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Estrategia de cooperación para la segunda medición de Metas
Regionales y Análisis de Políticas de Recursos Humanos para la Salud
Estrategia de cooperación para la segunda medición de Metas
Regionales y Análisis de Políticas de Recursos Humanos para la Salud
Taller de expertosLima, Perú, 14-16 de noviembre 2012
Taller de expertosLima, Perú, 14-16 de noviembre 2012
Charles GodueCoordinadorRecursos Humanos para la Salud
Principales marcos internacionales de políticas de recursos humanos para la salud
Ámbito re
gion
al Observatorio de RHS1999
Llamado a la Accion de TOR2005
20 Metas Regionales de RHS 2007‐2015
Reforma sectorial Renovación de la APS RISS
Joint Learning Initiative2003
Informe Mundial de la Salud 2006
Declaracion de Kampala2008
3er Foro Global de RHS
Recife 2013
Informe Mundial de la Salud 2010
Estamos en buen camino para
alcanzar las Metas?
Cual será la nueva
agenda de RHS post 2015?
Informe Mundial de la Salud 2008
20 Metas Regionales de RHS•Desarrollo de indicadores
•Desarrollo de una metodología•1era medición y línea basal en 24 países
•Informe de progreso para la CSPA•Medición en niveles descentralizados y 2nda medición
Proponemos a los países una 2nda medición?
(medición intermedia)
Si proponemos una medición intermedia para documentar avances y retrocesos, como podemos evaluar la contribución de
las políticas, estrategias y programas diseñados para alcanzarlas?
Un proceso de evaluación de políticas podría generar los insumos críticos al desarrollo de una nueva agenda de RHS post 2015?
Un proceso de evaluación de políticas de RHS puede informar:
Las Metas Regionales de
RHS?
Los objetivos y
prioridades nacionales de RHS?
Los objetivos sub‐regionales
de RHS?
Búsqueda de un denominador común, relacionado con la APS y la cobertura universal en salud, priorizando la disponibilidad de
un personal de salud suficiente, competente, motivado y apoyado en el primer nivel de atención
La propuesta de evaluación de política debe ser:
•Relativamente simple•Relevante, atractiva, con “tracción” política•Flexible y adaptable a contextos y realidades diversos (países de ingreso bajo / medio)•Articulada a iniciativas existentes (ej: Road Map en el CAR)
Resultados esperados (outcomes):
•Introducción de ajustes y mejoría de las políticas, estrategias y programas en marcha•Diseño de nuevas iniciativas•Identificación de los principales obstáculos•Fortalecimiento de las capacidades de planificación•Cultura de monitoreo y evaluación •Aprendizaje colectivo•Insumos para una nueva agenda de RHS post 2015
La estrategia de cooperación propuesta
Mónica PadillaCAM
Benjamín PuertasSur América
Don FergusonCAR
Mario Dal Poz CC UERJMargarita Velazco, Observatorio Social
Gail Tomblin, CC DU
ExpertosM. Nunez, R. Cameron
Consultores RegionalesOPS
Las expectativas del taller….
LOS INSUMOS
•Marco conceptual•Metodología•Tool kit•Glosario•Guías•Capacitación•Templates
LOS PROCESOS
•Identificación y preparación del grupo conductor•Participantes•Actividades (encuesta, estudios, grupos focales etc.)•Coaching
LOS PRODUCTOS
•Informes de análisis de políticas•Inventario de políticas•Estudios de caso•Publicaciones•Buenas practicas, policy briefs•Curso de planificación•otros
Red de Observatorios de RHS / Red de Aprendizaje (CVSP)
t
3er Foro Mundial de
RHSRecife
10‐13 NOV 13
Reunión regional de RHSSEP 13?
2nda medición y análisis de políticas
en los paísFEB ‐ AGO
Preparación y diseño
NOV12 –ENE13
2012 2013 2014
Los tiempos disponibles…
Observatoriorh.org
Gracias! Merci!Thanks!
HHR Observatory: core ideasHHR Observatory: core ideas
HRH POLICIES
PRINCIPLES AND VALUES
STAKEHOLDER’S INTERESTS
INFORMATION AND
EVIDENCE Evidence-based Healthcare Muir-Gray, J (1998)
THE HRH OBSERVATORY THE HRH OBSERVATORY
ANALYSISNEGOTIATIONAGREEMENT
HRH STRATEGIC INTERVENTIONS
NationalInter‐institutionalInter‐sectoral
Group
HRH Core Data Set
Comparative studies
Case Studies
Cooperation between countries
Information Clearinghouse
Training
Institutional Development
Direct Technical Cooperation
EVIDENCE FOR DECISION MAKING
HRH STEWARDSHIP
HRH POLICIESPLANNINGREGULATIONEDUCATION
HRH MANAGEMENT
Pan American Health OrganizationWorld Health Organization 2008
To lead strategic collaborative efforts among Member States and other partners to promote equity in health, combat disease,
and improve the quality of, and lengthen, the lives of the peoples of the Americas.
MMISSIONISSION
Pan American Health OrganizationWorld Health Organization 2008
HeadquartersCountry Offices
PAHOPAHO MMEMBER EMBER SSTATES and TATES and PAHOPAHO’’s PRESENCE IN THE REGION s PRESENCE IN THE REGION
Antigua &Barbuda
Argentina Bahamas Barbados Belize Bolivia Brazil Canada Chile Colombia Costa Rica Cuba Dominica EcuadorEl Salvador Grenada Guyana
Guatemala Haiti Honduras Jamaica Mexico Nicaragua Panama Paraguay PeruDominican Republic Saint Kitts and Nevis Saint Lucia Saint Vincent and
the Grenadines Suriname Trinidad & Tobago UruguayUSA Venezuela
Participating StatesFranceNetherlandsUnited Kingdom
Associate MemberPuerto Rico
Observer StatesSpainPortugal
Integration processes between countries
•NAFTA•SICA•CARICOM •CAN •MERCOSUR
PAHO HSS/HRTechnical CooperationPAHO HSS/HRTechnical Cooperation
HUMAN RESOURCES FOR HEALTH: THE REGIONAL APROACH
Four official languages:•English•French•Portuguese•Spanish
Joint Learning
Laying the FoundationLaying the Foundation
Joint Learning Initiative (2004) Toronto Call to Action (2005)
WHO World Health Report (2006)
HRH Data Management Project (2007)
The Health Agenda for the Americas (2008)
Kampala Declaration (2008) CARICOM CCH III (2008)
High Level Meeting, Caribbean HRH Road Map (2012)
Road Map Implementation, 2012‐17RROAD MAP IMPLEMENTATION, 2012‐17
Global Health Workforce Alliance (2006)
Regional Goals for HHR (2007)
HHR Road Map – The Journey
Population Health Issues
EpidemiologyAging PopulationChild HealthMental HealthEducationPoverty/EducationViolence/Crime
Health System Issues
InefficiencyCosts & CapacityPoor AccessService QualityLeadershipManagement
Context Components/Milestones Outcomes
HRH Issues
HRH Shortages
Rural Supply
Growing Needs
Attrition
Emigration
Health & Safety
Training
Productivity
GOVERNANCE
Develop & Implement
HRH Plans
HRH Policies
Workplace Improvements
HRH Inventories
EDUCATION & TRAINING
Managerial Skills
HIS Training
Policy Development
Staff Management
Provider Competence
HRH Database
HRH Observatory
HealthLearningNetwork
2012 2013-2017 2020+
STABILITY of Health Workforce
EFFICIENCY of Service Delivery
EFFECTIVENESS of Health Outcomes
ENABLERSLegislationProgramsPoliciesManagementFundingPlanningPartnershipsCommunicationsEvaluation/Monitoring
Impacts
WORKFORCEOptimalCompetentAligned with NeedsStableDistributedFlexibleAccountable
HEALTH SYSTEMEfficiencyQualityEquityAccessAdministrationSustainability
POPULATIONImproved AccessAppropriate AccessBetter QualityBetter InformedBetter Health
HRH PLANSCommunity Based Integrated PHC Teams – Enhanced Skills – Task Shifting – Competency Based Deployment – Needs Based Planning – Health Promotion – Disease Prevention – Chronic Care
HRH Capacity & Skills DevelopmentHRH Capacity & Skills Development
EDU
GO
ERNANCE
HRH Planners‐ Legislation & regulation‐ Policies & programs‐ Data systems & monitoring‐ Communications & partnerships‐ Research & evaluation‐ Evidence‐based planning‐ Funding ‐H R H
Facilities Managers‐ Health, safety & security‐ Labour relations‐ Assessment & deployment‐ Professional development‐ Performance management‐ Succession planning‐ Incentives & compensation‐ Recruitment & retention
HealthCare Providers‐ Primary health care‐ Public health‐ Chronic care‐ Health promotion‐ Disease prevention‐ Community‐based‐ Integrated teams‐ Task‐shifting‐ Competency‐baseddeployment
EDUCATION
TRAINING
INFORMATIONSUPPORT
GOVERNANCE
MANAGEMENT
SERVICE PROVISION
OBSERVATORY MODEL (AMRO)OBSERVATORY MODEL (AMRO)
MOH
UNI
P. A.
Other
Regional ObservatoryPAHO
Sub‐regionalSub‐regional
National Observatory
The HHR Observatory: definition
It is a regional network of governments, academic institutions, health services and social organizations, promoted by the Pan
American Health Organization, for the generation, analysis, access and
exchange of information, knowledge and experiences to support decision-making
and the formulation and implementation of public policies, in response to national
HHR priorities and the Regional Goals for HHR 2007-15
Mission
Through collaborative networking, contribute to the generation of information and knowledge aimed at strengthening the response capacity of the national health
authority and to the formulation and management of HHR policies, plans and strategies designed to achieve universal coverage and the development of health systems based on Primary Health Care
ObjectivesObjectives
• To produce evidence in HHR, through systematic and critical analysis and from different perspectives, based on a country’s needs
• To generate standardized information on HHR• To evaluate and monitor situations and trends
of HHR related to the 20 HHR regional goals and the 5 challenges of the Toronto Call to Action
ObjectivesObjectives
• To improve the quality of information and strengthen information systems on HHR
• To identify information gaps and research needs on HHR
• To design communication and dissemination strategies of information, evidence and concerted action
Observatoriorh.org
Observatoriorh.org
TORONTO CALL FOR ACTION
2005
• 20 REGIONAL GOALS FOR HHR 2007 – 2015
• HEALTH AGENDA OF THE AMERICAS
• PAHO STRATEGIC OBJECTIVE 13
1. Long term policies and plans
2. The right people at the right place
3. Appropriate education and competencies
4. Working conditions and performance
5. Migration of health personnel
• Capacity for HHR planning • Planning HHR for Ageing and NCDs• How to introduce more flexibility in the regulation of professional practice
• Reform of GME• Coordination with ministry of education
• Indigenous Peoples, cultural diversity and HHR
• Salaries, modes of remuneration, financial incentives to performance
• Health and safety of health workers
ChileActores claves
•Ministerios de Salud•Oficinas OPS• Universidades• Asociaciones
*
*
* ******
*Colombia
Costa Rica
Argentina
EcuadorPeru
Brasil
Mexico
Chile
Cuba
Paraguay
Red RegionalCVSP
* Nodo OPSNodos de Países
28
(21)139 Instituciones
(10)
(9)
(8)(13)
(10)
(7)
(34)
(6)
(21)
(10)
E‐learning Platform
THE NEED FOR AN HHR OBERVATORY THE NEED FOR AN HHR OBERVATORY IN CANADA?IN CANADA?
• Highly recognized technical expertise• Health system with values and principles coherent
with universal coverage and PHC strategy• Research know-how and capacity in HHR / Health
Systems• The essence: national relevance and contribution• The concept: technical cooperation (share
knowledge and information resources)• The way: structured network• Specific interest: Caribbean Region, Brazil, Chile