sesi_9_ysp_models and tools for health workforce and profesonalism

8/13/2019 Sesi_9_ysp_models and Tools for Health Workforce and Profesonalism

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MODELS AND TOOLS FOR

HEALTH WORKFORCEPLANNING AND PROJECTIONS

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Disarikan dari pustaka oleh:

Yayi S. Prabandari

S2 IKM FK UGM


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Topik kita hari ini Health work force

Profession and professionalisme Professional behavior

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Projections of future health workforcerequirements and supply are based on:

Firstly:on past and planned production, and

movements of the workforce and

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Secondly:on predictions of how the national situation,

health needs and delivery of services will change inthe future.


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. n making such projections, however,planners in the health ministry or otherstakeholder agencies are faced with

substantial uncertainties including :

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situation: demographic,

epidemiological,

economic, etc"

!he capacity #both current and projected$ forimplementing the proposed interventions"


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n making such projections, however,planners in the health ministry or otherstakeholder agencies are faced with

substantial uncertainties including %onflicting priorities between variousgovernment departments&ministries" and

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'eadership turnover: actions of government,

civil society and

other stakeholders that can impact on healthsystems development


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Policy

Finance

CriticalSuccessFactor

CountrySpecific context

IncludingLabour maket

Improved

BETTERHEALTHSituation

Preparation and Planning

HRH ACTION FRAMEWORK

HRMSystems

Leadership

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EducationPartnership

Im

plementation

Other healthSystem

Components

HealthWorkforceOutcomes

EquityEffectiveness

EfficiencyAccessibility

HEALTH

OUTCOME

Monitoring and Evaluation


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!ypical questions that may need to be addressed aspart of simulations include

(hat are the implications for staffing numbers and

mi) if salaries and benefits are increased with nobudget change*

(hat are training and staffing implications of

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of another to alleviate particular shortages* (hat isthe political feasibililty of doing this type ofsubstitution*

(hat will be the impact of an e)panding privatehealth sector on the training and recruitment of newand e)isting staff in the public sector*


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OUTLINE CONCEPT FOR LINKING HEALTH WORKFORCE REQUIREMENTS AND SUPPLY PROJCETIONS

Current populationDemography andEpidemiology

Current health needsAnd demands

Existing services

Current numbers ofStaff of different cadres

and skills required

Salary & benefits Terms & conditions

of employment Managementand motivation

Current staff

New graduates

Tranined staffreturning to wrk

Returne migrants

+

+

+CHANGE

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Future population

demography andepdemiology

Furue health

Needs anddemands

Future services

Future numbers ofstaff of different cadres

and skillss required

Out-migrants

Future staff

availableEQUAL ?

AFFORDABLE ?

IMPLEMENTATION

No.

CHANGE

CHANGE No.

Yes

No.

Yes


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!he appeal of using such models is theirpotential for e)ploring options about the futuredepending on the underlying assumptions.

%omputational models can be distinguished bywhether they are deterministic or stochastic.

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+eterministic models assume that an outcomeis certain, in other words, they always deliver

the same result for the same input values. s


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!hese, are by far, the most commonly used for- Projections for number of reasons,including

!hey provide an unambiguous result that is easy tounderstand.

!hey can be developed using commonly available

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!hey generally do not require advanced informationtechnology programming skills #other than whatwould normally be e)pected of someone working in

data processing and analysis


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The determinants of workforcerequirements and supply

i. !he workforcetopopulation ratio method

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ii. !he health needs methodiii. !he service demands method

iv. !he service targets method /


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Selected models and toolsi. !he world ealth 0rgan1ation2s workforce

and requirements projection modelsii. !he (0 western Pacific -egional 0ffice.

-e ional !rainin %enter (P-0 -!% health

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workforce planning modeliii. !he 3nited 4ations +evelopment

Programme2s integrated health model


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Special Studies and applicationsi. !he workload indicators of staffing needs

#(S4$ii. !rend analysis

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.

iv. 5etaanalysis

v. 6conometric analysis

vi. Simple models for consideration of otheraspects, such as the impact of 7 on theworkforce


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Operationalizing the WHO model forworkforce requirements and supply

projections!ypically, the data requirements are as follow

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+emographics: total population distribution in the starting #base$ year"

population distribution by age and se), anticipatedaverage population growth rate over the plan&projectionperiod"

urban&rural distribution of the population and how it hasbeen changing


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Operationalizing the WHO model for

workforce requirements and supply

projections

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6pidemiology: current major causes of morbidity and mortality"

e)pected changes in patterns of sickness and disease

over the plan period


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Operationalizing the WHO model for workforce

requirements and supply projections

!ypically, the data requirements are as follow

ealth workforce stock and flows:

total staff numbers for each cadre in the public and

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e)pected annual percentage attrition rate for eachcategory of staff over the plan period"

numbers of new graduates from health education andtraining institutions #both public and privateinstitutions$"

net flow of trained health workers into or out of healthservices industry #for both the public and and private

health sectors$


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Remuneration and other recurrent costs: salary bands for each type of staff #minimally for

public health sector staff$,

current average annual remuneration for each of thepersonnel categories including all pay and otherbenefits"

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#e)cluding any changes that are simply correcting forinflation$


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Economic growth :

gross domestic product #8+P$ for the base year"

average predicted annual percentage change in 8+Pover the plan period"

total current recurrent e)penditure for the public

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health sector as a whole and disaggregated betweene)penditure coming from the national governmentand that coming from donor organi1ations #if any$"

current recurrent public health sector e)penditure onpersonnel, again distinguishing between nationalversus international sources"

recurrent public health sector nonpersonnel

e)penditures over the plan period


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Private health sector economic data:

percentage allocation of public health non personnelfunding to the private health sector"

estimated private sector e)penditure in health care"

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personne cos s a percen age o pr va e ea sec ore)penditure


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Data requirements specific to the creation of

projections on the development of services

and institutions pertain to

ealth facilities: the current and ro ected number of health facilities of each

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type, both those with inpatient beds #such as generalhospitals,

longterm care hospitals and mental health facilities$ andthose without #health centers and subcenters, maternal andchild health centers, health posts, etc$ and

across both the public and private health sectors, averagecapacity of each facility type #e.g. number of beds, bedoccupancy rate, number of discharges per year, activity rates,e.g. ambulatory visits, surgeries, etc$.


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Data requirements specific to the creation ofprojections on the development of services

and institutions pertain to

Facility staffing current number of staff by type

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, ,

current staffing rations #i.e. staff to facilities,staff to beds, skills mi) ratio$" projectedchanges in staffing norms //


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!n addition" the health workforce is composed of a

large num#er of personnel located outside healthfacilities$ %his includes health workers in

8overnment ministries and departments"

-egional or district health offices"

Public health offices

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5anagement and support of nongovernmentalorgani1ations delivering health services #either forprofit or notforprofit$

omebased and communitybased health services"

-esearch institutions"

6ducation and training

Selfemployment


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(orkforce projections cannot be undertaken inisolation.

!he are highly dependent on otherdevelopments in the health system and eventhe broader social and economic conte)t of the

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country.

%onsequently, they are normally part of some

larger strategic process.


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.f the strategic planning process one thatcapitali1es on plausible projections is to besuccessful, among the considerations that need

to be addressed and the related processescoordinate form the initial stages are : 'eadership and commitment by senior officials

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management

9vailability resources #human, financial andtechnical$ for data collection, processing and

analysis 9vailability and use of appropriate data and tools for

- projections


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dentification of and consensus on -

strategic objectives 9vailability of resources for implementation ofthe - strategic plan

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armoni1ation wit ot er nationa ea t andevelopment plans


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nterministerial working group bringing together theministries of health, finance, education and labour aswell as professional associations and the publicservice commission for early alignment of essentialinputs.

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n a lowincome country conte)t, inclusion ofdevelopment partners and major nongovernmentalorgani1ations working in health services provision isalso recommended. !his can be achieved by creation

of a multistakeholder worker group which meetsregularly

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PROFESSION PROFESIONALISM

PROFESSIONALBEHAVIOR

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Professional Behavior

Some definitions ofprofession, professional,

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,

and behavioral sciences#Shounkhanov, et al., 1996, cited in

Sastrowijoto, 2006)

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Profession

9n occupation requiring considerabletraining and speciali1ed study, e.g. the

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,

engineering

!he body of qualified person in an

occupation or field, e.g. member of theteaching profession


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Professionalism

Professional status,

methods, character or

standards

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!he use of professional

performers, as in athletics

of arts

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Behavior !he manner in which one behave

+efinition from Psychology theaction or reaction of person or

things in response to e)ternal or

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interna stimu i

Synonym: behavior, conduct,

department

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Professional Behavior !he manner in which one behave suitable for a

profession e.g. medical, nursing profession !he action or reaction of person or things in response

to e)ternal or internal stimuli that suitable for a

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pro ession

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Professionalism

nvolving continuing training or education on a

certain science or speciality 0rientation toward care

Profession is determined by standardi1ededucation and training

Profession student learn based on e)perience thatsociali1ed more than other student

'egal aspect of profession practice is conducted by

giving license 'egali1ation and profession norm are issued by

profession association

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PROFESSIONALBEHAVIOR IN

MEDICINE

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Professionalism Category Template

&ltruism elp others without e)pecting

!he best interest of others including patients, colleagues,mentors and trainees, rather than selfinterest

(AAM Card NBME, 2003, cited in Van Luijk, 2005)

Honor and integrity onesty

'aring and compassion Sensitivity, tolerance, openness, communication

Respect +ignity, autonomy, other health care, professional teamwork,

building relationship between medical professionals, betweenspecialties, and between professional organi1ation

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Professionalism Category Template

Responsi#ility 9utonomy, self evaluation, motivation, insight

&ccounta#ility

(AAM Card NBME, 2003, cited in Van Luijk, 2005)

%ommitment, dedication, duty legal&policy compliment, selfregulation, services, timelines, work ethics

E(cellence and scholarship

9 conscientious effort to e)ceed e)pectations and to make a

commitment to lifelong learning

)eadership

5anagement and mentoring

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So, Professional behaviorin medicine is !he manner in which a medical doctor with his or her

e)pertise, response the problem in this or her medical practice

reflecting the ability of altruism, honor, and integrity, caring

and com assion res ect res onsibilit and accountabilit

e)cellence and scholarship and leaderships" including her or hisrelationship with colleagues and other health professional


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The challenge of professionalism mpairment impaired in their

ability to carry out theirprofessional obligations whencaring patients

attention to an impairedcolleagues

'ack of conscientiousness a

failure to fulfill responsibilities %onflict of interest

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Competence

Knowledge

sAttitude,

Behavior, ethic

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Development of Competence

Beginner

Advance

uCompetent

Expert

Master

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COMPETENCIES FOR PUBLIC HEALTHPROFESSIONALS Scientific Basis

Methodological and Analytical Skills

Management & Communications Skills

Policy and Advocacy Skills

Values & Ethics in Public Health Practices

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PUBLIC HEALTH FUNCTION

G d t d t d t h t l l

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Graduates degree program are expected to have entry-levelcompetence in the following essential public health services:

1. Monitoring health status to identify and solve community health problems

2. Diagnosing and investigating health problems and health hazards in thecommunity

3. Informing, educating, and empowering people about health issues

. Mobilizing community partnerships and action to identify and solve healthproblems

!. Developing policies and plans that support individual and community health

". #sing laws and regulations that protect health and ensure safety$. %in&ing people to needed personal health services and assuring the provision ofhealth care when otherwise unavailable

'. (valuating effectiveness, accessibility, and )uality of personal and population*based health services

+. onducting research for new insights and innovative solutions to health problems

1-. ommunicating effectively with public health constituencies in oral and writtenforms

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How can the students learn49


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o ca t e stude ts ea

professional behavior?

Others and I Others know, but I

Understand self : through JOHARIWINDOW

Others do not

know, but I know

Others and I do not

know

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WHAT IS THEBENEFIT OF DOING

PROFESSIONALBEHAVIOR?

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Positive work attitudes such as reliability,

loyalty and cooperation are as importantto success in a job as are technical skills.

-esearch studies show that of all

people who lose their jobs are dismissedbecause they lack good work habitsrather than because they lackappropr ate o s s

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Thank you

sesi_9_ysp_models and tools for health workforce and profesonalism

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