress report.

Now, the bad news: not all of these countries are implementing their plans. Among the 57 crisis countries, only 24 have evidence-based and costed plans and are in the process of implementing them. Countries may be daunted by perceived barriers to implementation.

That’s why it makes me hopeful to see how many countries are trying creative approaches and moving from planning to action. Read more »

Health Workforce Action after Bangkok

Maurice MiddlebergRecently a thousand people gathered in Bangkok for the Second Global Forum on Human Resources for Health. Since then many of us have been reflecting on where to focus our energies. Here’s what’s been on my mind.

Communicating about the crisis and its solutions
The forum opened with a wonderful video on health workers—the best piece in any medium I have ever seen in terms of communicating the essence of the health workforce crisis.

Effective communication about the issues—and how to resolve them—is vital to garnering the support we need to make real progress. To the extent possible, we should commit sufficient resources to this effort. Read more »

What Brought Us Here Won’t Get Us There: Implementing Country-Level Health Workforce Development Plans

CapacityPlus works with the Uganda Ministry of Health to enhance workforce performance support, including field testing the project’s global rapid discrete choice experiment (DCE) tool to address attraction and retention of health worker cadres in rural and remote areas and a retention costing tool, iHRIS Retain. This post was originally published on the IntraHealth International blog.

Three years ago, we met in Kampala, Uganda to discuss the critical needs of the global health workforce. Last week in Bangkok we gathered to take stock of what we’ve accomplished since.

Today, 86% of the 51 countries surveyed in the progress report on implementing the Kampala Declaration and Agenda for Global Action have a national human resources for health plan, but only 41% are actually implementing that plan. Read more »

Country-Led Health Workforce Planning and Implementation in the Dominican Republic

Paul MarsdenI was delighted to have the opportunity to collaborate face-to-face with Dr. Sonia Brito-Anderson recently. She leads CapacityPlus’s efforts to facilitate the development of a human resources strategy framework and implementation plan for the Ministry of Health in the Dominican Republic.

Along with other CapacityPlus colleagues—including Wilma Gormley, Mesrak Belatchew, and Dana Singleton—our task is to work with a national technical group, established by the Ministry of Health, to identify the key HR challenges and help to produce a strategy framework and implementation plan that is both feasible and doable.

Where are the health workers?
The Dominican Republic has a comparatively high number of health workers, yet maternal mortality rates and prevention of mother-to-child transmission of HIV coverage remain poor. Read more »

iHRIS in Kenya—The Key to Long-Term Sustainability

Brooke BuchananThe human resources information system (HRIS) implementation team for Capacity Kenya has championed the use of iHRIS software in Kenya. Because of their efforts we are excited to soon have a fully integrated system for human resources for health policy, planning, and management throughout the country.

Dr. Samwel Wakibi is now collaborating with the Ministry of Health and the Ministry of Public Health and Sanitation to ensure all human resources data for hiring, transferring, and retiring health workers are electronically entered into iHRIS by the Complement Section—the part the Human Resources Division within the Ministry of Health that handles all status changes for employed health workers, then sends these change orders to the Ministry of Public Service and then on to payroll. Read more »

Addressing Human Resources Constraints in Public Health Supply Chains

Amanda PuckettAt the recent Critical Issues Series: Strengthening Human Resources for Supply Chain Management of Health Commodities event, IntraHealth International staff Uche Ekenna presented CapacityPlus’s new Life Cycle Approach to professionalizing under-recognized cadres.

Ekenna delivered key messages on workforce development, workforce effectiveness, and policy and planning to specific supply chain functions. His panel focused on the professionalization of under-recognized cadres—i.e., supply chain management professionals—and how the Life Cycle Approach can systematically address all crucial steps in the cadre professionalization process.

Hosted by the USAID DELIVER Project, this event featured presentations by human resources for health (HRH) and health commodities panelists, and offered experts a forum to discuss and identify future areas for building strong collaborations, sharing lessons learned, and identifying strategies to address human resources constraints affecting the distribution of health commodities to clients. Read more »

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