scholarly journals (A257) Enhancing Human Resources for Health in Crisis: Experience from the War-Affected Districts of Sri Lanka

2011 ◽  
Vol 26 (S1) ◽  
pp. s71-s71
Author(s):  
K. Wickramage ◽  
T. Ranasinghe ◽  
A. Zwi

AimsThis paper examines the coordination framework and interventions undertaken by the Sri Lankan health sector in providing essential health services to the displaced communities in the aftermath of the violent conflict in 2009. The narrative describes, in a chronological format, the strategies and actions undertaken by the health sector in response to a rapidly changing humanitarian crisis. The paper examines some of the key challenges faced by the health sector in the post-conflict recovery phases, the most pertinent being the human resources for health needs.MethodsA review of Ministry of Health departmental meeting minutes/circulars, inter-agency health coordination meeting reports, weekly surveillance reports, inter-agency/agency assessments, media files, and donor and health cluster member reports were compiled and then analyzed in order to construct a narrative on how the Health Sector responded to the humanitarian crisis (from acute emergency phase to the post-conflict recovery and resettlement phase). The authors also were integrally involved in the planning, development, implementation, and monitoring of a spectrum of health sector interventions during the humanitarian crisis from within Government and the United Nations system.RecommendationsA health systems strengthening approach, which places emphasis on human resources for health, can be effective in delivering high impact, sustained, high quality health care even in difficult and complex humanitarian emergencies such as civil war. The Sri Lankan experience has shown that harnessing effective human resource management stratergies in crisis also is vital for the post-conflict health system recovery phase that follows.The excuse that “the system may be too overwhelmed”; or health departments “too overstretched” to lead a coordinated effort can be mitigated with positive leadership and planning. The dividends of working in such an approach also ushers reconcilliation via a unified health workforce and promoting the idea of health as a bridge for peace.

2005 ◽  
Vol 1 (1) ◽  
pp. 59-78 ◽  
Author(s):  
CARL-ARDY DUBOIS ◽  
MARTIN MCKEE

After a long period of neglect, the issue of human resources for health (HRH) has recently emerged as a core component on the international health agenda, with policy makers increasingly eager to learn from experience elsewhere. This article investigates systematically the opportunities and challenges associated with the use of cross-national comparisons of HRH policies and practices. It reviews the evidence in favour of using international comparative studies on HRH, discusses emerging opportunities for developing a cross-national research agenda to guide HRH policies in Europe, and highlights obstacles which may hinder the implementation of comparative studies on HRH. While demonstrating many opportunities offered by the comparative approach to improve understanding of human resources processes in the health sector, this article also emphasizes the dangers of simplistic pleas for the transfer of human resource policies without taking into account the context-specific factors and the generative capacity of the social actors in the design and implementation of policy changes.


2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Joshua Munywoki ◽  
Nancy Kagwanja ◽  
Jane Chuma ◽  
Jacinta Nzinga ◽  
Edwine Barasa ◽  
...  

Abstract Background Health sector priority setting in Low and Middle-Income Countries (LMICs) entails balancing between a high demand and low supply of scarce resources. Human Resources for Health (HRH) consume the largest allocation of health sector resources in LMICs. Health sector decentralization continues to be promoted for its perceived ability to improve efficiency, relevance and participation in health sector priority setting. Following the 2013 devolution in Kenya, both health service delivery and human resource management were decentralized to county level. Little is known about priority setting practices and outcomes of HRH within decentralized health systems in LMICs. Our study sought to examine if and how the Kenyan devolution has improved health sector priority setting practices and outcomes for HRH. Methods We used a mixed methods case study design to examine health sector priority setting practices and outcomes at county level in Kenya. We used three sources of data. First, we reviewed all relevant national and county level policy and guidelines documents relating to HRH management. We then accessed and reviewed county records of HRH recruitment and distribution between 2013 and 2018. We finally conducted eight key informant interviews with various stakeholder involved in HRH priority setting within our study county. Results We found that HRH numbers in the county increased by almost two-fold since devolution. The county had two forms of HRH recruitment: one led by the County Public Services Board as outlined by policy and guidelines and a parallel, politically-driven recruitment done directly by the County Department of Health. Though there were clear guidelines on HRH recruitment, there were no similar guidelines on allocation and distribution of HRH. Since devolution, the county has preferentially staffed higher level hospitals over primary care facilities. Additionally, there has been local county level innovations to address some HRH management challenges, including recruiting doctors and other highly specialized staff on fixed term contract as opposed to permanent basis; and implementation of local incentives to attract and retain HRH to remote areas within the county. Conclusion Devolution has significantly increased county level decision-space for HRH priority setting in Kenya. However, HRH management and accountability challenges still exist at the county level. There is need for interventions to strengthen county level HRH management capacity and accountability mechanisms beyond additional resources allocation. This will boost the realization of the country’s efforts for promoting service delivery equity as a key goal – both for the devolution and the country’s quest towards Universal Health Coverage (UHC).


Author(s):  
George W. Pariyo ◽  
Henry Lucas

This chapter highlights the main ethical issues that arise in addressing the challenges of global human resources for health (HRH). It includes a brief overview of global HRH problems including shortages and poor working conditions that lead to pressures on the international labor market for health workers, as well as strategies that countries and the global community have taken to mitigate them. The main ethical issues that arise in dealing with global HRH are presented. These include equity of access to quality health care, implications of public versus private health care provision, privacy and confidentiality, fairness to health workers in personnel policies and practices, and managing the push and pull factors in the labor market that lead to the pressure for international migration of health personnel. The chapter highlights existing global conventions that could help governments and other policymakers to alleviate these challenges in a more ethically responsible way.


2020 ◽  
Vol 16 (2) ◽  
pp. 1-7 ◽  
Author(s):  
Mihir Dilip Kalambi

India has a colossal shortage of human resources for health. The management of human resources in a healthcare institution is vital to enable the delivery of efficient and effective medical services and to achieve patient satisfaction. Everyone proclaims that the human asset is the most important asset. On the other side, health is declared to be one of the most important wealth. Hospitals and pharmaceutical companies constitute two arms of the “health management/ maintenance” effort of humanity. Human resource professionals face many hurdles in their attempt to deliver high-quality health care to citizens. Some of these constraints include budgets, lack of congruence between different stakeholders' values, absenteeism rates, high rates of turnover, and low morale of health personnel.


2016 ◽  
Vol 10 (1) ◽  
Author(s):  
Sophie Witter ◽  
Maria Paola Bertone ◽  
Yotamu Chirwa ◽  
Justine Namakula ◽  
Sovannarith So ◽  
...  

2021 ◽  
Vol 1 (12) ◽  
pp. e0000077
Author(s):  
Lizah Nyawira ◽  
Rahab Mbau ◽  
Julie Jemutai ◽  
Anita Musiega ◽  
Kara Hanson ◽  
...  

Efficiency gains is a potential strategy to expand Kenya’s fiscal space for health. We explored health sector stakeholders’ understanding of efficiency and their perceptions of the factors that influence the efficiency of county health systems in Kenya. We conducted a qualitative cross-sectional study and collected data using three focus group discussions during a stakeholder engagement workshop. Workshop participants included health sector stakeholders from the national ministry of health and 10 (out 47) county health departments, and non-state actors in Kenya. A total of 25 health sector stakeholders participated. We analysed data using a thematic approach. Health sector stakeholders indicated the need for the outputs and outcomes of a health system to be aligned to community health needs. They felt that both hardware aspects of the system (such as the financial resources, infrastructure, human resources for health) and software aspects of the system (such as health sector policies, public finance management systems, actor relationships) should be considered as inputs in the analysis of county health system efficiency. They also felt that while traditional indicators of health system performance such as intervention coverage or outcomes for infectious diseases, and reproductive, maternal, neonatal and child health are still relevant, emerging epidemiological trends such as an increase in the burden of non-communicable diseases should also be considered. The stakeholders identified public finance management, human resources for health, political interests, corruption, management capacity, and poor coordination as factors that influence the efficiency of county health systems. An in-depth examination of the factors that influence the efficiency of county health systems could illuminate potential policy levers for generating efficiency gains. Mixed methods approaches could facilitate the study of both hardware and software factors that are considered inputs, outputs or factors that influence health system efficiency. County health system efficiency in Kenya could be enhanced by improving the timeliness of financial flows to counties and health facilities, giving health facilities financial autonomy, improving the number, skill mix, and motivation of healthcare staff, managing political interests, enhancing anticorruption strategies, strengthening management capacity and coordination in the health sector.


2021 ◽  
Vol 7 (1) ◽  
pp. 19-36
Author(s):  
Jeremiah Ongori ◽  
Nelia Muiruri ◽  
Kulimankudya Vasco

Purpose: The management of human resources in healthcare institutions is vital to enable the delivery of efficient and effective medical and nursing services and to achieve clientele satisfaction. Motivation of human resources for health enhance quality service provision hence better outcomes. This study therefore sought to establish the influence of motivation on the performance of nursing officers, in devolved units, a case of Nyeri County, Kenya. Methodology: This study adopted a cross sectional descriptive research design. The respondents constituted all nursing staffs and managers in Nyeri County health facilities and at the County Director’s Office. Stratified random sampling was used to come up with a sample of 248 respondents. Data was collected using questionnaire. Descriptive statistics were used in the analysis of data with the help of SPSS 23. Chi-square analysis was used to establish relationships. Findings: The researcher found that motivation of nurses was not well done with a mean of 2.84, SD=1.090, and there were no upgrading and promotion opportunities (M=1.81, SD=1.133) for nurses in the county. There was a moderate performance of nurses with a mean value of 3.75, SD=1.100. Chi-square analysis showed that motivation (χ2 = 28.860, df=16, p=0.025) significant at 95% confidence level. The Cramer’s V value was positive indicating that motivation (v=0.473) enhance performance. Contribution to theory, practice and policy: The study concluded that motivation influences the performance of nursing officers, in devolved units in Kenya. Specifically, motivation approaches and techniques used in the health sector should be overhauled and/or reviewed as they are not effective. In particular, remuneration of staffs who have upgraded should be reviewed according to human resources policy.


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