5.1 R ECURSOS P ROPIOS : C APITAL S OCIAL

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Introduction

This Strategic Plan will describe the strategic actions towards building a competent and supported health staff. The content of the strategic plan will reflect country’s aspirations in addressing the major policy issues of HRH described in Section 2.

HRH Strategic Plan is developed after consultation with the key stakeholders to elicit their views on identifying the major issues and the most appropriate strategies and activities for addressing these issues. Those consulted included MoH officials, trade unions representing various categories of staff, professional associations, and regulatory bodies. Submissions and feedback received from these consultations have been incorporated into the Plan and strategies developed to address the key issues raised.

This plan is only a broad strategic plan. It is not a workforce plan, which should be developed as a subsequent activity based on this plan. The strategies are drafted to ensure that they address the root causes of the relevant issues and are feasible to implement.

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Scope

This plan is only a broad strategic plan and it is not a workforce plan. The strategies in this plan are drafted to ensure that it would address the root causes of HRH issues and are feasible to implement.

Thus the plan is meant to give only the direction for deciding the manpower requirements. In order to establish the appropriate numbers, mix and distribution patterns there is a need to come up with HR projections. We have not gone into the complex details of such an exercise which would be one of the main outputs from the strategic plan that need to be followed up.

The strategic framework in this document has identified the guiding principles, strategic objectives and broad activities that would be a reference framework for development of HRH

implementation plans. The broad activities in the strategic plan would therefore not have time schedules attached to them.

Each of the relevant authorities such as the Ministry of Health, Provincial Ministries of Health, Training Institutes etc would be expected to develop implementation plans to further identify sub activities with definite timeframes.

The scope of the strategic plan is confined to the government sector .However it’s influence of it on the private sector was considered during formulation of the plan. A further detailed study is required to determine the range of strategies government should use with the private providers in HRH production, ways of monitoring quality and standards, accreditation etc. Whilst this plan mentions about the influence of the non allopathic sector, it has not deliberated on strategies towards facilitating human resources development in this sector.

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Guiding Principles

The following guiding principles were considered in the development of the strategic plan.

The Strategic Plan shall:

• Be responsive to emerging demographic and disease patterns and changing technology;

• Be focused on PHC, supported by appropriate levels of secondary and tertiary care; • Be linked to the needs and demands of the health system;

• Provide health workers who have the capacity and appropriate skills to contribute to delivery of health services of high quality;

• Support achievement of strategic objectives of the Health Master Plan and the Millennium Development Goals; and

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Establishment of a Vision and Mission Statements

The vision and mission are formulated within the context of the National Health Policy and Health Master Plan vision and mission.

HRH Vision

A skilled and motivated health workforce in right numbers to help achieve equitable access and good quality care, responsive to the needs of the population.

HRH Mission

To strengthen the mechanisms and capacities in planning, production and management of HRH and develop them to equitably meet the population health needs and demands.

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Strategic Framework

The Strategy’s framework is comprised of 7 interrelated strategic objectives, organized around 3 key areas of planning, management and production. The strategies are aimed at achieving the following results:

• A health workforce that is responsive to population health needs ; • An effective and efficient workforce supply;

• Effective workforce management; Strategic Objectives

1. Strengthen HRH planning process to respond to the service and population needs

2. Institutionalise HRH planning as an integral part of national health development planning supported by relevant HRH policies

3. Improve the production and quality of training to meet skill and development needs in changing service environments.

5. Address health worker needs to ensure optimal workforce retention and participation

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6. Establish a performance management system for HRH, to improve productivity and performance of health workers

7. Ensure effective deployment procedures that minimise distribution imbalances

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Policy Directions

Section 2 has highlighted the challenges to be met, with focus on issues that requiring policy direction. The issues and challenges were analysed and the existing policies in relation to the issues were highlighted.

There are several policy implications related to the 3 components of HRH namely, HRH planning, HRH training skills development, and HR management. HRH management includes recruitment, deployment, utilization, HR information system, migration, motivation and research.

At various discussions, certain policy directions were made evident. The policy has recognised the need to define staff norms and standards for key cadres involved in healthcare delivery. While such norms as are available in the form of health worker / population ratios for public health services, a comprehensive set of norms for clinical and public health services are currently not available. The Strategic Plan recognises the importance of reviewing and developing such norms and standards to set targets for the required numbers and to define the required competencies.

Policy needs with regard to management and utilization of HRH including employment, recruitment, placement, transfer and remuneration have been elaborated in the situation analysis section.

The organisational structure that will be advocated in the policy is to have a separate HRH department with a new staffing profile. Another important element of HRH policy is to develop a human resource information system as a subsystem of the national health information system.

Policies related to continuing education / in-service training policy and practice, as well as those related to fellowships have to be defined. Career progression structure needs have to be developed for every category of health worker. Motivation and retention policies relating to incentives and benefit to staff such as housing, transport etc., have to be in place.

Policy on HRH research includes a unit in the organisational structure to document best practices and lessons learnt through policy and practice, and conduct research on related aspects. It also requires improvement of HRH problem solving skills and an active role for HRH in Total Quality Management (TQM). This unit should play a leadership role in outlining a HRH research agenda and in cultivating a culture and capacity to research human resources.

The content of the strategic plan will reflect the country’s aspirations in addressing the major policy issues of HRH.