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  • Handbook for Measurement and Monitoring

    ISBN 978-92-75-07423-7

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  • Handbook for Measurement

    and Monitoring

    AREA OF HEALTH SYSTEMS BASED ON PRIMARY HEALTH CARE (HSS)PROJECT OF HUMAN RESOURCES FOR HEALTH (HR)

    PAN AMERICAN HEALTH ORGANIZATIONPan American Sanitary Bureau, Regional Offi ce of the

    WORLD HEALTH ORGANIZATION

    WASHINGTON, DCMAY 2011

    for Human Resources

    for Health

    A Shared Commitment

    RegionalGoals

    Indicators of the

  • PAHO HQ Library Cataloguing-in-Publication

    Pan American Health Organization. Handbook for Measurement and Monitoring Indicators of the Regional Goals for Human Resources for Health: A Shared Commitment. Washington, D.C.: PAHO, 2011.

    ISBN 978-92-75-07423-7

    I. Title

    1. HEALTH HUMAN RESOURCE EVALUATION2. HEALTH MANPOWER organization & administration3. INDICATORS OF HEALTH SERVICES human resources4. ORGANIZATIONAL OBJECTIVES5. HEALTH SERVICES human resources6. HEALTH POLICY, PLANNING & MANAGEMENT - standards

    NLM W76

    The Pan American Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. Applications and inquiries should be addressed to Editorial Services, Area of Knowledge Management and Communications (KMC), Pan American Health Organization, Washington, D.C., U.S.A., which will be glad to provide the latest information on any changes made to the text, plans for new editions, and reprints and translations already available.

    Pan American Health Organization, 2011

    Publications of the Pan American Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. All rights are reserved.

    The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatso-ever on the part of the Secretariat of the Pan American Health Organization concerning the status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.

    The mention of specifi c companies or of certain manufacturers products does not imply that they are endorsed or recommended by the Pan American Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.

    Design and Layout: Matilde E. Molina

  • Contents

    ACKNOWLEDGMENTS ................................................................................................................................................ V

    PURPOSE .......................................................................................................................................................................1

    CHALLENGE 1Build long-range policies and plans to adapt the work force to the changes in the health system .....................3

    GOAL 1: All countries of the Region will have achieved a human resources density ratio level of 25 professionals per 10,000 inhabitants .......................................................................................................3

    GOAL 2: The regional and sub-regional proportions of primary health care physicians will exceed 40% of the total medical workforce ..................................................................................................................5

    GOAL 3: All countries will have developed primary health care teams with a broad range of competencies that systematically include community health workers to improve access, reach out to vulnerable groups, and mobilize community networks..............................................................................................7

    GOAL 4: The ratio of nurses to physicians will reach at least 1:1 in all countries of the Region ..........................12

    GOAL 5: All countries of the Region will have established a unit of human resources for health (HRH) which will be responsible for the development of HRH policies and plans, the defi nition of the strategic directions, and the integration of HRH with other sectors .....................................................................13

    CHALLENGE 2Put the right people in the right places, achieving an equitable distribution according to the health needs of the population ........................................................................................................................17

    GOAL 6: The gap in the distribution of health personnel between urban and rural areas will have been reduced by half in 2015 .........................................................................................................................17

    GOAL 7: At least 70% of the primary health care workers will have demonstrable public health and intercultural competencies .....................................................................................................................20

    GOAL 8: Seventy percent of nurses, auxiliary nurses and health technicians including community health workers, will have upgraded their skills and competencies appropriate to the complexities of their functions ................................................................................................................................................22

    GOAL 9: Thirty percent of health workers in primary health care settings will have been recruited from their own communities ...........................................................................................................................24

    CHALLENGE 3Promote national and international initiatives for countries affected by migration to retain their health workers and avoid personnel defi cits .......................................................................................................................27

    GOAL 10: All countries of the Region will have adopted a global code of practice or developed ethical norms on the international recruitment of health care workers..............................................................27

    GOAL 11: Each country of the Region will have a policy regarding self-suffi ciency to meet its needs in human resources for health ...............................................................................................................................30

    GOAL 12: All sub-regions will have developed mechanisms for the recognition of foreign-trained professionals .33

    CHALLENGE 4Achieve healthy workplaces and promote a commitment of the health work force with the mission of providing quality services to the whole population .................................................................................................35

    GOAL 13: The proportion of precarious, unprotected employment for health service providers will have been reduced by half in all countries .....................................................................................................35

    GOAL 14: Eighty percent of the countries of the Region will have in place a policy of health and safety for the health workers, including the support of programs to reduce work-related diseases and injuries ..37

  • GOAL 15: At least 60% of the health services and program managers will fulfi ll specifi c requirements for public health and management competencies, including ethics............................................................38

    GOAL 16: One hundred percent of the countries of the Region will have in place effective negotiation mechanisms and legislation to prevent, mitigate or resolve labor confl icts and ensure essential services if they happen ..........................................................................................................................40

    CHALLENGE 5Develop mechanisms of cooperation between training institutions and the health services institutions to produce sensitive and qualifi ed health professionals .............................................................................................43

    GOAL 17: Eighty percent of schools of clinical health sciences will have reoriented their education towards primary health care and country health needs and adopted interprofessio