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  • Data and measurement of HRH availability, accessibility, acceptability and quality

    TEHCNICAL WORKING GROUP (TWG) #3

    - DRAFT FOR CONSULTATION - Not to be quoted or referenced without prior permission from the

    authors. Not for wider distribution

    This paper serves as a background report to inform the Global Strategy for Human Resources for Health. The development of this paper has been coordinated through a thematic working group (TWG), comprising of 2 co-chairs and a group of experts drawn from various Global Health Workforce Alliance (GHWA) constituencies, operating under the oversight of the GHWA Board working group. The views expressed in the paper, do not necessarily reflect the official position of GHWA. All reasonable precautions have been taken by the co-chairs to verify the information presented in the papers

  • TWG3: HRH data and measurement

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    TABLE OF CONTENTS

    1. Introduction ................................................................................................................. 3

    2. Methods ...................................................................................................................... 3

    3. Evidence ...................................................................................................................... 4 A) The necessity to focus on HRH data ................................................................................. 4 B) Emerging issues ................................................................................................................ 4 C) Current challenges and opportunities in health workforce data and measurement ....... 6 D) Inter-operability and alignment ....................................................................................... 7 E) Forward opportunities on HRH data and inter-operability .............................................. 8

    4. Forward vision and recommendations ........................................................................ 10

    5. Conclusion ................................................................................................................. 13

    References ..................................................................................................................... 14

    LIST OF BOXES

    Box 1: HRH estimate and planning approaches ........................................................................ 6 Box 2: Kenyas experience with the development of a health workforce information system 7 Box 3: The potential of Health Facility Assessment (HFA) Tools ............................................... 9 Box 4: eHealth, mHealth and inter-operability - Country experiences ................................... 10

    ABBREVIATIONS AND ACRONYMS

    AAAQ availability, accessibility, acceptability and quality

    HFA health facility assessment

    HIE health information exchange

    HIS health information system

    HRIS human resources information system

    HRH human resources for health

    ISCO International Standard Classification of Occupations

    KHWIS Kenya health workforce information system

    MDG Millennium Development Goals

    MDS minimum data set

    TWG thematic working group

    UHC universal health coverage

    WHA World Health Assembly

    file://WIMS/HQ/GVA11/Secure/Departments/Dept-HWA/DivData/7_ADVOCATING_HRH_Issues/HRH%20strategy/Phase%201%20public%20consultation/TWG3_Paper_07Dec14.docx%23_Toc405810803file://WIMS/HQ/GVA11/Secure/Departments/Dept-HWA/DivData/7_ADVOCATING_HRH_Issues/HRH%20strategy/Phase%201%20public%20consultation/TWG3_Paper_07Dec14.docx%23_Toc405810804file://WIMS/HQ/GVA11/Secure/Departments/Dept-HWA/DivData/7_ADVOCATING_HRH_Issues/HRH%20strategy/Phase%201%20public%20consultation/TWG3_Paper_07Dec14.docx%23_Toc405810805file://WIMS/HQ/GVA11/Secure/Departments/Dept-HWA/DivData/7_ADVOCATING_HRH_Issues/HRH%20strategy/Phase%201%20public%20consultation/TWG3_Paper_07Dec14.docx%23_Toc405810806

  • TWG3: HRH data and measurement

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    Acknowledgements:

    Our thanks to all the individual experts who provided support to the development and review of this paper: Edson Araujo, World Bank; Elsheikh Badr, WHO, EMRO; Michael Bzdak, Johnson & Johnson; Margaret Caffrey, Liverpool School of Tropical Medicine; Mario Dal Poz, University of the State of Rio de Janeiro; Marilyn De Luca, NYC; Gilles Dussault, Instituto de Higiene e Medicina Tropical; Matt Edwards, Centre for Workforce Intelligence, UK ; Alfredo Fort, IntraHealth International; Louise Holly, Save the Children UK; Sofia Lopes, ICS Integrare; Zina Maan Jarrah, Management Sciences for Health; Shiv Mathur, NIHFW; Bjorg Palsdottir, Training for Health Equity Network; Luisa Pettigrew, World Organisation of Family Doctors ; Estelle Quain, USAID; Jody Ranck, SBC Global Advisors; Jessica Rose, USAID; Edward Salsberg, George Washington University; Xenia Scheil-Adlung, ILO; Michael Schoenstein, OECD; Dykki Settle, IntraHealth International (+ colleagues) ; Amani Siyam, WHO; Neil Squires, DFID; Keith Waters, CDC; Alexandra Zuber, CDC.

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    1. Introduction

    In the next 15 years, countries from all income groups will experience challenges (1,2) that

    will arise from and will shape the pathway towards the attainment of universal health

    coverage (UHC)(3,4). UHC aims to all people obtain the health services they need without

    suffering financial hardship(5). Financial and social protection are very important

    components of this new health paradigm, as highlighted in the ILO 202 Recommendation (6)

    and require strong commitment by countries.

    Human resources for health (HRH) are recognised as central to achieve UHC, and essential to

    respond to countries future challenges (7). A responsive and fit for purpose workforce

    requires an increasing focus on the availability and accuracy of health workforce data that

    enables workforce strategic planning and anticipation of future needs (3,8).

    WHO, European Union, OECD, and other international bodies have long-recognised the

    policy necessity and urgency of improving health workforce data and measurement.

    Technological advances, connectedness and Internet, as well as the rise of new approaches

    for health workforce futures(9), create opportunities for HRH data collection, gathering and

    utilization.

    This paper reviews the available evidence and outlines opportunities that would inform the

    governance and effectiveness of people-centred health and social protection systems. In

    particular how to progress towards minimum, inter-operable data sets, develop the

    necessary strategic intelligence on HRH and create a connected health workforce.

    Developed under the scope of the Global Health Workforce Alliances (GHWA) consultation,

    this paper on HRH data and measurement is the outcome of one of eight thematic working

    groups (TWG), which will inform the development of a global strategy on HRH relevant to

    the post-2015 development agenda (2015-2030). The consultation process is described

    elsewhere (10).

    2. Methods

    A mix-method approach was used to collect and analyse information about HRH data and

    measurement:

    1) Process-tracing of World Health Assembly (WHA) Resolutions

    All WHA Resolutions, from 2000 to 2014, were analysed and classified according to: 1)

    nature (health-related: health issues, HRH, social security; Non-health related: Financial and

    regulatory issues); and 2) content (against the Comprehensive Health Labour Framework for

    UHC (11)). A chronology of events linking the resolutions and HRH evidence and advocacy

    (e.g. Joint Learning Initiative, Kampala Declaration and the Agenda for Global Action, Recife

    Declaration) was established.

    2) Non-systematic review of the literature

    Literature on the best and most recently available evidence and approaches regarding

    future scenarios and health and social protection systems; big data and connected

    health; workforce strategic intelligence were reviewed. This included research papers,

    published reports and grey literature, identified by experts of different areas involved in this

    TWG.

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    3) Review of available data sets containing HRH data

    World Bank consultants performed a revision of the available datasets and relevant

    literature on HRH data or data initiatives. A total of 10 datasets and 13 papers were

    identified and revised.

    4) Key informants and country examples

    At regional level, key informants reported on HRH data and measurement issues from

    regional and countries experiences. Information was collected using a standardized matrix

    and where possible, focal points at country level were involved in data gathering. Key

    informants validated the information retrieved.

    5) Expert panel consultation

    Experts were identified with the support of GHWA and were asked to contribute from their

    field of expertise. Individual and group participation was established through email, the

    GHWA discussion forum and conference calls.

    3. Evidence

    A) The necessity to focus on HRH data The review of the WHA resolutions generated between 2000 and 2014 shows an increasing frequency of recommendations that call for strengthening the health workforce. During this period, WHO member states generated 374 WHA resolutions. Of the total number of resolutions, 209 are categorized as health-related in nature and are further analyzed. The 165 non-health resolutions, categorized a