Analysing public sector institutional capacity for health workforce governance in the South-East Asia region of WHO

Giorgio Cometto,Esther Nartey,Thinakorn Noree,Aishath Irufa,Tomas Zapata,Mikiko Kanda,Yunus Md,Kavita Narayan,Kirana Pritasari,Dileep De Silva,Ramkrishna Lamichhane

doi:10.1186/s12960-019-0385-1

Abstract

BackgroundIn order to analyse the institutional capacity for health workforce policy development and implementation in countries in the South-East Asia region, the WHO facilitated a cross-sectional analysis of functions performed, structure, personnel, management and information systems of human resources for health (HRH) units in Ministries of Health.Case presentationA self-assessment survey on the characteristics and roles of HRH units was administered to relevant Government officials; the responses were validated through face-to-face workshops and by the WHO staff. Findings were tabulated to produce frequency distributions of the variables examined, and qualitative elements categorized according to a framework for capacity building in the health sector.Ten countries out of the 11 in the region responded to the survey. Seven out of 10 reported having an HRH unit, though their scope, roles, capacity and size displayed considerable variability. Some functions (such as planning and health workforce data management) were reportedly carried out in all countries, while others (inter-sectoral coordination, research, labour relations) were only performed in few.Discussion and conclusionsThe strengthening of the HRH governance capacity in countries should follow a logical hierarchy, identifying first and foremost the essential functions that the public sector is expected to perform to optimize HRH governance. The definition of expected roles and functions will in turn allow identifying the upstream system-wide factors and the downstream capacity requirements for the strengthening of the HRH units. The focus should ultimately be on ensuring that all the key strategic functions are performed to quality standards, irrespective of institutional arrangements.

Highlights

In order to analyse the institutional capacity for health workforce policy development and implementation in countries in the South-East Asia region, the World Health Organization (WHO) facilitated a cross-sectional analysis of functions performed, structure, personnel, management and information systems of human resources for health (HRH) units in Ministries of Health.Case presentation: A self-assessment survey on the characteristics and roles of HRH units was administered to relevant Government officials; the responses were validated through face-to-face workshops and by the WHO staff
The contents of the questionnaire were informed by the approach adopted in previous similar analyses [9], and its development followed an iterative consultation process involving the WHO staff responsible for HRH policy dialogue and technical support at the global and regional levels; the survey instrument was validated with the assistance of a senior Government official with extensive experience of leading and overseeing the work of an HRH unit in a different country than those in the region
Among the 7 countries with HRH units, 28.6% had been in existence in the preceding 5 years while more than half (57.1%) had been established for over 5 years

Summary

Introduction

In order to analyse the institutional capacity for health workforce policy development and implementation in countries in the South-East Asia region, the WHO facilitated a cross-sectional analysis of functions performed, structure, personnel, management and information systems of human resources for health (HRH) units in Ministries of Health.Case presentation: A self-assessment survey on the characteristics and roles of HRH units was administered to relevant Government officials; the responses were validated through face-to-face workshops and by the WHO staff. It called upon all countries to have a human resources for health (HRH) unit or department, noting that such a unit should have the capacity, responsibility, financing and accountability for a standard set of core functions of HRH policy, planning and governance, data management and reporting. This need has been recognized at the regional level: in the first WHO progress report on the Decade for health workforce strengthening in the SouthEast Asia region (SEAR) included a call “to document. A better understanding of these factors, gained through the specific lens and focus on HRH units, can contribute to the wider discourse on the health workforce governance and management literature

Methods

Results

Conclusion