As illustrated in the World Health Organization’s (WHO) Health System Framework below, the health workforce is a critical element that enables health systems to ensure access to quality family planning/reproductive health, HIV and AIDS, maternal and child health, and other essential services for improved health outcomes of the population.
(Source: WHO 2007)
In recent years, there has been significant focus on scaling up health workforce production to increase the number of health workers in countries where there are severe shortages. While developing an adequate supply of health workers is critical, it is equally important to ensure that health systems enable currently practicing health workers to perform well and deliver effective, quality health services to the communities they serve. As countries implement strategies to expand and realign their health workforce in the long term, it may be possible to maximize health system performance in the short term through efficiency of service delivery and improved productivity of available health staff to contribute to reaching countries’ health goals.
Improving health workforce productivity should be an integral part of strengthening the workings of the larger health system as:
- “In health systems workers function as gatekeepers and navigators for the effective, or wasteful, application of all other resources, such as drugs, vaccines, and supplies.”
- “Human resources are often viewed as the most significant input since health care remains a very labor intensive industry with wages accounting for the largest component of health sector spending in both low and high-income countries,"
How effectively the health workforce performs and how effectively health workers use other health system inputs will contribute to improving health outcomes.
This toolkit focuses specifically on one quantitative approach for measuring the productivity of the health workforce and does not address the productivity of the health system as a whole. Nonetheless, an integral part of the process involves examining the interconnectedness of the different health system building blocks and considering how they affect health workers’ ability to perform their duties efficiently. For example, without financing and essential medicines and supplies, health workers cannot deliver effective services. Any weaknesses identified in health commodities or gaps in health financing may highlight issues in other components of the health system that inevitably affect health workers and their productivity. These weaknesses may be underlying causes for low workforce productivity.
NOTE: This toolkit does NOT address productivity theory broadly. It explores one method for assessing the productivity of health workers at the facility level, NOT the productivity of an entire health system.