iiph delhi ws 29th nov'11
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HR and HealthTRANSCRIPT
HR Innovations Strengthening HR
BBSR WS on 3rd-4th Feb’12 Dr D. N.Nayak
JD-Team LeaderState Human Resource Management Unit, Department of Health and Family Welfare,
Government of Odisha
HRH are the Key to success.. Disease burden and HRH in Odisha Requirement, Availability of Human
Resources & Gap analysis Initiatives……for Augmentation of Human
Resources Filling of Vacancies………..Recruitment Way Ahead……..
Out Lines….
Developing countries
2
WHO-norm:2.5/1000 poplCurrent:25% less
BACKGROUND
Gap Analysis
Category IPHS Sanc Pos vac Odisha
Staff Nurses 26574 2046 1798 248 14410
Pharmacist 4529 1945 1844 101 731
Lab. Technicians
4433 876 657 219 1172
Radiographer 1524 235 123 132 344
HW(F)/ANM 15211 7607 7246 361 8527
HW (Male) 8349 4729 3145 1584 8349
Gap AnalysisRequirement of Paramedics as per norms
Status of Key Specialists
Sl.No Category Sanc Pos vac
1 Spl.O&G 514 360 154
2 Spl. Paediatrics 374 228 146
3 Spl. Medicine 248 142 106
4 Spl. Surgery 243 137 106
5 Spl. Anaesthesiology 87 51 36
Gap analysis PH nursing – existing and proposedSl.N
oPositions Proposed
StrengthExisting sanction
Difference
1. ANM 8527 7607 (+1630 cont)
920
2. LHV 1599 1128 471
3. BPHN 314 0 314
4. Dy.DPHNO 60 0 60
5. DPHNO 30 6 14
Total 10530 8751 1779
Gap analysis-Clinical nursing – existing and proposedSl.N
oPositions Proposed Existing Difference
1. Staff nurse 14410 4100 10310
2. Nursing Sister (Head Nurse )
997 242 242 755
3. Asst.Matron 200 40 160
4. Matron 86 11 75
5. Chief Matron 18 3 15
Total 15711 4396 11315
Note : We have already proposed for 6963 posts of Staff Nurses
Gaps as per proposed norm for Odisha (Tutors)
Designation Required as for Odisha
Govt. Sanction Strength
Gap
Nursing Tutor / PHN Tutor ( ANM+ GNM+LHVTC)
131 131 0
Nursing Sister/Supervisor
997 242 755
DPHNO 30 16 14
Dy. PHNO 60 0 60
BPHN 314 0 314
College of NursingSl.n
oPositions Existing
sanctioned strength
Proposed strength
Difference
1. Clinical Instructor 8 8 Nil
2. Assoc. Prof (lecturer) 4 4 Nil
3. Assoc. Prof (Reader) 1 1 Nil
4. Vice Principal 0 1 1
5. Principal 1 1 Nil
Total 14 15 1
Filling of Vacancies
Filling of Vacancies……factors…. Recruitment Placement Remuneration Recognisation Job Satisfaction Retention Output-…….Achievements……Goals
Challenges Recruitment
Availability Gap…. demand and supply- No. of training Institution do not cope with requirement for the state
OPSC Adhoc- Reluctant to join Contractual- mostly retired and over aged
Placement Filling of Vacancy specially in difficult areas Skewed distribution Reluctance to work in difficult areas-demotivation
Transfer- un-certainty
Non Joining Retention
Salary package Compensation Attractive Career Path Recognisation Job Satisfaction
Absenteeism- Rotation Private Practice
Challenges
Recruitment…. Process and modes Process
Public Service Commission Ad hoc Contractual Contract-in Counseling Referral
Modes Centralised Decentralised Mixed
Recruitment…. Process and modes
Recruitment of doctors Recruitment through O.P.S.C
1st Batch-481 2nd Batch-311 3rd Batch-under process
Ad-hoc appointments 1st Batch-287 2nd Batch-96 3rd Batch -350
Contractual engagement (up to 68 Years) 309 doctors engaged
Decentralized recruitment at District level
Paramedics made into district cadres CDMOs authorised to fill vacant posts on priority
basis. Policy decisions to engage pharmacists as HW(M) Policy shift from Contractual to regular appointment
Regularisation of service as permanent government servant after 6 years of uninterrupted service-
Multi-skilling – Doctors/Lab Technicians Task Shifting- Public Health & Management functions
may be entrusted with others.
Recruitment of paramedics
Initiatives for Strengthening HR management
Institutional Arrangement State Human Resource Management Unit
(SHRMU) Nursing Management Support Unit (NMSU) with
focus on realignment of structure Database, HRMIS Capacity building Operational research to generate evidence
Steps to make government service more attractive /
Retention Entry level posts upgraded to Jr. Class – I. Specialist allowance introduced @ Rs.3,000 More promotional avenues created: About 1200
medical officers have already been promoted Post Mortem allowance @ Rs.500 to each Medical
Officer Legislation for doctors’ safety Later retirement age from 58 to 60 Development of rational and transparent transfer policy
in process
Financial Additional financial incentives for doctors working in
KBK regions (periphery Rs.8,000 and District HQ Rs.4,000)
Contractual doctors (PG qualified) receive Rs.25,000 for District HQ, Rs.30,000 for periphery institution.
Non Financial Promotion PG study Other Facilities- Cluster housing facilities at block
level (in process)
Incentives for difficult areas….
We are working on -Public Health Cadre HR Policy Frame working…. Nursing Restructuring in progress Creation of dedicated….Public Health Cadre is in
progress and is a priority for the state Functions defined Functionaries identified Institutions identified, renamed and finalised Structural Reform in progress
HR Policy .. Future ….. Focus on
Primary Care- Grass Root Level Ensure availability of motivated and dedicated !! health
work force at delivery points
Let us join hands to work on it together.
Enhancing Production Capacity
Doctors Promoting establishment of more medical colleges Enhancing UG seats in medical colleges (+43 X 3 MCH) Enhancing PG seats in key disciplines in medical Colleges Planning for Diploma courses in key disciplines
Paramedics Establishment of more institutions for nurses, especially in under served
areas. Engaging SN/ ANMs passing out from private government recognised
institutions Increasing the intake capacity of Nurses and planning for more
autonomy for Nurses Promoting Private Nursing Institutions Increasing seats -LTs and radiographers in government colleges
Can we consider out of box….? Non-Financial-(Green Channel)
Weigtage for PG selection, Post-graduate other PG or Diploma courses @ 5%-10% per annum per year of service
Out of the way promotion- Accelerated assured carrier progression (years-10,15,20,25)
Post dated Transfer and relieve Order Choice of posting after completion of tenure in
hard and difficult area Housing Facilities
Recognisation…..Letter of appreciation.
Financial Conveyance Allowance to and fro twice in a
year Differential package
Non-Practicing/Rural Allowance(25%-50%)
Can we consider….?
THANK YOU
Proposed structure of PH nursing
DPHNO30(0.28%)
Dy.DPHNO(60-0.57%)
BPHN 314 (2.98%)
LHV-1599 (15.18%)
HW(F) (8527-81%)
Proposed structure of clinical nursing
Chief Matron18(0.11%)
Dy.Nsg Supt (Matron)(86-0.55%)
Asst.Nsg.Supt( A.Matron) 200 (1.27%)
Nursing Sister (Supervisor)-997(6.34%)
Staff Nurse (14410-92%)
Sl. NoCategory Of Institutions
Number of
Institution
New Institution Sanctioned
Present Intake
Capacity
Intake capacity
(Proposed)
1ANM (Govt.)
16 2 640 720
2 ANM (Pvt) 5030 NOC
to be Given
1490
TOTAL 66 32 2130 720
Existing numbers and intake capacity of ANM Schools
Existing numbers and intake capacity of GNM Schools
Sl No
Category
Number of Institutions
Intake Capacity
Existing Institutions
New Sanction
ExistingPropose
d
1 GNM trg schools 3 1+4 200200 + 300
2 GNM (Pvt) 36 8 1355 1430
3GNM (pub sector) Rourkela & Talcher
2 0 70 60
TOTAL 41 13 1625 1990
Sl. No.Category of Institution
No. Institutions
Intake capacity
Remark
1Nursing College (B.SC) – Govt.
1+1 20+60SCB
Nursing College
2Nursing College (Pvt.)
12 600
TOTAL 13+1 620+60
Existing numbers and intake capacity of B.Sc Nursing
Existing numbers and intake capacity of M.Sc Nursing
Sl. No.Category of Institution
No. Institution
s
Intake capacity
Remark
1Nursing College (M.SC) - Govt
1+1 10+25 SCB Nursing College
2Nursing College
(Pvt)
3 50
TOTAL
4+1 60+25
Capacity building / Skill Development
Institutionalisation of Training Programmes State level training selection committee constituted
Focus on Public Health28 MBBS doctors already trained in post graduate
diploma in public health management .Training of total 60 BEE, BPO and Ayush doctors in
health promotion medicine in progressTraining of 20 MBBS doctors in family medicine in
progress Multi-skilling
Personnel trained in additional skills, eg SBA, EMoC
Training Training of senior and middle level managers in disaster
management at IIPH Hyderabad Training of mid-level managers on economic evaluation and
cost effective analysis at IIPH, New Delhi Training on research methodology in health science
Exposure visits Hospital managers for bio-medical waste management Nursing personnel to Andhra Pradesh Nursing personnel to University of Nottingham, UK
Capacity building Ctd.
Innovations & Initiatives
Databases for doctors, health institutions established and for paramedics in process
SHRMU encourages professionals to submit research proposals
Research and Ethical Committee constituted Study under way on retention of health personnel
in remote and rural parts of Orissa.
More Steps to reduce vacancies• Centralised web-based application and
recruitment using pre-designed software• Short-listing of candidates at central level, with
final verification and appointment at district level• Recruiting on campus • Existing and retiring staff nurses, tutors etc
considered for recruitment to faculty positions• B.Sc and M.Sc qualified nurses may be posted at
the ANM / GNM trg schools / nursing colleges• Possible additional allowances for difficult areas• Increase in sanctioned staff nurse posts by 6,963• Establishment of tribal ANM schools with free
education and bonding in disadvantaged areas
Status-Human Resources on Health
Category Requirement as per
IPHS’05
Requiremen
t as per
IPHS’11
Sanction Position
Regular Contractual
Mar’05
Sept. 11
Mar’ 05
Sept. 11
NRHM Others
Doctors (Allopathy)
6422 4259 4394 3459 3575 278
Specialist 4233 824 1819 673 1123 - -
Staff Nurse 11088 2244 3522 2122 1775 884 6
MPHW(M) 6695 4911 5727 4659 3083 - 602
MPHW(F) 14724 7121 9237 6871 7072 1186 -
Lab. Tech 2667 801 1639 728 653 110 271
Pharmacist 2704 2039 2114 1957 1812 134 5
Radiographer
941 162 235 123 115 - -
Doctors in KBK & KBK+ Districts
Sl. No District Sanction Position
Vacancy
1 Bolangir162 150 12
2 Boudh56 38 18
3 Gajapati83 71 12
4 Kalahandi176 130 46
5 Kandhamal146 87 59
6 Koraput168 116 52
7 Malkangiri88 54 34
8 Nawarang Pur116 56 60
9 Nuapada70 45 25
10 Rayagada121 85 36
11 Sonepur76 64 12
Total (KBK &KBK+) 1262 896 366 (29%) Total (Non-KBK) 3089 2475 614(19.9%)
Specialists in KBK & KBK+ Districts
Sl. No District Sanc. Pos.
Vac.
1 Bolangir 69 45 242 Boudh 25 16 93 Gajapati 36 26 104 Kalahandi 83 48 355 Kandhamal 65 40 256 Koraput 71 40 317 Malkangiri 35 15 208 Nawarang Pur 47 12 359 Nuapada 33 18 15
10 Rayagada 48 24 2411 Sonepur 34 24 10
Total 546 308238
(56.4%) Total (non KBK) 1273 815 458(35.9%)
Sl. No DistrictStaff Nurse
San Pos Vac1 Bolangir 130 88 422 Boudh 36 15 213 Gajapati 49 35 144 Kalahandi 145 81 64
5Kandhamal
112 68 446 Koraput 136 102 347 Malkangiri 76 39 378 NawaraPur 90 18 729 Nuapada 37 41 -4
10 Rayagada 78 40 3811 Sonepur 46 29 17
Total 935 556 379(40.5%) Total (non KBK) 3522 2665 857 (24.3%)
Status of Staff Nurse in KBK & KBK+ Districts
Sl. No DistrictPharmacist
San Pos Vac1 Bolangir 83 72 112 Boudh 19 18 13 Gajapati 34 34 04 Kalahandi 94 94 0
5 Kandhamal 81 75 66 Koraput 84 83 17 Malkangiri 68 52 168 NawaraPur 63 64 -19 Nuapada 30 31 -1
10 Rayagada 57 54 311 Sonepur 37 28 9
Total 650 605 45(6.9%) Total (State) 2114 1951 163(7.7%)
Status of Pharmacists in KBK & KBK+ Districts
Sl. No DistrictRadiographer
San Pos Vac1 Bolangir 6 3 32 Boudh 5 1 43 Gajapati 4 2 24 Kalahandi 6 5 1
5 Kandhamal 9 8 16 Koraput 7 3 47 Malkangiri 7 4 38 NawaraPur 2 2 09 Nuapada 4 4 0
10 Rayagada 3 2 111 Sonepur 4 2 2
Total 57 36 21( 36.8% ) Total (State) 235 115 120(51%)
Status of Radiographer in KBK & KBK+ Districts
Sl. No DistrictHW (Male)
San Pos Vac1 Bolangir 199 147 522 Boudh 64 44 203 Gajapati 160 102 584 Kalahandi 235 192 435 Kandhamal 190 150 406 Koraput 244 177 677 Malkangiri 116 65 518 NawaraPur 184 66 1189 Nuapada 134 117 17
10 Rayagada 201 110 9111 Sonepur 167 134 33
Total 1894 1304 590( 31.2%) Total (State) 5727 3685 2042(35.7%)
Status of Health Worker (M) in KBK & KBK+
Districts
Status of Health Worker (F) in KBK & KBK+ Districts
Sl. No DistrictHW (Female)
San Pos Vac1 Bolangir 316 299 172 Boudh 92 91 13 Gajapati 231 173 584 Kalahandi 350 345 55 Kandhamal 247 226 216 Koraput 409 349 607 Malkangiri 218 192 268 Nawarang Pur 378 388 -109 Nuapada 147 143 4
10 Rayagada 310 315 -511 Sonepur 121 124 -3
Total 2819 2645 174 ( 6.17 %) Total (State) 9237 8258 979 ( 10.6%)
Status of Lab. Technicians in KBK & KBK+ Districts
Sl. No DistrictLab. Technicians
San Pos Vac1 Bolangir 65 55 102 Boudh 21 13 83 Gajapati 31 25 64 Kalahandi 54 35 195 Kandhamal 62 37 256 Koraput 79 45 347 Malkangiri 54 18 368 NawaraPur 54 25 299 Nuapada 46 17 29
10 Rayagada 54 43 1111 Sonepur 25 15 10
Total 545 328 217(40.56%) Total (State) 1639 1034 605 ( 37%)
Category of Health Personnel
Requirement ExistingSanction
GAP
IPHSMinimum
(RHS-2009)Vacancy
RHS (MinimumPosts to be
created)
Staff Nurses 14410 10132 2046 271 8086
Pharmacist 2676 1914 1945 133 731
Lab. Technicians 2823 2069 897 244 1172
Radiographer 918 511 235 120 344
HW(F)/ANM 14985 14608 7607 535 7001
HW (Male) 6718 6688 4667 1584 2021
Requirement of Paramedics as per norms
Vacancies filled during last year
Category Periphery NRHM Total
Staff Nurse 251 884 1135
Pharmacist 71 32 103
MPHW (F)/ Addl.ANM
NA 1186 1186
MPHW (M) 421 NA 421
L.T 215 109 324
HR Status as on October'2011
Sl. No Category of Post Sanction Position Vacancy
1 Doctor 4394 3853 541(12.3%)
2 Pharmacist 2114 1951 163 (7.7%)
3 Staff Nurse 3522 2665 857(24.3%)
4 L.T 1639 1034 605 (37%)
5 MPHW (M) 5727 3685 2042(35.7%)
6 MPHW (F) 9237 8258 979(10.6%)
7 LHV 1128 1013 1159(10.2%)
7 Radiographer 235 115 120(51%)
A Framework for Managing Human Resources
50Source: Joint Learning Initiative, Harvard University