health workforce tools for planning and projections

Health workforce tools for

planning and projections

Health workforce planning and management meeting

OECD Conference Centre, Paris

17 and 18 September 2012

Angelica Sousa

Human Resources for Health, Department for Health Systems Policies and Workforce, WHO, Geneva

Health workforce tools for planning and projections | 17-18 Sept 2012 2 |

Background

The world is experiencing a shortage of 4 million health workers needed to achieve

the Millennium Development Goals. One of the main reasons for this shortage is

that the vast majority of countries are not training enough health workers to meet

their needs.

Several others factor aggravate the shortage of health workers within countries:

migration, unequal distribution of health workers within countries, low productivity,

and imbalances in skill mix composition.

Problems not exclusive to developing countries; many developed countries are

likely to face severe shortages of health workers as a consequence of the financial

crisis.

Emerging issues such as aging population and chronic conditions will be an

additional pressure for a higher demand of health services in developed countries.


WHO agenda to paradigm change on HRH

planning

Producing and sharing knowledge and evidence/experiences

Technical cooperation

– Strengthening governance capacities for HRH planning and management

– Supporting mechanisms and processes – HRH Observatories

Development of tools and approaches


HRH planning and projections

The purpose of workforce planning projections is to

contribute to evidence-based, rationalize decisions in the formulation of national HRH policies and strategies .

rationalize policy options based on a (financially) feasible picture of the future in which the expected supply of HRH matches the requirements for staff within the overall health service plans

identify short and longer term actions for achieving longer-term objectives.

Making projections is a policy-making necessity, and needs regular re-evaluation and adjustment


Some tools to support HRH planning & projections

The Workload Indicators of Staffing

Need (WISN) method is a human

resources management tool. It

provides a systematic way to make

staffing decisions in order to

optimize the human resources.

It is a software tool for recording,

analyzing and reporting data

related to staffing conditions at the

health facility level

http://www.who.int/hrh/resources/wisn_software_manual/en/index.html


Example:

WISN analysis as baseline for decision-making

Staff category: Midwives in a health centre in Wisnela province

Workload

pressure

WISN

ratio

Workforce

problem

Shortage

or excess

Required

staff,

based on

WISN

Current

staff

Health

centre

High 0.5 Shortage -2 4 2 A

None 2 Surplus 2 2 4 B

None 1.2 Surplus 2 9 11 C

Normal 1 Balance 0 6 6 D


Objective: to develop

alternative scenarios of

how the health sector

might, or could, develop.

This tool enables to

analyze the possible

effects of different

assumptions on HRH

supply, requirements,

training, costs,

productivity, and

distribution.

Two approaches are

possible:

– Long-term (15-30

years)

– Short-term (5-15 years)

Some tools to support HRH planning & projections


Labor market and productivity

Building knowledge and skills on the analysis of

health labour market and productivity in selected

countries:

• Cameroon

• Kenya

• Zambia

• Sudan

Objectives:

– to provide an overview of health labour market

– to explore how productivity improvements in HRH can

improve the supply of primary care in the public and

private sector.

In collaboration with EC, AFRO, EMRO, and

Berkeley University.


Shortage of health care workers in Zambia, 2011

Figure 4: Health-Care Worker Shortage in Zambia, 2011

Source: Ministry of Health, 2011


Benchmarks for planning midwifery services

Objective: to produce benchmarks for productivity in health care

by measuring midwifery productivity in health facilities which are

known and reputed to provide good quality care.

– First phase: measure midwifery productivity using secondary data (head-

counts)

– Second phase: develop an instrument to collect primary data on hours

worked to measure midwifery productivity in selected countries


Methods and application for measuring health

workforce inequalities

Objective: to identify the most appropriate inequality indices to measure geographical inequalities in the health workforce and identify the sources of the inequalities.

Three inequality indices:

– Gini

– Theil L

– Theil T


Inequalities in the distribution of the health

workforce in Brazil

Source: Sousa A, Dal Poz MR, Carvalho CL (2012) Monitoring Inequalities in the Health Workforce: The Case Study of Brazil 1991–2005. PLoS ONE

7(3): e33399. doi:10.1371/journal.pone.0033399.

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0 .5 1 1.5 2Physician & nurse professional density x1000 pop

Area of the symbol proportional to state's population

Inequalities in 1991

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0.2

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The

il in

dex

0 .5 1 1.5 2Physician & nurse professional density x1000 pop

Area of the symbol proportional to state's population

Inequalities in 2005


Building capacity: Technical workshops on

measuring health workforce inequalities

First workshop (Geneva, 2010):

– AMRO: Peru, Costa Rica and Brazil (observer)

– WPRO: Malaysia and Philippines

– AFRO: Ghana, Senegal and South Africa

– EMRO: Jordan

Regional workshop for WPRO

(Philippines, 2012):

– Cambodia, Vietnam, Laos, Mongolia,

Australia, Malaysia and Philippines

Next workshop to be held in Brazil

(AMRO)


Thank you!

Angelica Sousa [email protected]

health workforce tools for planning and projections

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