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Jim Campbell: Fish & Chips or Caviar. Bellagio Center, Feb 05, 2014

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Information about Jim Campbell: Fish & Chips or Caviar. Bellagio Center, Feb 05, 2014
Health & Medicine

Published on March 1, 2014

Author: jimcampbell311493

Source: slideshare.net

Description

Colombia University (USA) and Public Health Foundation India hosted a 3-day conference at the Rockefeller Foundation's Bellagio Center, titled "On the move: studying and addressing health systems postings and transfers in LMICs".

This presentation raised questions on the types of research that would elicit new perspectives and information on health systems posting and transfers.
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Bellagio: health systems postings and transfers in LMICs ` “Fish & chips or caviar?” Deep dive: What kind of research for the future? On the move: studying and addressing health systems postings and transfers in LMICs. Colombia University-PHFI Rockefeller Foundation, Bellagio, Italy 05 February, 2014 Jim Campbell Director, ICS Integrare, Barcelona, Spain enquiries@integrare.es `

Bellagio: health systems postings and transfers in LMICs ` #OverlyHonestMethods `

Bellagio: health systems postings and transfers in LMICs ` Framing the research – what’s the narrative? • • • • • • • • • • Right to health MDGs Post-2015 Universal Health Coverage Healthy Life for All Equity / Social justice / “Just health” (Daniels) Effective coverage “80 x 40” “mission consistency” Positionality `

Bellagio: health systems postings and transfers in LMICs ` Time to “rethink and improve” “The foundations for a strong and effective health workforce for the future are being corroded in front of our very eyes by failing to match today’s supply of professionals with the demands of tomorrow’s populations. To prevent this happening, we must rethink and improve how we teach, train, deploy and pay health workers so that their impact can widen.” Dr. Marie-Paule Kieny, WHO Assistant Director-General for Health Systems and Innovation. November, 2013. `

Bellagio: health systems postings and transfers in LMICs ` Framing the research – where’s the HRH entry point? • International? – Global strategy on HRH for post-2015 – KD + AGA – WHO Advisory Committee – Global Code of Practice – Recife Declaration • Regional? • National? • Sub-national? – the geography of HRH and equity? `

Bellagio: health systems postings and transfers in LMICs ` Do we have basic data? `

Bellagio: health systems postings and transfers in LMICs ` Labour markets? Private Public Other Exits Health sector ‘supply’ Unemployed Employed Qualified healthcare workers Healthcare education and training High School graduates (male/female) Source: adapted from Vujicic and Zurn, 2006 ` ‘participation’ ‘potential supply’

Bellagio: health systems postings and transfers in LMICs ` Effective coverage? Service Delivery Goal Target population who do not contact services Process of service provision Effective Coverage People who receive effective care Contact Coverage People who use the service Acceptability Coverage People willing to use the service Accessibility Coverage People who can use service Availability Coverage People for whom service is available Target Population Sources: adapted from Tanahashi 1978; Campbell 2012; Speciale 2014 `

Bellagio: health systems postings and transfers in LMICs ` Drivers of change? Source: Campbell et al 2013 `

Bellagio: health systems postings and transfers in LMICs ` Metrics perspective? • Descriptive “evidence” – – – – – – – – • Quantitative “evidence” – – – – ` Stock- ✓ Distribution- ✓ Performance- ✓ Wage bill- ✓ Roles and responsibilities - ✓ Financing - ✓ Political economy analysis - ✓ Posting & Transfers - ✓ Turnover rates -✗ Retention rates -✗ Stability index-✗ Survival rates -✗

Bellagio: health systems postings and transfers in LMICs ` Professional health workers / 1,000 population (WHO 2013) Midwifery workforce: National context and challenges How to “bend the curve” for midwifery workforce UP-wards? 12.0 + ..improve quality care + quality care provider? 11.0 10.0 ..who’s looking out for the poor and vulnerable? ? 9.0 ..address rural/urban + socio-economic equity? 8.0 7.0 6.0 NEEDS a DECADE OF WORKFORCE INNOVATION Demands political solutions not “quick fixes”!! 5.6 5.0 4.0 3.5 89 3.0 2.3 2.0 57 POPULATION GROWTH (96% urban) 1.0 0 2013 2020 2015 ` 2025 2030 Year

Bellagio: health systems postings and transfers in LMICs ` A research question resulting: 'What is the appropriate midwifery workforce, and how is it best deployed, to equitably deliver essential MNH interventions at scale and quality, and what (including costs) needs to be put into place to achieve universal access?' `

Bellagio: health systems postings and transfers in LMICs ` What if? Labour markets + effective coverage + UHC + metrics Source: de Sousa et al 2013 `

Bellagio: health systems postings and transfers in LMICs ` What kind of research for the future? Schaaf & Freedman (2013): • emic approach & nuances • ‘unwritten rules’ • public policy & interests • power & agency • complexity In addition, EBDM context: – – – – – scale (present and future) the geography of HRH disaggregation 80 x 40 challenge workforce science and surveillance • stability • survival • turnover • retention • attrition – counterfactual + consequence – IPOOI (results chain) – return on investment `

#overlyhonestmethods presentations

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