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Human Resources for Primary health Care

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Human Resources for Primary health Care. Adetokunbo O. Lucas, MD. The Global Crisis. Global shortage of nurses & other health professionals Migration of nurses & doctors to developed countries Impact on delivery of care & health outcomes

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Presentation Transcript
the global crisis
The Global Crisis
  • Global shortage of nurses & other health professionals
  • Migration of nurses & doctors to developed countries
  • Impact on delivery of care & health outcomes
  • Undermines Africa’s effort to achieve Millennium Development Goals
major studies publications
Major Studies & Publications
  • Joint Learning Initiative (JLI)
  • World Health Report 2006
    • Extended the JLI report
    • Additional data
the health worker density index hrh index
The Health Worker Density Index (HRH index)

1. A composite index

2. A density of 2.5 workers per 1,000 -- a threshold to cover essential health interventions & core MDG-related health services.

3. Sub-Saharan Africa need 1 million additional health workers.

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Is the density of the workforce

the main determinant of :

> Delivery of health care

> Health outcomes?

numerical approach
Numerical Approach
  • Valuable for advocacy
  • Prompted debate & discussion
  • Stimulated policy review
systematic analysis back to basics
Systematic Analysis: Back to basics

1. Task analysis

  • Identify needed skills & competence
  • Design training & apprenticeship
  • Review job descriptions / deployment

2, Managing migration

  • Dimensions & determinants
  • Amelioration

3. Balanced investment in health systems

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.

.

.

Primary Health Care

.

.

.

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PUSH

PULL

Anchor

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Higher income

  • Better working environment
  • Security
  • Low income
  • Unpaid salaries
  • Shortage of drugs, etc
  • Poor logistic support
  • Loyalty to nation
  • Family ties
  • Social & other interests
managing migration
Managing Migration
  • Realistic national human resource policy
  • Gather data & monitor trends
  • Tackle ‘push’ factors
  • Negotiate managed migration
  • Make most effective use of health workers
  • Note: the large amount of funds repatriated by African workers
amelioration of push factors
Amelioration of PUSH factors
  • Financial incentives
    • Realistic salaries in terms of local realities
    • Regular payment of salaries. Allowances & pensions
  • Non-financial incentives
    • Improving working environment
    • More efficient management of services
  • Consultations accredited representatives of:
    • Health workers
    • Civil society
balanced investment in the health system
Balanced investment in the health system

Mismanaged, malfunctioning health systems ‘Sick System Syndrome’

  • Staff salaries - high percentage of recurrent budget (60-80%)
  • Infrastructure, supplies, logistics, etc. inadequate
  • Vertical programmes fragment health systems
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Training Obstetricians in Ghana

Can other nations adopt lessons learnt?

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Training manual

  • Developed in Ghana
  • Translated to French, Spanish, Vietnamese, Russian, etc.
  • Used in 30 countries
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