World Health Report 2006World Health Report 2006
Health workforce is importantHealth workforce is important
Health system : 3 MHealth system : 3 M ManMan**
MoneyMoney Material/TechnologyMaterial/Technology
Note * : ShortageNote * : Shortage
Health WorkersHealth Workers
Global health workforce’s situationGlobal health workforce’s situation
Amount : Amount : Shortage, Need-based sufficiencyShortage, Need-based sufficiency
Distribution : Distribution : Density, MigrationDensity, Migration
Diversity : Diversity : Gender/Tribe/AgeGender/Tribe/Age
Skill mixSkill mix Public-private mixPublic-private mix
Forces driving the workforce
Responding to urgent health needsResponding to urgent health needs
High priority services : MDGsHigh priority services : MDGs Burden of chronic diseases and Burden of chronic diseases and
injuriesinjuries Natural disasters and outbreaksNatural disasters and outbreaks Working in conflict and post Working in conflict and post
conflict environmentsconflict environments
Challenges:Challenges: MDGsMDGs Epidemics of in-service training Epidemics of in-service training Overburdened district staff Overburdened district staff Two tiers of salariesTwo tiers of salaries
Solutions:Solutions: Strategy 2.1 Scale up workforce planning Strategy 2.1 Scale up workforce planning Strategy 2.2 Capitalize on synergies across priority Strategy 2.2 Capitalize on synergies across priority
programmeprogramme Strategy 2.3 Simplify services and delegate appropriately Strategy 2.3 Simplify services and delegate appropriately Strategy 2.4 Secure the health and safety of health Strategy 2.4 Secure the health and safety of health
workersworkers
Challenges:Challenges: Preparing the workforce for the growing burden of Preparing the workforce for the growing burden of
chronic diseases and injuries chronic diseases and injuries New paradigms of care require a workforce New paradigms of care require a workforce
responseresponse
Solutions:Solutions: Strategy 2.5 Deploy towards a continuum of care Strategy 2.5 Deploy towards a continuum of care Strategy 2.6 Foster collaboration Strategy 2.6 Foster collaboration Strategy 2.7 Promote continuous learning for Strategy 2.7 Promote continuous learning for
patient safetypatient safety
Optimal mix of health services
Self-care
Informal community care
Health services through primary health care
Community
healthservices
Healthservices in
generalhospitals
Long-stayfacilities
andspecialistservices
Challenges:Challenges: Mobilizing for emergency needs: natural disasters and Mobilizing for emergency needs: natural disasters and
outbreaks outbreaks Preparedness plans can helpPreparedness plans can help
Solutions:Solutions: Strategy 2.8 Take a “command and control” approach Strategy 2.8 Take a “command and control” approach Strategy 2.9 Help remove sector boundaries Strategy 2.9 Help remove sector boundaries Strategy 2.10 Train appropriate health staff for emergency Strategy 2.10 Train appropriate health staff for emergency
response response Strategy 2.11 Develop an emergency deployment strategy for Strategy 2.11 Develop an emergency deployment strategy for
different kinds of health workers different kinds of health workers Strategy 2.12 Ensure adequate support for front-line workersStrategy 2.12 Ensure adequate support for front-line workers
Challenge:Challenge: Working in conflict and post-conflict environmentsWorking in conflict and post-conflict environments
Solutions:Solutions: Strategy 2.13 Obtain and maintain strategic information Strategy 2.13 Obtain and maintain strategic information Strategy 2.14 Invest in advanced planning and focused Strategy 2.14 Invest in advanced planning and focused
interventions interventions Strategy 2.15 Protect what works Strategy 2.15 Protect what works Strategy 2.16 Repair and prepare Strategy 2.16 Repair and prepare Strategy 2.17 Rehabilitate when stability beginsStrategy 2.17 Rehabilitate when stability begins
Preparing the health workforcePreparing the health workforce Working lifespan strategies
Getting the mix right: challenges to health workforce production
Pipeline to generate and recruit the health workforce
Functions of health educational institutions to generate the health
workforce
Relationship of education, labour and health services marketswith human resources
Making the most of Making the most of existing health workersexisting health workers
Human resource indicators to assesshealth workforce performance
Levers to influence the four dimensions
of health workforce performance
Exit routes from the health workforce
Managing exits from the workforceManaging exits from the workforce
MigrationMigration External migrationExternal migration
Source countrySource country Receiving countryReceiving country
Internal migrationInternal migration RetirementRetirement
External migration;External migration;
Source country strategiesSource country strategies
Strategy 5.1 Adjust training to need and Strategy 5.1 Adjust training to need and demands demands
Strategy 5.2 Improve local conditionsStrategy 5.2 Improve local conditions
External migration;External migration;Receiving country strategiesReceiving country strategies
Strategy 5.3 Ensure fair treatment of migrant Strategy 5.3 Ensure fair treatment of migrant workersworkers
Strategy 5.4 Adopt responsible recruitment Strategy 5.4 Adopt responsible recruitment policies policies
Strategy 5.5 Provide support to human Strategy 5.5 Provide support to human resources in source countriesresources in source countries
External migration;External migration;
International instruments International instruments
Strategy 5.6 Develop and implement tactics Strategy 5.6 Develop and implement tactics against violenceagainst violence
Strategy 5.7 Initiate and reinforce a safe work Strategy 5.7 Initiate and reinforce a safe work environmentenvironment
Internal migration;Internal migration;Challenge:Challenge: Change of occupation or work statusChange of occupation or work status
Solutions:Solutions: Choosing a reduced work weekChoosing a reduced work week Strategy 5.8 Accommodate workers’ needs Strategy 5.8 Accommodate workers’ needs
and expectationsand expectations
Internal migration;Internal migration;Challenge:Challenge: Health workers not employed in their fieldHealth workers not employed in their field
Solution:Solution: Strategy 5.9 Target health workers outside the Strategy 5.9 Target health workers outside the
health sectorhealth sector
Internal migration;Internal migration;Challenge:Challenge: Absentees and ghost workers Absentees and ghost workers
Solution:Solution: Strategy 5.10 Keep track of the workforceStrategy 5.10 Keep track of the workforce
Retirement;Retirement;Challenges: Challenges: Retirement rates and the risk of shortages Retirement rates and the risk of shortages Health workforce ageingHealth workforce ageing
Solution:Solution: Strategy 5.11 Develop the capacity and policy Strategy 5.11 Develop the capacity and policy
tools to manage retirementtools to manage retirement The need for knowledge transfer The need for knowledge transfer Strategy 5.12 Develop succession planningStrategy 5.12 Develop succession planning
Formulating Formulating national health workforce strategiesnational health workforce strategies
Building trust and managing expectations Fair and cooperative governing Strong leadership Strengthening strategic intelligence Investing in workforce institutions
Organizations influencing the behavior ofhealth workers and the health institutions
Professional organizations:Self regulations of entry
And market rules throughCodes of ethics, sanctions,
Training, role models
Institutional regulators:Administrative measures,
funding mechanisms,employment and contracts
managed by state,social health insuranceor similar institutions
The behaviorof health care institutions
and health workers
Civil society organizations:Protection of the interest of
citizens by: empowering users,functioning as watchdogs,
setting policy agenda
The country strategies
1. Build national strategies out of concrete action points that cover
management of entry, workforce and exit as well as: building or rebuilding trust; multi-stakeholder management of the regulatory environment; and
leadership capacities.
The country strategies
2. Pay attention to the process. The choices to be made may be difficult and controversial: it is essential to
ensure procedural fairness by being inclusive and transparent, but
with the courage to arbitrate when vested interests are taking over.
The country strategies
3. Strengthen strategic intelligence, focusing on: (i) understanding the extent and
nature of health workforce problems; (ii) evaluating what is being done and
determining what can be done; (iii) identifying the political drivers that led to
the current situation; (iv) understanding workers’ viewpoints and
anticipating their possible reactions to change.
The country strategies
4. Build the country’s health workforce institutional capacity, with a focus on regulation, leadership and strategic
information, including: (i) analysis and evaluation of microinnovations(ii) scenario building and planning for the future
Working together for healthWorking together for health, , within and across countrieswithin and across countries
Country LeadershipCountry Leadership
Global SodalityGlobal Sodality
Ten-year plan of action
Global stakeholder alliance
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