scholarly journals Tracking health sector priority setting processes and outcomes for human resources for health, five-years after political devolution: a county-level case study in Kenya

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Joshua Munywoki ◽  
Nancy Kagwanja ◽  
Jane Chuma ◽  
Jacinta Nzinga ◽  
Edwine Barasa ◽  
...  
Keyword(s):  
Service Delivery ◽  
Human Resources ◽  
Priority Setting ◽  
Human Resources For Health ◽  
Health Sector ◽  
Health Service Delivery ◽  
County Level ◽  
Health Coverage ◽  
Middle Income

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).

Need for Increased Investment in Human Resource for Health in India: Estimating the Required Investment for Increased Production of Health Professionals for Achieving Universal Health Coverage and Sustainable Development Goals by 2030.

2021 ◽  
Author(s):  
Anup Karan ◽  
Himanshu Negandhi ◽  
Mehnaz Kabeer ◽  
Tomas Zapata ◽  
Dilip Mairembam ◽  
...  
Keyword(s):  
Human Resources ◽  
Health Worker ◽  
Health Workforce ◽  
Health Workers ◽  
Human Resources For Health ◽  
Labour Force ◽  
Labour Productivity ◽  
Health Sector ◽  
National Income ◽  
Health Coverage

Abstract BACKGROUND: COVID-19 has reinforced the importance of having sufficient, well-distributed and competent health workforce. In addition to improving health outcomes, increased investment has the potential to generate employment, increase labour productivity along with fostering economic growth. With COVID-19 highlighting the gaps in human resources for health in India, there is a need to better and empirically understand the level of required investment for increasing the production of health workforce in India for achieving the UHC/SDGs.METHODS: The study used data from a range of sources including National Health Workforce Account 2018, Periodic Labour Force Survey 2018-19, population projection of Census of India, and review of government documents and reports. The study estimated shortages in the health workforce and required investments to achieve recommended health worker: population ratio thresholds by the terminal year of the SDGs 2030.RESULTS: Our results suggest that to meet the threshold of 34.5 skilled health worker per 10,000 population, there will be a shortfall of 0.16 million doctors and 0.65 nurses/midwives in the total stock of human resources for health by the year 2030. The shortages at the same threshold will be much higher (0.57 million doctors and 1.98 million nurses/midwives) in active health workforce by 2030. The shortages are even higher when compared with a higher threshold of 44.5 health workers per 10,000 population. The estimated investment for the required increase in the production of health workforce ranges from INR 523 billion to 2,580 billion for doctors. For nurses/midwives, the required investment is INR 1,096 billion. Such investment during 2021-25 has the potential of an additional employment generation within the health sector to the tune of 5.4 million and contribute to national income to the extent of INR 3,429 billion annually.Conclusion: India needs to significantly increase the production of doctors and nurses(/midwives) through investing in opening up of new medical colleges. Nursing sector should be prioritized to encourage talents to join nursing profession and provide quality education. India needs to set-up a benchmark of skill-mix ratio and provide attractive employment opportunities in health sector to increase the demand and absorb the new supply of graduates.

Human Resources for Health in India: Strategic Options for Transforming Health Systems Towards Improving Health Service Delivery and Public Health

2021 ◽  
pp. 097206342199500
Author(s):  
Sanjay Zodpey ◽  
Himanshu Negandhi ◽  
Ritika Tiwari
Keyword(s):  
Public Health ◽  
Health Service ◽  
Service Delivery ◽  
Human Resources ◽  
Health System ◽  
Human Resources For Health ◽  
National Level ◽  
Health Service Delivery ◽  
Lessons Learnt ◽  
Strategic Options

Introduction: The health workforce is the channel for delivering health interventions to populations. A critical mass of health professionals is necessary to manage a health system and is often a crucial limiting factor in the delivery of quality health services. India’s current situation, juxtaposed with its medium-term and long-term HRH (human resources for health) requirements, necessitates reassessing the policy levers that are available at the national level. Objective: To suggest strategic options to recommend India’s way forward to meet challenges related to health service delivery and public health with an HRH focus. Methodology: We reviewed and compared studies from different countries which focused on strengthening HRH at the national level. A two-step approach towards identifying and selecting HRH strategic options was adopted: desk review and discussions. A list of strategic options for reforming the current state of HRH in India was developed on the basis of lessons learnt from the review. These options were then scored and plotted on a grid (for innovation, disruption, difficulty of implementation, budget for implementation, importance and time period for implementation) in discussion with experts. Result: Based on the lessons learnt, eight strategic options were suggested for India: instituting a national HRH body; developing partnership models for the public sector and the private sector; setting benchmark HRH ratios; allocating at least 2.5% of the GDP to health; allocating at least 25% of all development assistance for health to HRH; halving the current levels of disparity in health worker distribution between urban and rural areas; evaluating HRH support through the National Health Mission (NHM); and maintaining a live register of HRH. Conclusion: The research is timely as India moves towards the implementation of the Sustainable Development Goals (SDGs) with a particular focus on universal health coverage (UHC) and Ayushman Bharat Yojana. The suggested strategic options for the way forward shall help India in dealing with the current health crisis to emerge with a strong public health system.

scholarly journals Reproductive, maternal, newborn and child health service delivery during conflict in Yemen: a case study

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Hannah Tappis ◽  
Sarah Elaraby ◽  
Shatha Elnakib ◽  
Nagiba A. Abdulghani AlShawafi ◽  
Huda BaSaleem ◽  
...  
Keyword(s):  
Child Health ◽  
Health Service ◽  
Service Delivery ◽  
Health Service Delivery ◽  
Child Health Service ◽  
Newborn And Child Health ◽  
And Child Health

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
Keyword(s):  
Human Resources ◽  
Comparative Studies ◽  
Human Resources For Health ◽  
Health Sector ◽  
International Health ◽  
Comparative Approach ◽  
Generative Capacity ◽  
International Comparative ◽  
Context Specific ◽  
Cross National

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.

scholarly journals Human resources for health interventions in high- and middle-income countries: findings of an evidence review

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Sophie Witter ◽  
Mariam M. Hamza ◽  
Nahar Alazemi ◽  
Mohammed Alluhidan ◽  
Taghred Alghaith ◽  
...  
Keyword(s):  
Human Resources ◽  
Human Resources For Health ◽  
Health Interventions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Evidence Review

scholarly journals Breast Cancer: Reimbursement Policies and Adoption of New Therapeutic Agents by National Health Systems

Breast Care ◽  
2019 ◽  
Vol 14 (6) ◽  
pp. 373-381 ◽  
Author(s):  
Dario Trapani ◽  
Giuseppe Curigliano ◽  
Alexandru Eniu
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Priority Setting ◽  
Financial Distress ◽  
Quality Care ◽  
Premature Death ◽  
Health Coverage ◽  
Breast Cancer Patients ◽  
Middle Income ◽  
Timely Access

Background: Breast cancer is a cause of morbidity for more than half a million of patients in Europe, resulting in broad societal impacts that affect patients, families, and societies from a human, emotional, economic, and financial perspective. Expenditure for cancer medicines represents one of the principal driving costs of healthcare. The aim of this review is to describe the European policy and regulatory landscape of innovation uptake in breast oncology – with emphasis on value in cancer healthcare. Summary: In Europe, several reimbursement models or policy tools have been developed by countries to compose their benefit packages. The most commonly applied scheme is the product-specific eligibility model, prioritizing selected medicines and their indications. Mixed models are commonly developed, addressing the protection of more vulnerable people, ensuring protection from impoverishment caused by cancer and containing disparities. However, the risk to incur significant out-of-pocket expenses for essential or newer medicines for cancer is still substantial in Europe, especially in low- and middle-income countries, determining greater financial distress and poorer outcome for patients. Value-based priority setting is an essential mechanism to ensure timely access to the most valuable medicines for breast cancer patients. Estimations of the value of medicines can be provided within health technology assessment services and networks and informed by benefit scales and tools. Key Messages: There is ample room for reciprocal support across the diverse cultural and legal realities in Europe. The aim is common: save cancer patients from premature death by ensuring the timely access to the best care, protecting from financial hardships and distress to leave no cancer patient behind in poverty. Steps are to be taken to promote value-based priority setting, paving the way toward universal health coverage in Europe, where health of people is protected, and affordable best quality care is the only standard pursued and acceptable.

Using Enterprise Architecture to Transform Service Delivery

2011 ◽  
pp. 307-339 ◽  
Author(s):  
Timothy Biggert
Keyword(s):  
Service Delivery ◽  
Human Resources ◽  
Enterprise Architecture ◽  
Collaborative Governance ◽  
The United States ◽  
Common View ◽  
Office Of Personnel Management ◽  
The Common ◽  
United States Federal Government

This chapter provides a case study on how the U.S. Office of Personnel Management has led the establishment of the Human Resources Line of Business (HR LOB). It explains how the HR LOB program has used enterprise architecture to drive transformation to a new Human Resources service delivery model across the United States Federal government. The authors propose that the common view and vocabulary that EA artifacts provide, along with the collaborative governance that took place to create the artifacts, has produced a solid business foundation for this extensive business transformation effort.

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