OVERVIEW: RESOURCE REQUIREMENT TOOL (RRT) FOR HUMAN RESOURCES FOR HEALTH
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OVERVIEW: RESOURCE REQUIREMENT TOOL (RRT) FOR HUMAN RESOURCES FOR HEALTH Overview of the RRT functionalities July 13, 2009
GHWA Financing Task Force (FTF) • Alberto Carrasquilla, Former Minister of Finance, Colombia • Sanjeev Gupta, Senior Advisor, International Monetary Fund • Eyitayo Lambo, Former Minister of Health, Nigeria • Mamadou Lamine Loum, Former Prime Minister, Senegal • K. Srinath Reddy, Head of the India Public Health Foundation • Rick Rowden, ActionAid • Julian Schweitzer, World Bank • Netsanet Walelign, UNICEF • Hong Wang, Abt Associates Inc. • Ex-officio members
Discussion Topics • RRT overview • Description of RRT components • Employment component • Pre-service training component • Affordability component
Purpose of the tool 4 • Estimate/project cost to (i) hire and (ii) train planned HRH • Analyze affordability of the HRH plan • Conduct “what if” analyses of (i) policies; (ii) plans; (iii) assumptions • Produce specific information for advocacy • Monitor implementation of HRH plan • Provide input into human resource information systems (HRIS) design related to costs and financing
RRT audience and users • Ministries of Health • Ministries of Education • Ministries of Finance • Development partners • Advocacy Groups
RRT structure: three components RESOURCE REQUIREMENT TOOL EMPLOYMENT • How much would it cost to hire, retain and deploy HRH? • Estimates public sector HRH employment and HRM costs • Accounts for private sector employment 1 ABILITY TO FUND 3 PRE-SERVICE TRAINING • How much would it cost to train HRH? • Estimates resource requirements for public sector HRH pre-service training • Accounts for private sector PST capacity • Can it be afforded? • Estimates gap between required and available resources for government HRH plans 2
Discussion Topics • RRT overview • Description of RRT components • Employment component • Pre-service training component • Affordability component
Employment component: Inputs (1/2) • Basic Country information • Employment-specific information • Public sector HRH (by cadre and by geographic areas) • Resources dedicated to public sector HRH by cadre, by geographic area • Salary and benefits • Deployment cash and non-cash bonuses • Performance-related cash and non-cash bonuses • Assumed productivity improvements due to performance-based financing • In-service training costs • HR Management (HRM) staff and related costs • Private sector HRH, accounting for “moonlighting” RESOURCE REQUIREMENT TOOL Country HRH Scale up Plans EMPLOYMENT 1 ABILITY TO FUND 3 PRE-SERVICE TRAINING 2
Employment component: Scenarios (1/2) RESOURCE REQUIREMENT TOOL • Scenarios: • Vary the number of projected pubic sector HRH • Vary resources for public sector HRH by cadre by geographic area • Salary and benefits • Deployment cash and non-cash bonuses • Performance-related cash and non-cash bonuses • Vary potential performance savings • In-service training costs • Vary resources dedicated to HRM • HRM salaries and benefits • HRM recurrent costs • HRM capital investments Country HRH Scale up Plans EMPLOYMENT 1 ABILITY TO FUND 3 PRE-SERVICE TRAINING 2
Discussion Topics • RRT overview • RRT description • Employment component • Pre-service training component • Affordability component
PST component: Inputs (1/2) • Inputs are listed by 1) ministry and 2) by type of cadre that is trained • Names of publictraining institutions and years of training for this cadre • Total students in the university • HRH graduates in the current year (by region urban/rural) and total HRH graduates • Total capacity for HRH students per graduating year • Number of years to reach capacity • HRH student average drop out rate • Weighted average variable cost per HRH student • Weighted average fixed cost per HRH student • Total capital costs RESOURCE REQUIREMENT TOOL Country HRH Scale up Plans EMPLOYMENT 1 ABILITY TO FUND 3 PRE-SERVICE TRAINING 2
Scenarios that can be created for pre-service training RESOURCE REQUIREMENT TOOL Country HRH Scale up Plans • Scenarios: • Vary • HRH attrition rate • HRH rate of re-entry into the sector • Costs of education • Capital investment requirements • Expected revenues • Private competition for grads EMPLOYMENT 1 ABILITY TO FUND 3 PRE-SERVICE TRAINING 2
Discussion Topics • RRT overview • RRT description • Employment component • Pre-service training component • Affordability component
Likely Affordability: Inputs RESOURCE REQUIREMENT TOOL • Inputs: • Total GDP/GNI • Share of GDP/GNI captured by government • Share of public spending allocated to health • Share of health spending for HRH • Share of public spending on education • Share of education spending on HRH pre-service training via MOE • Donor funds committed/expected for HRH employment or training • Revenues from public universities Country HRH Scale up Plans EMPLOYMENT 1 ABILITY TO FUND 3 PRE-SERVICE TRAINING 2
Likely Affordability: Scenarios RESOURCE REQUIREMENT TOOL • Scenarios: • Vary: • Growth of GDP • Government capture of GDP • Government allocations for health and education • Health allocation for HRH • Education allocation for HRH • Donor commitments for HRH Country HRH Scale up Plans EMPLOYMENT 1 ABILITY TO FUND 3 PRE-SERVICE TRAINING 2
Based on gaps countries can adjust HRH plans RESOURCE REQUIREMENT TOOL Country HRH Scale up Plans Inputs Scenarios Inputs Scenarios EMPLOYMENT Outputs 1 ABILITY TO FUND 3 PRE-SERVICE TRAINING Outputs 2 Outputs Inputs Scenarios Feedback
Countries can monitor implementation of plans over time 17 RESOURCE REQUIREMENT TOOL RESOURCE REQUIREMENT TOOL RESOURCE REQUIREMENT TOOL YEAR 1 Country HRH Scale up Plans Country HRH Scale up Plans Country HRH Scale up Plans EMPLOYMENT EMPLOYMENT EMPLOYMENT YEAR 2 1 1 1 ABILITY TO FUND ABILITY TO FUND ABILITY TO FUND 3 3 3 PRE-SERVICE TRAINING PRE-SERVICE TRAINING PRE-SERVICE TRAINING YEAR 3 2 2 2
Sample Outputs: West African Country RRT application 18 18 • Gaps that can be used for advocacy or for reconsideration of HRH plans Gap Dollars Year
What RRT is not… • RRT notJUST a costing tool: • It estimates projected resource requirements including costs and expenditures and compares resource requirements to availability • RRT not a tool for projecting and planning HRH numbers (i.e., number of HRH is taken as input) • It can inform HRH planning when used interactively • RRT lets users vary number of HRH as feedback to planners who may choose to change planned levels of HRH
What RRT is not… • RRT not a conceptual framework • Builds on ideas from conceptual frameworks and literature on HRH financing • Practical tool ready for use by MOHs • BUT it can be complimented with two papers by the Financing Task Force: 1) Economic and Financing Issues in Scaling Up HRH and What Countries Can Do Now Paper • RRT not a demand forecast for public sector HRH • BUT it is provides a model for estimating private sector demand • RRT does not replicate exiting tools, but builds on them • Content based on WBG Costing Tool (March 2007) and WHO Costing Tool (2002) • Design based on GAVI FSP, Malaria costing tool, etc
Sample output: Employment costs 22 HRH Employment Cost (Dollars in thousands) Dollars for HRH Employment Year
Sample Outputs: Pre-Service Training Costs 23 Costs for Scaling HRH Pre-Service Training Dollars in Thousands Year