Using data to develop effective human resources policies for health worker recruitment and retention

1
Using data to develop effective human resources
policies for health worker recruitment and
retention

• Your name(s)
• Your Position, Project, Organization
• Date of Presentation
• Location/Context of Presentation

2
Presentation Objectives

• Identify the elements of a national health worker
  registry system for effective policy making
• Replicate a stakeholder analysis that identifies
  key players implement a workforce registry
• Articulate types of health worker policies a
  Ministry can develop from information from a
  licensed professional registry system

3
Need for Data

• HR Challenges in the developing world
• The demand for medical professionals is
  increasing.
• In response to the HIV/AIDS pandemic
• While the supply is decreasing.
• Medical professionals are dying prematurely of
  AIDS
• Medical professionals are emigrating to other
  countries or leaving the sector

4
Good HRIS Data is needed for

• Training - to train quantity type
• Registration to ensure qualified supply
• Deployment to meet needs
• Management of personnel
• Planning future needs
• Data exists, BUT
• in paper form
• in different agencies
• making it very difficult to work with!

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Indexing form B.Nursing
TRACKBachelor of Nursing
Retention form
Indexing form Diploma
TRACKDiploma in Nursing
Retention form
Psychiatry
Com HealthPost-basic
Indexing form Enrolled nurse
TRACKEnrolled Nursing program
Retention form
Com HealthPost-basic
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Data on Paper Lesotho, Uganda and Kenya
Registries
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Good HRIS Data is needed to answer policy and
management questions (examples)

• How many doctors and nurses are being trained?
• What is the distribution of cadres in urban and
  rural areas?
• Who is eligible for promotion?
• Who will be retiring over the next five years?
• How many health professionals have applied to
  out-migrate?
• How long does it take before a new employee is
  recruited and put on the payroll?

8
Meeting HRIS Needs Successfully

• Participatory Approach
• Needs-based system
• Cost-effective and user friendly
• Build upon lessons learned in other countries
• Ensure sustainability and continuous improvement

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Participatory Approach

• Generate ownership
• Build capacity
• Empowerment
• Share with other
• Ministries and Sectors
• Countries

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Purpose of Participatory Approach for
Stakeholder Leadership Groups

• Generate ownership
• Empower stakeholders
• Build capacity
• Communicate needs
• Share with other
• Ministries and Sectors
• Countries
• Regions

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Participatory Approach Stakeholder Leadership
Group

• Managers Ministry of Health)
• HR Ministry of Public Service)
• Payroll Ministry of Finance
• Registrars Health Councils
• Training Centers
• Scholarship Boards

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Uganda Health Workforce Advisory Board

• HRDD (MOH) Assistant Commissioner
• Computer Resource Center (MOH) Asst.
  Commissioner
• Payroll (MOH) Principal Personnel Officer
• Registrar Nursing Council
• Registrar Medical and Dental Council
• Registrar Allied Health Council
• Registrar Pharmacy Council
• DHRH/EU
• Aga Khan University
• Makerere University
• Capacity Project

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Role of stakeholder leadership group

• To lead, coordinate, harmonize, and provide
  oversight function for HRIS related activities
• Role of funder offer technical assistance and
  support to facilitate implementation of
  activities

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Establishing framework for stakeholder leadership
groups (SLG)

• Establish consensus on mission/purpose of SLG
• Agree on principles of operation
• Agree on advisory board structure
• Develop timeline activities and meetings

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Purpose of Participatory Approach for
Stakeholder Leadership Groups

• Generate ownership
• Empower stakeholders
• Build capacity
• Communicate needs
• Share with other
• Ministries and Sectors
• Countries
• Regions

16
Essential elements for establishing stakeholder
leadership groups (SLG)

• Establish consensus on mission/purpose of SLG
• Agree on principles of operation
• Agree on advisory board structure
• Develop timeline activities and meetings

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Stakeholder Leadership Group Tenets

• Mission
• Identify needs workforce data
• Link HR data from pre-service to attrition
• Structure
• Chairperson nominated
• Secretariat established
• Meeting location
• Principles of operation
• Transparency
• Respect each others view

Capacitys participatory approach
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Capacitys HRIS Software Approach

• Free/Open-Source Software
• International development and support community
• Development for one country or application made
  available to all
• Web-based
• Maximum utility, access, and compatibility
• Familiar interface
• Regional and Global Partnering
• Sustainability
• Standards for sharing and contextual analysis
• Training institute twinning for technology
  training and support

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Regional Sharing Uganda Study Trip to Kenya, Nov
2005
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Country Activities

• Uganda
• Rwanda
• Swaziland
• Lesotho
• Tanzania
• Zanzibar
• Southern Sudan
• Kenya
• Ghana
• Mali

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How can an HRH Information System answer our
policy questions?
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World Health Day April 2006
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How many student nurses enter training every
year? How many go on to become registered?
Academic Year 2001-2002
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How does this break down by gender? Implications?
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How does this break down by district?
Implications?

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What can we learn about outmigration from an
HRIS? (one example)
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65
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Nurses Applying for External Licensing in Uganda,
2000-2005
Nurses Enrolled/Registered in Uganda, 2004
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Lessons Learned

• Comprehensive stakeholder identification and
  involvement from the beginning
• Stakeholders dont know about each other and
  available data sources
• Free and Open Source software offers best
  supported and most cost effective model
• Inter-country sharing prevents repeat mistakes,
  leverages successes, and ensures consistency

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Next Steps!

• Develop HRIS Strengthening action plans for all
  countries
• Finish mature software solutions and release to
  open-source development community
• Work with global (WHO, World Bank, EU) and
  regional (eg. ECSA) partners to build consensus
  and ensure sustainability.

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Zanzibar HRIS process
pre-Capacity
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Thank you!