Developing Bundles of Human Resources for Health Systems
This workshop focuses on strategies to improve health workforce performance by developing bundles of human resources. Topics include interventions to enhance staffing levels, understanding individual staff performance, and managing workforce performance effectively.
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Presentation Transcript
Health workforce performance: developing the bundles of human resources/health systems strategies National workshop 2 [location, dates]
Session overview Interventions to improve staffing levels Understanding individual staff performance Areas for consideration for managing workforce performance The concept of bundles of strategies Steps for developing bundles Planning process and tools
PERFORMs definition of health workforce performance 1. Both collective and individual performance 2. Clinical, managerial and support staff 3. Availability of staff Right number, competencies, in right place Levels of absence 4. Quality and quantity of work output
Interventions to improve staffing levels HS strategies HR strategies Change skills mix (inc. volunteers) Develop partnerships (MoH, other sectors, NGOs, FBOs non-formal providers) Increase entrants Reduce losses Improve distribution Improve productivity
Understanding individual staff performance HR strategies Job satisfaction Direction Competencies Intrinsic Reward/ Sanction Performance Effort Extrinsic Resources Praise, incentives, etc HS Fairness strategies
Areas for consideration for managing workforce performance Availability (posts filled/distribution/staff present) Direction (on what staff should do and how well they are doing) Competencies (appropriate skills, knowledge and attitudes to carry out the tasks assigned) Rewards and sanctions (to influence their behaviour and therefore their performance) Health systems (other building blocks) including resources: equipment, drugs and supplies Infrastructure (buildings) Transport
The concept of bundles of strategies no single magic bullet for a sustainable solution coordinated bundle of HR strategies have greater impact that individual strategies Avoid deadly combinations of HR practices Add wider health systems strategies to the bundles effectiveness of the bundles depends on organisational context
Key steps for developing bundles Identify problems to be addressed in problem tree (and other related areas) Review options of strategies by performance area (see Appendix 1) Put selected strategies in planning table and complete all columns
Tools & guides for planning the bundles of HR/HS strategies Table with sample strategies to assist planning the HR/HS bundle of strategies - for review before planning Planning table for HR/HS strategies (blank) for completion by DHMTs * On memory stick
Table with sample strategies A. Performance area/broad objective 1. Availability Increase # staff in post B. Strategy C. Sample activities D. Expected change E. Possible indicators for M&E F. Link to/conflict with other HR/HS strategies G. Comments Additional recruitment Advertise for specific vacant posts More staff available % posts vacant by cadre and facility type Induction Which staff can DHMT recruit? Workforce planning Attraction incentives Funding initial training with bonding More applications for jobs # applications/post by cadre Ensure staff are also being retained Check whether the main problem is attraction or retention More strategies Attraction incentives for rural areas only Improve distribution between rural and urban facilities Funding initial training with bonding More staff available in rural areas % posts vacant by cadre in rural districts Workforce planning Training takes staff away from the workplace; may need to stagger training % trainees who complete the bond Retention incentives for rural areas Identify financial and/or nonfinancial incentives that can be funded from the district budget More staff available in rural areas % posts vacant by cadre in rural districts Less money available in operational budget for equipment and supplies for staff Note that non- financial incentives still cost money % trainees who complete the bond
Review comments anything helpful there? Choose relevant performance area(s) Check expected change ; does it Table with sample strategies address the problems identified? A. Performance area/broad objective 1. Availability Increase # staff in post B. Strategy C. Sample activities D. Expected change E. Possible indicators for M&E F. Link to/conflict with other HR/HS strategies G. Comments Additional recruitment Advertise for specific vacant posts More staff available % posts vacant by cadre and facility type Induction Which staff can DHMT recruit? Workforce planning Choose strategies to achieve Attraction incentives Funding initial training with bonding More applications for jobs objective(s) # applications/post by cadre Ensure staff are also being retained Check whether the main problem is attraction or retention Choose complete set of activities to support strategies More strategies Attraction incentives for rural areas only Improve distribution between rural and urban facilities Funding initial training with bonding indicators for measuring this change More staff available in rural areas % posts vacant by cadre in rural districts Workforce planning Training takes staff away from the workplace; may need to stagger training Identify possible Identify links of conflict with other HR/HS strategies (new of existing) % trainees who complete the bond Retention incentives for rural areas Identify financial and/or nonfinancial incentives that can be funded from the district budget More staff available in rural areas % posts vacant by cadre in rural districts Less money available in operational budget for equipment and supplies for staff Note that non- financial incentives still cost money Choose broad objective(s) % trainees who complete the bond
Steps for identifying and selecting appropriate HR/HS bundles A. Select relevant performance areas for your problem. Review and select appropriate objectives. B. Review and select appropriate strategies*. C. Review sample activities D. Check that the expected change given in the table fits with what you want to achieve. E. Review Link to other HR/HS strategies to identify other strategies to be added to the bundle ; or identify conflicts F. Review comments * Note: some strategies may serve several different purposes e.g. supervision may be useful for improving skills and provision of feedback on performance
Planning table A. Broad objective B. Strategy C. Sample activities D. Expected change E. Possible indicators for M&E F. Link to/conflict with other HR/HS strategies G. Comments
Next steps Evening activity: Read section 4 of the DHMT manual on Selecting bundles of HR/HS strategies to improve workforce performance (including the 10-page table in Annex 1) Tomorrow: Develop a bundle of HR/HS strategies for improving workforce performance using template provided Peer review of bundle by other district teams Refining bundles based on feedback
