scholarly journals Cross-national comparisons of human resources for health – what can we learn?

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.

Author(s):  
Nam Ngoc Pham

This paper addresses issues related to health, health care, human resources in the health sector, characteristics of human resources for health, the need to develop a health workforce, analyzing criteria for evaluating human resources for health in terms of both quantity and quality; the position and role of human resources in the health sector, the development of human resources in the health sector under the process of industrialization, modernization and socio-economic development of Vietnam in the current period, achievements and limitations in human resources development in Vietnam's health care sector. In addition, the study also highlights statistics, some works and reports on health, human resources for health, contents of health human resources development; allocation of health human resources, education and training of health human resources in the country and some developed countries such as India, China, and the situation of domestic and international health human resources to draw some recommendations for the development of health human resources in Vietnam afterwards.


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).


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.


2020 ◽  
Author(s):  
Lizah Nyawira ◽  
Rahab Mbau ◽  
Julie Jemutai ◽  
Kara Hanson ◽  
Sassy Molyneux ◽  
...  

Efficiency gains is a potential strategy to expand Kenyas 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 collected data 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. We divided stakeholders into three groups and carried out facilitated group discussions followed by whole group feedback and discussion session. 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 (RMNCH) are still relevant, emerging epidemiological trends characterized by an increase in the burden of non-communicable diseases (NCDs) 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.


2021 ◽  
Author(s):  
Dipika Shankar Bhattacharyya ◽  
Goutam Kumar Dutta ◽  
Iffat Nowrin ◽  
Sohana Shafique ◽  
Md. Zahidul Islam ◽  
...  

Abstract Introduction: In Bangladesh, to address the challenges of ensuring adequate human resources for health (HRH), the government began implementing a digital tool for HRH management in 2017. However, evidence suggests institutionalizing such tools in low-and-middle-income-countries are impeded by policy aspects like implementation strategy and poor regulatory framework. We aimed to explore factors in the current policy landscape that might facilitate and challenge the implementation of the tool in Bangladesh.Methods: We conducted a review of policies related to ICT implementation and human resources management in health sector in Bangladesh using qualitative content analysis method. Twelve policies have been identified and comprehensive reading was done to ascertain common themes and patterns. A document analysis matrix was developed to synthesize and help interpreting the findings. Results: Regarding facilitators, strong upstream level commitments were reflected in the content of policies in terms of setting out specific objectives, targets, timeline, and budget allocation. However, lack of explicit monitoring strategy and extent of stakeholders’ engagement was not well-defined, ultimately create chances for making downstream implementation disjointed. In addition, effective coordination among stakeholders and different HRH and ICT policies could be strengthened. Discussion: Findings support the current discourse that national commitment plays a vital role in integration of ICTs in health services. However, well-defined monitoring strategy and inter-ministry and intra-ministry policy coordination is crucial.


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