Health Workforce Planning : An overview and suggested approach in Oman

In most countries, the lack of explicit health workforce planning has resulted in imbalances that threaten the capacity of healthcare systems to attain their objectives. This has directed attention towards the prospect of developing healthcare systems that are more responsive to the needs and expectations of the population by providing health planners with a systematic method to effectively manage human resources in this sector. This review analyses various approaches to health workforce planning and presents the Six-Step Methodology to Integrated Workforce Planning which highlights essential elements in workforce planning to ensure the quality of services. The purpose, scope and ownership of the approach is defined. Furthermore, developing an action plan for managing a health workforce is emphasised and a reviewing and monitoring process to guide corrective actions is suggested

Using concept mapping to identify policy options and interventions towards people-centred health care services : a multi stakeholders perspective

Background: People-centred health care (PCC) services are identified by the WHO as important building blocks towards universal health coverage. In 2016 the WHO formulated a comprehensive framework on integrated PCC services based on an international expert consultation. Yet, expert opinions may fail to recognize the needs of all health system stakeholders. Therefore, a consultation method that includes the health workforce and laypersons, can be instrumental to elaborate this framework more in-depth. This research sought to identify participants' perspectives on policy options and interventions to achieve people-centred health care services from a multi stakeholder perspective. Methods: Study participants, both laypersons and health professionals, were recruited in Belgium. A total of 53 participants engaged in one of the seven concept mapping workshops. In this workshop the concept mapping methodology developed by Trochim, a highly structured qualitative group method for brainstorming and idea sharing, was used to generate and structure participants perspectives on what is needed to achieve PCC services. The method was validated using the WHO framework. Results: The seven workshops together resulted in 452 different statements that were structured in a framework forming 35 clusters and four overarching domains. The four domains with their most prominent clusters were: (1) governance & policy with intersectoral health policies and affordable health for all; (2) health workforce with excellent communication skills, appreciation of health literacy challenges and respectful attitude based on cultural self-awareness; (3) integrated health services with a greater emphasis on prevention, health promotion and the availability of health education and (4) patient, person and community empowerment and participation with support for informal care, promotion of a healthy lifestyle and contextualised health education. Additionally, this study generated ideas that fitted into every single approach described in the WHO framework. Discussion and conclusion: This study shows that in order to achieve PCC a participative approach involving all stakeholders at all levels is needed. The concept mapping process is one of these approaches that brings together diverse stakeholders and foments their egalitarian and respectful participation. The framework that resulted from this study can inform future debate regarding planning, implementation and monitoring of PCC

Aligning vertical interventions to health systems: a case study of the HIV monitoring and evaluation system in South Africa

<p>Abstract</p> <p>Background</p> <p>Like many low- and middle-income countries, South Africa established a dedicated HIV monitoring and evaluation (M&E) system to track the national response to HIV/AIDS. Its implementation in the public health sector has however not been assessed. Since responsibility for health services management lies at the district (sub-national) level, this study aimed to assess the extent to which the HIV M&E system is integrated with the overall health system M&E function at district level. This study describes implementation of the HIV M&E system, determines the extent to which it is integrated with the district health information system (DHIS), and evaluates factors influencing HIV M&E integration.</p> <p>Methods</p> <p>The study was conducted in one health district in South Africa. Data were collected through key informant interviews with programme and health facility managers and review of M&E records at health facilities providing HIV services. Data analysis assessed the extent to which processes for HIV data collection, collation, analysis and reporting were integrated with the DHIS.</p> <p>Results</p> <p>The HIV M&E system is top-down, over-sized, and captures a significant amount of energy and resources to primarily generate antiretroviral treatment (ART) indicators. Processes for producing HIV prevention indicators are integrated with the DHIS. However processes for the production of HIV treatment indicators by-pass the DHIS and ART indicators are not disseminated to district health managers. Specific reporting requirements linked to ear-marked funding, politically-driven imperatives, and mistrust of DHIS capacity are key drivers of this silo approach.</p> <p>Conclusions</p> <p>Parallel systems that bypass the DHIS represent a missed opportunity to strengthen system-wide M&E capacity. Integrating HIV M&E (staff, systems and process) into the health system M&E function would mobilise ear-marked HIV funding towards improving DHIS capacity to produce quality and timely HIV indicators that would benefit both programme and health system M&E functions. This offers a practical way of maximising programme-system synergies and translating the health system strengthening intents of existing HIV policies into tangible action.</p

‘Trust and teamwork matter’: Community health workers’ experiences in integrated service delivery in India

A comprehensive and integrated approach to strengthen primary health care has been the major thrust of the National Rural Health Mission (NRHM) that was launched in 2005 to revamp India’s rural public health system. Though the logic of horizontal and integrated health care to strengthen health systems has long been acknowledged at policy level, empirical evidence on how such integration operates is rare. Based on recent (2011–2012) ethnographic fieldwork in Odisha, India, this article discusses community health workers’ experiences in integrated service delivery through villagelevel outreach sessions within the NRHM. It shows that for health workers, the notion of integration goes well beyond a technical lens of mixing different health services. Crucially, they perceive ‘teamwork’ and ‘building trust with the community’ (beyond trust in health services) to be critical components of their practice. However, the comprehensive NRHM primary health care ideology – which the health workers espouse – is in constant tension with the exigencies of narrow indicators of health system performance. Our ethnography shows how monitoring mechanisms, the institutionalised privileging of statistical evidence over field-based knowledge and the highly hierarchical health bureaucratic structure that rests on top-down communications mitigate efforts towards sustainable health system integration

Emerging challenges and health system capacity: the case of non- communicable diseases in Pakistan; a review

Background: Pakistan is facing double burden of disease and the contribution of mortality by non-communicable diseases has over numbered the communicable diseases. The focus of health system of Pakistan is inclined more towards communicable disease and maternal & child health. Therefore, there is a need to review health policy, health sector budgeting and health setup in order to meet the needs of healthcare in context of non-communicable disease. Objective: To review the health system capacity to manage the emerging challenge of non-communicable diseases in Pakistan. Methodology: A thorough literature search on PubMed and Google Scholar was done. Reports from W.H.O, other national and international organizations and government & non-government policy papers were also reviewed. We used following search terms; Non Communicable Disease, Health system capacity, Pakistan. Results: Several health system issues emerged through the review of the health system capacity for NCDs. These included lack of political commitment, services more focused on communicable disease and MNCH, inadequate human resources, lack of inter-sectoral approach, insufficient funding opportunities and fragmented health system. These issues can be addressed through government support for combating burden of NCDs, provision of services for NCD at PHC level, human resource training regarding NCDs and integrated care system. Finance should be allocated for NCDs and existing HMIS should also be used for utilizing information regarding NCDs. Conclusion: Health systems framework to NCD means in summary re-examining the planning and organization of the entire health system, from service provision to financing, from information generation to ensuring adequate supply of pharmaceuticals/technologies or human resources, from improving facility management to performance monitoring

United Nations Development Assistance Framework for Kenya

The United Nations Development Assistance Framework (2014-2018) for Kenya is an expression of the UN's commitment to support the Kenyan people in their self-articulated development aspirations. This UNDAF has been developed according to the principles of UN Delivering as One (DaO), aimed at ensuring Government ownership, demonstrated through UNDAF's full alignment to Government priorities and planning cycles, as well as internal coherence among UN agencies and programmes operating in Kenya. The UNDAF narrative includes five recommended sections: Introduction and Country Context, UNDAF Results, Resource Estimates, Implementation Arrangements, and Monitoring and Evaluation as well as a Results and Resources Annex. Developed under the leadership of the Government, the UNDAF reflects the efforts of all UN agencies working in Kenya and is shaped by the five UNDG programming principles: Human Rights-based approach, gender equality, environmental sustainability, capacity development, and results based management. The UNDAF working groups have developed a truly broad-based Results Framework, in collaboration with Civil Society, donors and other partners. The UNDAF has four Strategic Results Areas: 1) Transformational Governance encompassing Policy and Institutional Frameworks; Democratic Participation and Human Rights; Devolution and Accountability; and Evidence-based Decision-making, 2) Human Capital Development comprised of Education and Learning; Health, including Water, Sanitation and Hygiene (WASH), Environmental Preservation, Food Availability and Nutrition; Multi-sectoral HIV and AIDS Response; and Social Protection, 3) Inclusive and Sustainable Economic Growth, with Improving the Business Environment; Strengthening Productive Sectors and Trade; and Promoting Job Creation, Skills Development and Improved Working Conditions, and 4) Environmental Sustainability, Land Management and Human Security including Policy and Legal Framework Development; and Peace, Community Security and Resilience. The UNDAF Results Areas are aligned with the three Pillars (Political, Social and Economic) of the Government's Vision 2030 transformational agenda

Towards integrated island management: lessons from Lau, Malaita, for the implementation of a national approach to resource management in Solomon Islands: final report

Solomon Islands has recently developed substantial policy aiming to support inshore fisheries management, conservation, climate change adaptation and ecosystem approaches to resource management. A large body of experience in community based approaches to management has developed but “upscaling” and particularly the implementation of nation-wide approaches has received little attention so far. With the emerging challenges posed by climate change and the need for ecosystem wide and integrated approaches attracting serious donor attention, a national debate on the most effective approaches to implementation is urgently needed. This report discusses potential implementation of “a cost-effective and integrated approach to resource management that is consistent with national policy and needs” based on a review of current policy and institutional structures and examination of a recent case study from Lau, Malaita using stakeholder, transaction and financial cost analyses