Broadly defined, health work includes not only technical skills and expertise directly responsible for creating and sustaining health but also the skills needed in support systems and the linkages that facilitate the application of technical skills. The health sector is not only labour-intensive but it also depends on a precise application of the knowledge and skills of its workforce to ensure patient security and health. In this sense, the World Health Organization (WHO) continues to develop tools and guidelines to improve the development and management of human resources for health (HRH) in member countries.
Most countries have particular forms of human resource policies and plans, either as part of national health policy and strategies or as stand-alone documents. Their comprehensiveness varies, as many of these are not based on exhaustive situation analysis. About half of WHO member countries are reviewing or developing their HRH policies, strategies and plans for more comprehensiveness and thoroughness in order to respond to current challenges. Planning and implementation have had limited success due to several factors, which include: an insufficient balance between the plan and the planning process, lack of access to and use of planning methods and tools suitable for solving problems found in many developing countries, lack of appropriate and accurate data and information such as that related to workforce supply, annual attrition rates, private sector data, service outputs and staff productivity, low levels of involvement of stakeholders in the planning process, and insufficient advocacy to attract resources for implementation.
See also: The Shift in Employee Healthcare Benefits
It is, therefore, critical that the situation of HRH development in a country is properly and thoroughly documented as the initial step before drawing up a policy and a plan. WHO recommended the following policies to be considered by health professionals:
- Strengthen the content and implementation of HRH plans as part of long-term national health and broader development strategies to strengthen the health system. This can be achieved by ensuring consistency between health, education, employment, gender, migration, development cooperation and fiscal policies.
- Promote decent working conditions in all settings. Ministries of health, civil service commissions and employers should adopt gender-sensitive employment conditions, remuneration and non-financial incentives. It is particularly important to ensure that public sector rules and practices are conducive to adequate incentive mechanisms, working conditions and career structures for health workers, with appropriate levels of flexibility and autonomy.
- Ensure the effective use of available resources. Accountability systems should be put in place to improve the efficiency of health and HRH spending. In addition to measures such as improving pre-service training completion rates and removing ghost workers from the payroll, it is critical to adopt appropriate, cost-effective and equitable population health approaches to provide community-based, person-centred, continuous and integrated care.
- Adopt transformative strategies in the scale-up of health worker education. Public and private sector investments in health personnel education should be linked with population needs and health system demands. Education strategies should focus on investment in trainers, for which there is good evidence of a high social rate of return.
- Optimise health worker motivation, satisfaction, retention, equitable distribution and performance. The ‘decent employment’ agenda entails strategies to improve both performance and equitable distribution of health workers.
- Harness – where feasible and cost-effective – information and communication technology (ICT) opportunities. New ICT tools can be of particular relevance in relation to e-learning, electronic health records, telemedicine, clinical decision-making tools, links among professionals and between professionals and patients, supply chain management, performance management and feedback loops, patient safety, service quality control, and the promotion of patient autonomy. New professional qualifications, skills and competency are needed to harness the potential of ICT solutions to health-care delivery.
- Build greater resilience and self-resilience in communities. This will encourage them to become key stakeholders and assets to a health system and to collaborate actively in the production and quality assurance of care, rather than being passive recipients of services.
- Strengthen capacities of domestic health workforce in emergency and disaster risk management for greater resilience and health-care response capacity. Provide resources, training and equipment for the health workforce and include them in policy and implementation of operations for emergencies at local, national and international levels.
- Enhance and promote the safety and protection of medical and health personnel. There are several points to emphasise here, including but not restricted to:
- Clear and universally recognized definitions and norms for the identification and marking of medical and health personnel, their means of transport and installations;
- Specific and appropriate educational measures for medical and health personnel, State employees and the general population;
- Appropriate measures for the physical protection of medical and health personnel, their means of transport and installations;
- Other appropriate measures, such as national legal frameworks where warranted, to effectively address violence against medical and health personnel;
- Collection of data on obstruction, threats and physical attacks on health workers.
Read also: The 21st-Century Context for Progressive Health Workforce Agenda: WHO