The Philippine HRH Master Plan (2005-2030)
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Transcript of The Philippine HRH Master Plan (2005-2030)
The Philippine HRH Master Plan
(2005-2030)
F. Marilyn E. Lorenzo DrPHCollege of Public Health
University of the Philippines, Manila
First GHWA Conference Kampala, Uganda
March 5,2008
2
HRH Master Plan Goal
Develop and install HHRMD systems that will support Philippine health sector reforms to improve health outcomes
3
II. Situational Analysis
3. Lack of
Operations Research to rationalize HR standards
National HHRD Plan
of 1994 not implemented
1. No integrated policies on HHR
2. Weak HRH info
system to support other HR systems (eg. health facilities, HRH stock and needs)
Functions of organizations with HR roles are not integrated(DOH, PRC. CHED, DBM, POEA, DOLE, DILG, TESDA, Private Hospitals)
Inadequate HRH Management Systems
10 Inadequacy in Budgeted
Items for HRHresource in government and private facilities at the provincial
and municipal levels
HR Standards
outdated or inappropriate
Variable cost of health sciences education
Proliferation of substandard schools (eg. nursing schools)
Inequitable
distribution of health professionals
Other health
professionals going into nursing
Increased Migration
of Health
LowProductivit
y of Health Profession
al Dissatisfaction
Weak Health System
Inappropriate or outdated skill and skill mix
Low Quality
HR Standards
outdated or inappropriate
7. No rational basis for
opening of health science schools
11. Inequitable distribution of health professionals
5. Other health professionals going into nursing
Increased Migration of Health
professionals
Lack of integrated HRH systems in general: Information system, HRH development, compensation/ benefits/ incentives, production,regulation, deployment/ placement, utilization, monitoring/ evaluation, policy and standard development, HRH planning
6.Poor Working Conditions;
Limited Career Progression Opportunities; Unfavorable terns of
employment
4.Compensation: Low; Large
gap exists between salaries of government and private based
health workers
Lack of system for local recruitment and deployment
LowProductivity
of Health Profession
al Dissatisfaction
Salaries of resident doctors and nurses pale in
comparison to professionals in other sectors
Low Quality
4
Situational Analysis Summary: Strengths / Opportunities
1. Presence of Organizations with HRH functions and existence of informal ties
2. DOH: Ability to solve HRH problems that surface
3. New emphasis on HRH globally and nationally
4. Competitiveness of Health Sciences Professions; Popularity of Health Sciences programs over other
professional programs
5
Situational Analysis Summary:Weaknesses and Threats
• Government organizations have fragmented HRH functions
• Non- integrated organizational policies
• No evidence-based staffing standards–politicized, limited
and outdated
• Contractualization of HRH: Job Order, Labor List
• Lack of Functional HRH systems in general
• Inequitable distribution of HRH
• Inadequately budgeted items for HRH
6
Framework for Human Resource Framework for Human Resource
for Healthfor Health
External Environment
Socio-economic Planning, Health Planning, Disease Conditions,
Government Pressures and Regulation,Market Conditions,Union pressures,
Stage of country’s Development and Culture, HHR Needs and Resources
Internal Environment
Health Services, Sectoral Strategy,
Job Technology, HR Characteristics
HR Outcomes
•Competence
•Congruence
•Commitment
•Org Effectiveness
•Cost Effectiveness
•Productivity
•Readiness for
Change and innovation
Long Term
Consequences
•Individual Well Being
•Organizational Effectiveness
•Societal Well Being
•Quality Work life
Feedback system for control
Multiple Interests
(Values) of
the Key Stakeholders
Health
Workers
Community
Unions
Health
Facilities
NGOs
Federation of
Health Prof
Orgs
LGUs
Development
of HHR
Systems
Figure 1: National Health Human Resource Development Framework
HR PlanPRC, DOH, CHED
-Policy and Standard Development
-Monitoring and Evaluation of Policies-Information System
-Research
HR Productionand RegulationAcademe, PRC,
CHED,TESDA
HR Management and StrategiesDOH, Prof. Association, CSC
Recruitment, Deployment/Placement
Orientation, Supervisory System
Production Stds, Non-labor Inputs, Career Pathways
HR Development
PRC, DOH, CHED, Specialty Boards
Academe/ Institutions-Continuing Education
-Training
7
Planning Bases
• Medium Term Development Plan NEDA 2005-2010
• UN Millennium Development Goals
• Devolution
– Inter-local Health Zones
• Health Sector Reform
• Health Needs (Disease Patterns; Triple burden of Disease)
• Health financing (Philhealth, commercial, community)
• Domestic HRH demand based on socio-demographic trends
• Foreign HRH demand based on known demand trends
• Regulatory standards e.g. AO 70, AO 147
• National Health Plan 1994-2020
8
Planning Assumptions
• Implementation of HSRA until 2030
• Workforce plans based on following requirements:
– population
– equitable distribution based on needs, geographic characteristics and
socio-economic factors
– Regulatory standards
• Phased HRHD planning feasible
– 12 HRH categories covered in first phase
– 11 HRH categories covered in second phase
• Each HRH category is assumed to have possible multiple roles as clinicians, educators and
researchers
• EO 366 is implemented
17,5414,9652,3202,64511,5371,039Midwives
1,2828413934480441
Pharmacist
s
9718413934480130OT
9578413934480116PT
4,1028413934482,296965MedTech
4,4238413934482,2961,286Dentists
65,90051,445
24,04
0
27,40
52,29612,159Nurses
22,87313,6766,3917,2852,2966,901Doctors
TotalPrivatePublicTotal
Positions in HospitalsNo. of
RHUs/MHCs/
BHS
Existing
DOH/NGAs
positions
Number of Positions
Professions
Available Positions in the government and hospitals for various health professional groups
10
Assumptions:
8. Tertiary care medical centers assumed to have 15 dept
7. Tertiary care hospitals assumed to have 7 dept
6. Secondary care hospitals assumed to have 4 dept
5. Admin positions (chiefs, supervisors) taken into account for doctors and nurses
4. Medtech, OT, PT, Pharm to hospital bed ratio assumed to be 1 per hospital except for birthing homes and infirmary
3. HW to hospital bed ratio based on AO. 70
2. RHUs/MHCs require only one health worker per type of profession
1. Distribution of HW based on distribution of public (53.27%) and private (46.73%) hospital beds
11
26,75124,51322,46920,60318,89717,338Midwives
33,32230,52727,97625,64623,51821,572Pharmacists
16,618 15,218 13,940 12,774 11,713 10,769 OT
23,58421,14419,08817,31415,67514,313PT
7,7797,5537,0336,6336,3936,386MedTech
12,80211,73510,7619,87115,9548,629Dentists
263,244241,166221,010202,603185,788170,423Nurses
47,15143,19639,58636,28933,27730,525Doctors
203020252020201520102005
Projected Workforce RequirementsProfessions
Workforce projections for various health professional groups, 2005-2030
122,50016,3982,29315,045Midwives
7,20916,3086,61314,959Pharmacists
4,7416,9724,3596,410Occupational Therapists
6,4379,2385,8788,435Physical Therapists
6125,7806125,774Medical Technologists
1,41814,5367677,862Dentists
67,775118,01362,170108,253Nurses
9,29823,9798,52921,996Doctors
PrivatePublicPrivatePublic
20102005
Projected Workforce Requirements
Professions
Distribution of projected workforce to public and private sectors for various health professional groups,
2005-2010
13
-1,17716,39817615,04515,221Midwives
-15,41916,308-14,07014,959889Pharmacists
-2,8353,413-2,5683,146578OT
-3,9414,505-3,5834,147564PT
-2,0715,780-2,0655,7743,709MedTech
-10,50614,536-3,8327,8624,030Dentists
-76,153118,013-66,393108,25341,860Nurses
-7,49723,979-5,51421,99616,482Doctors
Difference
(A-C)
Projections
(C)
Difference
(A-B)
Projections
(B)
20102005
Projected Workforce RequirementsExisting positions in public
sector (A)
Professions
Difference between projected workforce for the public sector and existing
positions for various health professional groups, 2005-2010
14
-1,17716,39817615,04515,221Midwives
-15,41916,308-14,07014,959889Pharmacists
-6,3946,972-5,8326,410578OT
-8,6749,238-7,8718,435564PT
-2,0715,780-2,0655,7743,709MedTech
-10,50614,536-3,8327,8624,030Dentists
-76,153118,013-66,393108,25341,860Nurses
-7,49723,979-5,51421,99616,482Doctors
Differe
nce (A-
C)
Projections
(C)
Difference
(A-B)
Projections
(B)
20102005
Projected Workforce Requirements
Existing
positions
in public
sector (A)Professions
Difference between projected workforce for the public sector andexisting positions for various health professional groups,
2005-2010
15
Salary costs of projected workforce to public and private sectors for various health professional groups, 2005-2010, in Billions PhP
0.835.461.087.10Midwives
2.315.232.144.84Pharmacists
0.731.070.110.17OT
2.052.950.440.63PT
0.444.140.403.73MedTech
0.444.520.383.94Dentists
25.344.0024.542.6Nurses
3.138.064.0910.54Doctors
PrivatePublicPrivatePublic
20102005
Projected Workforce Requirements
Professions
16
Cost projections (Training) for various health profession
groups for 2021-2030 Philippines (in Billions Php)
879.84235.7874.7730.0313.594.41Total
48.0225.6113.657.283.880.08OT
17.249.194.902.611.390.74PT
3.012.051.390.950.640.44MT
4.032.151.150.610.330.17Pharm
1.280.540.230.160.110.07MW
5.653.842.621.781.210.82DMD
35.0218.9710.324.121.610.79RNs
765.61173.4340.5112.524.411.28MDs
203020252020201520102005
YearsProfessions
17
Cost projections (Salaries) for various health profession
groups for 2005-2030 Philippines (in Billions Php)
321.99242.31175.91132.00107.12106.65Total
18.8512.938.865.781.790.28OT
7.104.923.332.251.521.09PT
7.826.785.905.174.584.12MT
23.2316.8612.479.577.536.98Pharm
5.484.364.425.106.298.18MW
8.857.656.615.724.964.32DMD
214.60157.72113.2782.6769.2667.04RNs
36.0731.0921.0415.7311.1914.63MDs
203020252020201520102005
YearsProfessions
18
Assumptions for workforce projections (Nurses)
Regions
1747353002337RN Graduation Patterns
0.2200.330Geographic Weight
0.170.170.330Cultural Weight
0.1100.220SES Weight
70,694 104,230 120,409 127,383 Current Cost to train RN
Student
301,104 301,104 285,138 301,104 Current Salary Costs/RN
1.56%1.39%1.90%1.19%Annual Population
Growth Rate
3,087,476 4,491,386 1,560,867 11,240,743 Current Population
4.17%0.00%7.32%11.76%RN Attrition Rate
14,28512,6696,22032,603Number of RNs at
beginning of year
1.581.581.581.58Preferred Nurses to
Population Ratio
IIICARNCRAssumptions
19
Assumptions for workforce projections (Doctors)
Regions
1910891559MD Graduation Patterns
0.2200.330Geographic Weight
0.170.170.330Cultural Weight
0.1100.220SES Weight
550,000 550,000 550,000 550,000 Current Cost to train MD
Student
285,138 285,138 285,138 285,138 Current Salary Costs/MD
1.56%1.39%1.90%1.19%Annual Population
Growth Rate
3,087,476 4,491,386 1,560,867 11,240,743 Current Population
7.14%57.89%1.41%30.30%MD Attrition Rate
2,7641,8691,68014,391Number of MDs at
beginning of year
0.283 0.283 0.283 0.283Preferred Doctors to
Population Ratio
IIICARNCRAssumptions
20
General Assumptions
6. Adjusted for socio-economic, cultural, and geographic indices
7. Increased graduation patterns by 10% starting 2006 for all regions except for NCR
5. Attrition rate assumed to be the same as that for government HWs
4. Distribution of HWs across regions assumed to be the same as distribution of government HWs
3. Stock of HW derived from licensees (PRC data) adjusted for unemployment (11.4%) and migration (per category of HW)
2. Wages from government rates (entry level)
1. NSO population projections using medium assumptions
21
The Proposed HRH The Proposed HRH
Implementing Implementing
OrganizationOrganization
Support & coordinating
agencies
Planning, Resource Mgmt, Coordination ,
ChampionDOH
BLHD, HHRDB,,IMS,
HPDPB, BIHC, BHFS, NCFHD
PartnersProposed
Implementers of the
Plan
DOF NGOs
Funding
PHIC/
International
Donors like
WHO
CSCNEDA
Data
source:
LGU’s
DTI
DILGRetention,
Compensa-
tion & Career
Dev’tDBM, PHA &
LGUs
Production
Academe &
Accredited
Professional Organizations
RegulationPRC,
Professional Regulatory
Boards,
CHED, TESDA & PHIC
Domestic
Deployment
DOLE &
League of
Municipalities
and Cities
Int’l
Deployment
POEA, DFA
& OWWA
POPCOM PITAC
22
Monitoring the HRHMP: Comp. I
Establishment : HRH Implementing Org.
Formulation: Evaluation scheme for 7 HRH systems
Program Development: domestic and international deployment
Competency-Based Job Analysis Interventions
Career Development Management Systems Interventions
Establishment: HRH units and HRHIS
Pilot: Staffing Plan, 15 Pilot ILHZs
Workforce planning in local levels
Finalization of HRH Master Plan
201020092008200720062005
Year (2005-2010)
HRHMP Outputs Phase I
HRHMP Time Frame (Phase I)HRHMP Time Frame (Phase I)
23
Monitoring of the HRHMP
Conferences between private and public sectors
Maintenance of HRHIO
Staffing Components Implementation: 46 ILHZs
Maintenance of HRHIS
HRHIS expansion: 46 ILHZs
Programs implementation: Quality health science schools
CDMS Implementation: expansion areas
Deployment Projections: medium and long terms
2020201920182017201620152014201320122011
Year (2011-2020)HRHMP OutputsPhase II
HRHMP Time Frame (Phase II)HRHMP Time Frame (Phase II)
24
HRHMP Time Frame (Phase III)HRHMP Time Frame (Phase III)
Planning for the next master plan
Revision of HRH programs based on monitoring and evaluation
Review of Master Plan
Monitoring of Staff Performance and Satisfaction
Evaluation of HR management Systems and HRHMP
Implementation of 7 Management Systems Continued
CDMS Implementation (entire public sector)
2020201920182017201620152014201320122011
Year (2011-2020)
HRHMP Activities/ Outputs Phase III
Thank you!