Guideline for Regional HRH Country Strategic Planning

1
Guideline for Regional HRH Country Strategic
Planning

• Philippine Consultant Team

2
Philippine Consultant Team

• F. Marilyn E. Lorenzo
• Kenneth Ronquillo
• Co- project team leaders
• Dr. Rodel Nodora
• Prof. Esmeralda Silva
• Co- Consultants

3
Presentation Outline

• Process of Development of Regional Guideline for
  Country Strategic Planning
• Situational Analysis Results
• Draft Regional Guideline
• Next Steps

4
Process of Development of Regional Guideline for
Country Strategic Planning
5
Development of Regional Guideline for Country
Strategic Planning

• Review HRH situation in AAAH member countries and
  the existence of national HRH strategies or
  master plans in these countries
• Literature review Peruse existing guidelines on
  national health workforce strategy development
• Drafting regional guideline that can be used as
  reference for AAAH member countries
• Consultation with AAAH member countries through
  teleconference
• Finalize draft guidelines

6
Situational Analysis

• Main objective was to review HRH Situation in
  AAAH member countries and determine the existence
  of national HRH strategies or master-plans within
  countries
• Requested focal points to assist team in
  accomplishing five sets of worksheets

7
WORKSHEETS DEVELOPED FOR THE PROJECT

• SELECTED SOCIO-DEMOGRAPHIC ANDHEALTH PROFILES
• TOTAL POPULATION
• POPULATION GROWTH RATE, 1980-2006
• UNEMPLOYMENT AND UNDEREMPLOYMENT NUMBER AND
  RATES 2000-2006
• INFANT, UNDER-5 MATERNAL MORTALITY RATES
  2000-2006
• NUMBER OF REGISTERED DEATHS AND CRUDE DEATH RATES
  2000-2006

8
WORKSHEETS DEVELOPED FOR THE PROJECT

• SUPPLY SIDE
• NUMBER AND DENSITY OF HEALTH WORKERS TO
  POPULATION
• By Priority Professions
• 2000-2007
• NUMBER OF HEALTH WORKERS IN GOVERNMENT SERVICE
• By Priority Professions
• 2000-2007
• NUMBER OF REGISTERED PROFESSIONALS
• By Priority Professions including Community
  Volunteer Health Workers
• 1980-2007
• NUMBER OF SCHOOLS AND NUMBER OF FIRST YEAR
  ENROLLEES
• By Priority Professions
• 1999-2007
• NUMBER OF NUMBER OF GRADUATES
• By Priority Professions
• 2000-2007

9
WORKSHEETS DEVELOPED FOR THE PROJECT

• DEMAND SIDE
• DEMAND FOR HEALTH WORKERS IN ALL NATIONAL
  GOVERNMENT AGENCIES ( PRIVATE) , INCLUDING THE
  MINISTRY OF HEALTH
• NUMBER OF HEALTH PROFESSIONALS WHO LEFT THE
  COUNTRY TO WORK ABROAD
• AVERAGE MONTHLY SALARIES OF HEALTH PROFESSIONALS
  IN THE GOVERNMENT AND PRIVATE SECTORS (IN US)
• MONTHLY SALARY OF MIGRANT HEALTH PROFESSIONS IN
  TOP 5 DESTINATION COUNTRIES (IN US)
• ATTRITION RATE FOR PRIORITY HEALTH PROFESSIONS
  2000-2007
• NUMBER OF HEALTH FACILITIES AND BEDS IN THE
  GOVERNMENT AND PRIVATE SECTORS
• STANDARD REQUIREMENT FOR HUMAN RESOURCES

10
WORKSHEETS DEVELOPED FOR THE PROJECT

• HUMAN RESOURCE SYSTEMS
• HRH FRAMEWORK
• HUMAN RESOURCE PLAN
• JOB RELATED RECRUITMENT AND SELECTION
• TRAINING AND DEVELOPMENT NEEDS ANALYSIS
• HUMAN RESOURCE FOR HEALTH INFORMATION SYSTEM
• PERFORMANCE MANAGEMENT SYSTEM
• INDIVIDUAL CAREER PLANNING
• CAREER PATHING/ CHARTING
• SUCCESSION PLANNING
• RETENTION PLANNING
• COMPENSATION AND BENEFITS
• LABOR RELATIONS

11
Summary of Responses to 1 HR System, by country
LEGEND C Complete I Incomplete
12
Country-specific Responses to HR System worksheets
13
(No Transcript)
14
(No Transcript)
15
Results of the Situational Analysis
16
Situational Analysis Results

• Country definitions of many HRH elements were not
  the same
• definitions of health workers i.e. what
  constitute the group of physicians, nurses,
  community health workers and other HRH
  classifications
• some countries expressed their HRH needs in terms
  of FTEs required while others specified their
  requirements in absolute numbers
• Understanding of HRH plans is varied some think
  of HRH planning as merely workforce projections
  while others include in their plans the
  establishment of systems

17
Situational Analysis Results

• Unclear framework models some frameworks were
  workforce forecasting models and not planning
  frameworks
• A number of country plans were not systems based
  i.e. there was no mention of HRH systems set up
  except for recruitment and training and
  development systems.
• Consultant team believes HRH systems development
  need to be basis of optimal utilization and
  development of HRH to ensure the quantity and
  quality of HRH in any country.

18
Situational Analysis Results

• Poor Quality of data on HRH,
• Available information seems to still be
  incomplete, and non-standardized
• Current HRH information available identified
  health workers either to be providing care only
  in private or public sectors, rather than in both
  
• There is a need for standardized, uniform
  information available within the region for
  comparability and forecasting purposes.

19
Situation Analysis Results

• Only Thailand, China , Papua New Guinea and the
  Philippines have formal HRH plans but plans are
  all different Some plans are mere workforce
  projections
• Not all plans have systems developed and
  implemented

20
Situation Analysis Results

• Critical systems are planning, training,
  recruitment and performance management,
  compensation and benefits. Most country focal
  points are aware of the systems. The levels of
  country development cannot be discerned.

21
Situation Analysis Results

• There is a need for the guidelines to develop
  common definitions, create uniform understanding
  of HRH systems and planning, advance standard
  formulation at country levels and develop HRH
  systems.

22
Draft Guidelines for Developing Country HRH
Master Plans
23
1. Accomplish a situational Analysis

• External Environment Analysis
• Labor and Employment environment
• Socio-economic context
• Political situation
• Internal Environment
• Health sector systems assessment
• Levels of Classification for HRH systems

24
2. Decide on Goals of the Master Plan

• Goals
• Recommend the adoption of work of Hornby and
  Ozcan for Malawi (Hornby and Ozcan,2003).
• Designed to ensure that each countrys health
  services have effective and well-motivated
  workforce and are appropriately managed.

25
2. Decide on Goals of the Master Plan

• Health Services should have
• The right number of people,
• The right category,
• In the right place,
• At the right time,
• With the right skills,
• With the right motivation and attitudes,
• At the right cost,
• Doing the right work,
• Under the right work conditions.

26
2. Identify Objectives of the Master Plan

• Suggested broad objectives
• Specify the direction of country HR development
  in three planning frames short term (5 years),
  medium term ( next 10 years) and long term ( next
  10 years)
• Determine HRH development objectives, key
  strategies, activities and evaluation indicators
  for the above mentioned time frames
• Identify short term, medium term and long- term
  actions, including policy and program actions
  that are needed to proceed to medium term and
  long term

27
3. Decide on a Planning Framework

• Overarching vision/mission/goals
• Strategies and mandates of the health sector
• Ensure that all aspects of HRH development from
  production and planning, utilization, placement
  and development are given the necessary
  attention.
• Identify planning frames, assumptions, and
  context of plans

28
3. Decide on a Planning Framework

• Recommend the adoption of a modified version of
  the WHO Framework for sustainable HRH Development
  (WHO-Dayrit, 2006)
• Framework contains common technical framework
  for human resources to help national governments
  and national planners understand the myriad and
  complex problems of human resources for health
  and find feasible solutions.

29
3. Decide on a Planning Framework

1. define key dimensions of technical competencies
   needed to develop and implement a strategy for
   human resources
2. help inform the growing number of groups
   interested in the health workforce and prevent
   the simplistic and limited views on what is
   involved and
3. provide a common reference point for all health
   workforce stakeholders and save policy-makers,
   implementers, donors, the academe, and others the
   effort to reinvent the wheel (WHO-Dayrit, 2006).

30
WHO Framework (2006)
31
c
ANALYSIS

• OTHER HEALTH SYSTEM COMPONENTS IMPLICATIONS ON
  HRD
• Financial Management
• Quality Management System
• Strategic Management System
• Organizational Information System
• Audit and Risk Management System

IMPLEMENTATION
COUNTRY SPECIFIC CONTEXT (Issues,Culture and
Behavior)
HEALTH SERVICES CHARACTERISTICS Equity Effectivene
ss Efficiency Quality Accessibility Acceptability
Appropriateness
HEALTH SECTOR PERFORMANCE IMPROVEMENT
HRD Quality of staff Mix of staff cadres Number
of staff Staff distributed Staff
productivity Education Training HR Management
BETTER HEALTH OUTCOMES
32
(No Transcript)
33
4. Identify Key Issues that needs to be addressed
by Master Plan

• Results of the situational analysis to identify
  key issues
• Utilize decision making models i.e. decision tree
• problem trees
• Utilize Algorithms
• Problem Tree and Core Problems Philippine
  Example

34
(No Transcript)
35
5. Identify Key Result Areas of the Plan

• Key result areas are focused on key issues that
  have been identified
• Need to be measurable
• Will include workforce projections
• Will require projection models
• Philippines used simple workforce projection
  model commissioned by WPRO

36
6. Craft effective and appropriate strategies

• Strategies have to be planned for different
  phases
• Short term Most detailed with clear indicators
• Medium term- Directional plan based on
  accomplishment of short term objectives
• Long term- Directional plan
• Strategies include systems development

37
7. Accomplish Operational Plan

• Log Frame Analysis
• Verifiable Indicators
• Identification of risks and assumptions
• Identification of key activities, tasks and
  responsible persons
• Timelines
• Budget

38
LOGICAL FRAMEWORK (Purpose 2.2 To implement retention schemes in all facilities in the health sector) LOGICAL FRAMEWORK (Purpose 2.2 To implement retention schemes in all facilities in the health sector) LOGICAL FRAMEWORK (Purpose 2.2 To implement retention schemes in all facilities in the health sector) LOGICAL FRAMEWORK (Purpose 2.2 To implement retention schemes in all facilities in the health sector) LOGICAL FRAMEWORK (Purpose 2.2 To implement retention schemes in all facilities in the health sector)
Program Retention Program Program Retention Program Program Retention Program Team Team
NO. NARRATIVE SUMMARY (Outputs) OBJECTIVELY VERIFIABLE INDICATORS (OVI) MEANS OF VERIFICATION (MOV) IMPORTANT ASSUMPTIONS/RISKS
Best practices and feasibility of retention schemes explored with government, pilot ILHZ stakeholders and private health facilities, DOH) regarding the following Facilities development HRH Functions Job design Job pricing Rewards system Career progression Training and Development Consultation sessions conducted Documentation of the session and analysis of the data done Implementing organization secretariat (DOH-HHRDB) documentation Results of process evaluation of 6 HRH functions available. Participation of stakeholders from 27 pilot ILHZs, government and private health facilities, LGU
Implementation of retention schemes Hospital based retention program and activities implemented LGU based retention program and activities implemented Hospital Retention Program plan LGU Retention Program plan Consensus on retention schemes Participation of government, private and LGU health facility stakeholders
39
8. Identify Key Policies and Programs to support
Master Plan

• There are key policies that need to be reviewed,
  updated
• New policies that need to be instituted
• Programs that need to be prioritized, emphasized
  or designed

40
9. Craft Monitoring and Evaluation Scheme

• Monitoring and Evaluation to start in short term
• Drive the refinement of the Master Plan
• Based on HRH information system established
• Review and revise Master Plan over periods of time

41
10.Plan for Annual Plan Review and Replanning

• Annual Strategic Planning Review to evaluate
  accomplishments and re align plans, activities
  and tasks for given year
• Detailed annual planning and readjustment of
  strategic directions

42
Summary of Guideline Steps

• Do situational Analysis
• Decide on Goals of the Master Plan
• Decide on a Planning Framework
• Identify Key Issues that needs to be addressed by
  master-plan
• 5. Identify Key Result Areas of the Plan
• 6. Craft effective and appropriate strategies
• 7. Accomplish Operational Plan
• 8. Identify Key Policies and Programs to support
  plan
• 9. Craft Monitoring and Evaluation Scheme
• 10. Plan for Annual Plan Review

43
Next Steps

• Organize a country team - The team should be
  multidisciplinary and inter-sectoral
• Staff from the Human Resource Department within
  the Department/Ministry of Health and other key
  stakeholders
• Other agencies such as education, finance,
  planning as well as professional regulatory
  bodies, professional organizations, academe, and
  development partners.
• Team leader - someone that can provide immediate
  guidance on issues at hand and has a network
  among various departments/ministries and other
  relevant agencies.

44
The Philippine HRH Implementing Organization
Partners Proposed Implementers of the Plan
Support coordinating agencies
44
45
Next Steps

• Ensure adoption of HRH Master Plan by government
  as the official HRH development strategy
• Ensure buy-in by various stakeholders in HRH
  development

46
Next Steps

• Commit roles and responsibilities terms of
  reference clear and well understood by everyone.
  A work plan should be developed to include
  specific tasks and assignments, timelines,
  budgets, and responsible persons.
• Hold discussions with key informants -
  Interviews, meetings, focus group discussions and
  other approaches for further information should
  be done to validate existing strategies,programs

47
MABUHAY!Xie Xie!