Professionalizing Under-Recognized Cadres:
Lessons Learned and Recommendations

  Lessons Learned and Recommendations

  • Critical for any country is the need to understand that health systems are staffed by a wide range of workers at different levels of the system with varying types of education and training. Professionalization of under-recognized cadres requires advocacy to demonstrate the critical role these cadres play and the contributions they make to the delivery of quality health services and improvement of health outcomes.
  • Many countries lack data on under-recognized cadres that are regularly collected, analyzed, and used in decision-making and planning. Further, these workforces are often fragmented and spread across sectors. As a result, workforce data are scattered, hard to track, and not readily available on a routine basis. Progress in mapping the social service and supply chain workforces is contributing to a clearer picture, but there is much work to be done. As one step, a theory of change should be developed and agreed on that provides recommended metrics for measuring the success of global and national initiatives to strengthen these workforces.
  • Countries should be encouraged to take a “life cycle approach” to attract, educate, retain, and support workers in under-recognized positions. The approach should include: formally recognized avenues for education, training, and certification; suitable job descriptions and ladders for career progression; structures such as associations for interacting with peers and communicating the needs of workers with a common voice; and opportunities for continuing professional development.
  • Countries should receive continued support to apply validated approaches and tools—such as the WHO WISN method and CapacityPlus Rapid Retention Survey Toolkit—to estimate the numbers and types of workers needed and the packages of salaries and incentives that will attract and retain personnel to under-recognized professions.
  •  Collaboration across disciplines is needed to effectively link health and social service workforce and service delivery needs. A holistic approach to health workforce planning, involving a variety of stakeholders and based on service delivery needs, must be followed to ensure the development of integrated networks of care that include the range of workers needed to support the delivery of quality services.  
  • Specific job descriptions or career ladders, coupled with incentives, are needed to make supply chain management an attractive professional option. Various cadres such as doctors, nurses, midwives, laboratory technicians and assistants, and even information technology specialists need clarity with respect to their roles, responsibilities, and accountability in the supply chain, and an understanding of who will provide functional supervision.