Country Coordination and Country Coordination and Facilitation Facilitation

04 May04 May 2010 2010San SalvadorSan Salvador

Hirotsugu AigaHirotsugu Aiga, MPH, PhD, MPH, PhDCoordinator, GHWA secretariatCoordinator, GHWA secretariat

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OutlineOutline of presentation of presentation

Background & introductionPart 1

Country coordination and facilitationPart 2

Way forwardPart 3

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Background & introduction

Part 1

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Countries with a critical HRH shortageCountries with a critical HRH shortagePart 1

[Source] WHO. (2006). World Health Report 2006. WHO: Geneva.

Of 57 crisis countries, 5 are in Latin America.

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Vision: access for all to a skilled, motivated, and supported health worker as part of a functioning health system.

What is GHWA?What is GHWA?Part 1

Mission: mobilize all stakeholders to collaboratively advocate and take appropriate actions to achieve access for all to skilled and motivated health workers, with a focus on the 57 countries in crisis.

Stakeholders: 258 Alliance Members and 29 Alliance Partners, representing developing and developed countries, health professional organizations, academia, NGOs and the private sector.

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1. Africa Public Health Alliance2. African Christian Health Association (ACHA)3. African Medical and Research Foundation4. Asia Pacific Action Alliance on Human Resources for Health5. Bill & Melinda Gates Foundation6. Duke University7. East, Central, and Southern African (ECSA) Health Community8. Federal Ministry for Economic Cooperation and Development, Germany9. French Development Agency - Agence Française de Développement10. Health and Life Sciences Partnership11. International Council of Nurses12. International Hospital Federation13. Intrahealth International, Inc.14. Irish Aid - Department of Foreign Affairs, Ireland15. Japan International Cooperation Agency (JICA)16. Norwegian Agency for Development Cooperation (NORAD)17. Physicians for Human Rights18. Realizing Rights – The Ethical Globalization Initiative19. Results for Development Institute20. The Canadian International Development Agency (CIDA)21. The College of Surgeons of East, Central, & Southern Africa (COSECSA)22. The UK Department for International Development (DFID)23. The United States Agency for International Development (USAID)24. Tropical Health and Education Trust25. Uganda National Association of Community & Occupational Health26. University of Ottawa - Université d'Ottawa27. World Health Organization (WHO)28. World Health Professions Alliance29. World Medical Association

29 GHWA partners29 GHWA partnersPart 1 + 258 GHWA members+ 258 GHWA members

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Core functions of GHWACore functions of GHWAPart 1

Convening all stakeholders => regional meeting, technical working groups, task forces, consultations, etc.

Advocating for keeping HRH issues high on the global agenda => High level commitment at G8 2008 and 2009, Global forum on HRH

Brokering knowledge => country profile, technical tools, community of practice, etc.

Three core functions “ABC”:

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:

Kampala Declaration & Agenda for Kampala Declaration & Agenda for Global ActionGlobal Action

Part 1

1. Building coherent national and global leadership for HW solution

2. Scaling up education and training

3. Managing pressures of the international health workforce market and its impact on migration

4. Retaining an effective, responsive and equitably distributed health workforce

5. Securing additional and more productive investment in the health workforce

6. Ensuring capacity for an informed response based on evidence and joint learning

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Country coordination and facilitation (CCF)

Part 2

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Why? Why?

Part 2

Qua

ntity

:

Pre

-ser

vice

trai

ningQ

uality:

In-service training

Professional dev’t

Recruitment

Deployment &distribution

Migration & retention

Accreditation

Soci

al re

cogn

ition

(1) MOH

(4) MOL(5) MOFA

(2) MOE=>Education

(3) MOF=> Investment

(6) Health professional association

(7) Private sector

(1) MOH

(4) Civil society

(5) NGO

HRH as a complex polyhedronHRH as a complex polyhedron

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What is “Country Coordination and What is “Country Coordination and Facilitation” (CCF)?Facilitation” (CCF)?

Part 2

Transparency => All the stakeholders share the information and decision making process

CCF is the process which brings all the key stakeholders in the country to develop and implement a comprehensive evidence-based HRH plan

Ownership => All the stakeholders share the roles and responsibility

Comprehensive solution => All the stakeholders work together as a multi-sectoral team

Maximizing existing mechanism => Reinforce the existing HRH committee, if there is.

12Develop & implement costed HRH plan

National HRH Committee[ Country level ]

[ Regional level ]

Flow of the CCF processFlow of the CCF processPart 2

[ Global level ]

Ministry of Health

Ministry of Education

Ministry of Labor

Health Prof Association

Ministry of Finance

Civilsociety

Private sector

............

GHWA secretariat

STEP1

CCF regional mtg=>sensitization

Local institution

STEP 3

CCF national trg

STEP 4

Coaching & mentoring

STEP 6

Facilitation & acceleration

GHWA partner in country:Multi-/bi-lateral

agency

STEP 5

CCF facilitation guidance

[ Note ] STEP 2 and STEP 5 will be undertaken as a combined sessions.

Regional institution

STEP 2

CCF regional TOT

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GHWA partner(eg, PAHO, USAID, WB….)

Facilitation & acceleration

National HRH Committee

Consultation

CCF process in the countryCCF process in the countryPart 2

Supervision &

Coaching

Local institution

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Expected outcome of CCFExpected outcome of CCFPart 2

[Outcome 1] Preparation of HRH country profile

[Outcome 2] Development of comprehensive costed HRH plan

[Outcome 3] Implementation of comprehensive costedHRH plan

[Outcome 4] M&E of implementation of comprehensivecosted HRH plan

National HRH Committee throughout the processes & outcome

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Way forward

Part 3

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Lessons learned from other regionsLessons learned from other regionsPart 3

1. Inadequate dialogues between stakeholders => Information was not adequately shared between the sectors

2. In particular, health professional associations are not adequately involved. => involvement of non-state stakeholders is key.

3. Stakeholders’ involvement had been limited to validation of HRH strategy and plan. => they would like themselves to be more involved.

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Then,the CCF

process starts

5. Request for CCF support from GHWA, if needed

4. Identify local institute & the Alliance partner

3. Discuss how the HRH costed plan should be

2. Think about organizing national HRH committee

?

Way forward, to start CCFWay forward, to start CCFPart 3

1. Open a dialogue between key stakeholders

Thanks for your attention.Thanks for your attention.Let us work together!Let us work together!

Contact:Contact:

Hirotsugu AigaHirotsugu Aiga Laurence CodjiaLaurence CodjiaCoordinator, GHWACoordinator, GHWA Technical Officer, GHWATechnical Officer, GHWAEmail: Email: aigah@who.intaigah@who.int Email: Email: codjial@who.intcodjial@who.intPhone: +81-22-791-2450Phone: +81-22-791-2450 Phone: +81-22-791-2360Phone: +81-22-791-2360http://www.who.int/workforcealliance/en/