advertisement

The Right to Health and Health Workforce Planning

50 %
50 %
advertisement
Information about The Right to Health and Health Workforce Planning
Health & Medicine

Published on February 24, 2009

Author: bgreenberg

Source: slideshare.net

Description

Overview:
Refresher on health workforce crisis
Right to health overview
Value of human rights approach to health workforce planning
Human rights and health workforce planning
What you can do
advertisement

The Right to Health and Health Workforce Planning By Eric A. Friedman Physicians for Human Rights Physicians for Human Rights National Student Conference Providence, RI, Jan. 31-Feb. 1, 2009 [Contact: efriedman@phrusa.org]

Overview Refresher on health workforce crisis Right to health overview Value of human rights approach to health workforce planning Human rights and health workforce planning What you can do

Refresher on health workforce crisis

Right to health overview

Value of human rights approach to health workforce planning

Human rights and health workforce planning

What you can do

Overview of health workforce crisis Africa has 24% of the world’s disease burden, but only 3% of the world’s health workers WHO has identified 57 countries with severe shortages, including 36 in sub-Saharan Africa Shortage is 4.3 million health workers total, 1.5 million in Africa

Africa has 24% of the world’s disease burden, but only 3% of the world’s health workers

WHO has identified 57 countries with severe shortages, including 36 in sub-Saharan Africa

Shortage is 4.3 million health workers total, 1.5 million in Africa

Nurses, midwives, and physicians per 100,000 population

Beyond numbers Severe internal inequities, underserved rural areas Poor management and lack of regular, supportive supervision Lack of medicines and supplies Unsafe working conditions Mistreatment of patients

Severe internal inequities, underserved rural areas

Poor management and lack of regular, supportive supervision

Lack of medicines and supplies

Unsafe working conditions

Mistreatment of patients

Health workforce solutions Beyond the health system (addressing economy, political situation, corruption, etc.) Health system investments Medicines, supplies, equipment, facility infrastructure Logistic systems, referral systems, financial management, etc. Infection prevention and control (e.g., gloves) Health worker-specific investments: Financial and non-financial incentives Massive scale-up of pre-service training Continuing professional development Comprehensive health and HIV/AIDS services Health workforce management Policy changes Mid-level and community health workers Retirement age

Beyond the health system (addressing economy, political situation, corruption, etc.)

Health system investments

Medicines, supplies, equipment, facility infrastructure

Logistic systems, referral systems, financial management, etc.

Infection prevention and control (e.g., gloves)

Health worker-specific investments:

Financial and non-financial incentives

Massive scale-up of pre-service training

Continuing professional development

Comprehensive health and HIV/AIDS services

Health workforce management

Policy changes

Mid-level and community health workers

Retirement age

Right to health overview

Right to health (1) States “recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. ” – International Covenant on Economic, Social and Cultural Rights, article 12 Further defined in General Comment 14 of the Committee on Economic, Social and Cultural Rights Health services, goods, and facilities must be accessible, available, acceptable, and of good quality Obligation to respect, protect, and fulfill right

States “recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. ” – International Covenant on Economic, Social and Cultural Rights, article 12

Further defined in General Comment 14 of the Committee on Economic, Social and Cultural Rights

Health services, goods, and facilities must be accessible, available, acceptable, and of good quality

Obligation to respect, protect, and fulfill right

Right to health (2) State must spend “maximum of its available resources” towards fulfilling this and other rights States must progressively realize this right “ continuing obligation to move as expeditiously and effectively as possible towards the full realization of” the right Minimum “core obligations” that states must meet now Equitable distribution of health goods, services, and facilities Non-discriminatory access To adopt and implement a national public health strategy

State must spend “maximum of its available resources” towards fulfilling this and other rights

States must progressively realize this right

“ continuing obligation to move as expeditiously and effectively as possible towards the full realization of” the right

Minimum “core obligations” that states must meet now

Equitable distribution of health goods, services, and facilities

Non-discriminatory access

To adopt and implement a national public health strategy

Value of human rights approach to health workforce planning

A necessary combination Technical considerations + Human rights = Skilled, motivated, equipped, supported health workforce for everyone

Technical considerations + Human rights

= Skilled, motivated, equipped, supported health workforce for everyone

Value of human rights approach Guides what plan aims to achieve Health services must be accessible to everyone Emphasizes certain areas Adds additional aspects

Guides what plan aims to achieve

Health services must be accessible to everyone

Emphasizes certain areas

Adds additional aspects

Right to health and health workforce planning

Elements Accountability Participation Equity and non-discrimination Comprehensiveness Funding Quality Sustainability & human rights education

Accountability

Participation

Equity and non-discrimination

Comprehensiveness

Funding

Quality

Sustainability & human rights education

Guiding goals: Accountability to commitments (1) Health workforce plan as accountability mechanism Accountability to right to health, universal access HIV and other to health services, Millennium Development Goals If you don’t plan for a sufficient health workforce, you won’t get one Reality: Many countries developing policies, few with comprehensive, costed plans Not all plans aimed at achieving goals Uganda scenarios: Business as Usual v. Health for People

Health workforce plan as accountability mechanism

Accountability to right to health, universal access HIV and other to health services, Millennium Development Goals

If you don’t plan for a sufficient health workforce, you won’t get one

Reality: Many countries developing policies, few with comprehensive, costed plans

Not all plans aimed at achieving goals

Uganda scenarios: Business as Usual v. Health for People

Guiding goals: Accountability to commitments (2) Goals Meet commitments – suggest what is achievable with maximum of available resources and progressive realization Progressive realization: “continuing obligation to move as expeditiously and effectively as possible towards the full realization….” Near term: Essential health care to be available to all “ Minimum basket” concept Build towards health care at all levels accessible to all How measure? One approach: Determine number of health workers by considering level of coverage needed to meet goals, which workers, and how long for each activity

Goals

Meet commitments – suggest what is achievable with maximum of available resources and progressive realization

Progressive realization: “continuing obligation to move as expeditiously and effectively as possible towards the full realization….”

Near term: Essential health care to be available to all

“ Minimum basket” concept

Build towards health care at all levels accessible to all

How measure?

One approach: Determine number of health workers by considering level of coverage needed to meet goals, which workers, and how long for each activity

Adding emphasis: Participation Recognized that needs to be more than Ministry of Health involved in developing plan, but… Who is involved? How are they involved?

Recognized that needs to be more than Ministry of Health involved in developing plan, but…

Who is involved?

How are they involved?

Adding emphasis: Participation diverse perspectives Health consumers Health workers Poor and rural populations Home caregivers Women Youth and elderly People living with HIV/AIDS People with disabilities

Health consumers

Health workers

Poor and rural populations

Home caregivers

Women

Youth and elderly

People living with HIV/AIDS

People with disabilities

Adding emphasis: Features of participation Resources are dedicated to participation People meaningfully informed and opinions respected Possibilities Inclusive team leading plan development Community and national forums open to all Consultations with NGOs and health worker groups Opportunities for written input Continued participation in monitoring and evaluating plan implementation

Resources are dedicated to participation

People meaningfully informed and opinions respected

Possibilities

Inclusive team leading plan development

Community and national forums open to all

Consultations with NGOs and health worker groups

Opportunities for written input

Continued participation in monitoring and evaluating plan implementation

Adding emphasis: Benefits of participation Ondo State, Nigeria Asked health workers their needs 62%: Equipment, supplies, medicines Government responded Proportion of nurses serving in rural areas 28% > 66% (3 years)

Ondo State, Nigeria

Asked health workers their needs

62%: Equipment, supplies, medicines

Government responded

Proportion of nurses serving in rural areas 28% > 66% (3 years)

Added emphasis: Equitable distribution (1) Equitable distribution and emphasis on needs of marginalized and vulnerable populations central to right to health Requires using all levers to improve distribution and reach underserved

Equitable distribution and emphasis on needs of marginalized and vulnerable populations central to right to health

Requires using all levers to improve distribution and reach underserved

Added emphasis: Equitable distribution (2) Incentives Zambia: more than 70 physicians on 3-year contract in rural areas receive: hardship allowance accommodation allowance education allowance for children eligibility/funding for post-graduate training eligibility for a loan Expanding to nurse tutors, nurses, clinical officers, more Basic infrastructure Ondo State, Nigeria Zambia to receive support from GAVI to bring clean water and power to rural health facilities

Incentives

Zambia: more than 70 physicians on 3-year contract in rural areas receive:

hardship allowance

accommodation allowance

education allowance for children

eligibility/funding for post-graduate training

eligibility for a loan

Expanding to nurse tutors, nurses, clinical officers, more

Basic infrastructure

Ondo State, Nigeria

Zambia to receive support from GAVI to bring clean water and power to rural health facilities

Added emphasis: Equitable distribution (3) Education Recruitment from rural areas Scholarships to serve in rural areas Training in primary health care Service in rural areas Skills mix Who is most likely to serve in rural areas?

Education

Recruitment from rural areas

Scholarships to serve in rural areas

Training in primary health care

Service in rural areas

Skills mix

Who is most likely to serve in rural areas?

Additional aspects: Countering health worker discrimination (1) “ Clinic staff were reluctant to test me because they didn’t think older people like myself were at risk.” – 62-year old South African grandmother, HIV-positive “ Unfortunately the nurse I met knew that I was HIV positive; she refused to touch my wound and gave me the bandage to stop the bleeding myself.” – HIV/AIDS patient, Nigeria “ Governments tell drug users to act responsibly and not to infect others, but the clinics shut the doors in the faces of those seeking to take care of themselves.” – Open Society Institute

“ Clinic staff were reluctant to test me because they didn’t think older people like myself were at risk.” – 62-year old South African grandmother, HIV-positive

“ Unfortunately the nurse I met knew that I was HIV positive; she refused to touch my wound and gave me the bandage to stop the bleeding myself.” – HIV/AIDS patient, Nigeria

“ Governments tell drug users to act responsibly and not to infect others, but the clinics shut the doors in the faces of those seeking to take care of themselves.” – Open Society Institute

Additional aspects: Countering health worker discrimination (2) Proper information and training (pre-service and in-service) Clear policies against discrimination Management and leadership sensitized to dangers of discrimination and lack of respect for patients Avenues of redress for patients Protective equipment (universal precautions)

Proper information and training (pre-service and in-service)

Clear policies against discrimination

Management and leadership sensitized to dangers of discrimination and lack of respect for patients

Avenues of redress for patients

Protective equipment (universal precautions)

Additional aspects: Human rights education for health workers Human rights training for health workers Own practice Advocacy Policymaking “ A deep understanding of human rights compels one to stand in solidarity with marginalized groups who suffer discrimination in terms of access to healthcare service delivery. ” – Physician, Niger State, Nigeria “ Human rights education changes your perception from seeing medicine as an employment – where you can make some money – to a service to humanity.” – Medical Student, Kampala, Uganda

Human rights training for health workers

Own practice

Advocacy

Policymaking

“ A deep understanding of human rights compels one to stand in solidarity with marginalized groups who suffer discrimination in terms of access to healthcare service delivery. ” – Physician, Niger State, Nigeria

“ Human rights education changes your perception from seeing medicine as an employment – where you can make some money – to a service to humanity.” – Medical Student, Kampala, Uganda

Additional aspects: Dissemination of plan Government accountable to people Should publicly disseminate plan (and key aspects) Translate into local languages Educate people on rights and entitlements under the plan

Government accountable to people

Should publicly disseminate plan (and key aspects)

Translate into local languages

Educate people on rights and entitlements under the plan

What you can do

Steps taken so far PHR published The Right to Health and Health Workforce Planning: A Guide for Government Officials, NGOs, Health Workers and Development Partners (2008) Broad distribution Turning guide into more user-friendly indicators Seeking to have indicators part of Global Health Workforce Alliance (GHWA) monitoring and evaluation process of country actions GHWA is international partnership addressing health workforce crisis Seeking to have Guide part of standard package of tools to assist countries in developing health workforce plans

PHR published The Right to Health and Health Workforce Planning: A Guide for Government Officials, NGOs, Health Workers and Development Partners (2008)

Broad distribution

Turning guide into more user-friendly indicators

Seeking to have indicators part of Global Health Workforce Alliance (GHWA) monitoring and evaluation process of country actions

GHWA is international partnership addressing health workforce crisis

Seeking to have Guide part of standard package of tools to assist countries in developing health workforce plans

How you can help Share health workforce planning guide http://physiciansforhumanrights.org/library/documents/reports/health-workforce-planning-guide-2.pdf Potential project Review health workforce plans Analyze plans based on right to health and health workforce indicators Please let me know if you would be interested ( [email_address] )

Share health workforce planning guide

http://physiciansforhumanrights.org/library/documents/reports/health-workforce-planning-guide-2.pdf

Potential project

Review health workforce plans

Analyze plans based on right to health and health workforce indicators

Please let me know if you would be interested ( [email_address] )

PEPFAR and health workers PEPFAR reauthorization Train and support the retention of at least 140,000 new health professionals and paraprofessionals Help countries achieve 2.3 doctors/nurses/midwives per 1,000 population and strengthen primary health care Support national health strategy, advance safe working conditions, promote codes of conduct on ethical recruitment

PEPFAR reauthorization

Train and support the retention of at least 140,000 new health professionals and paraprofessionals

Help countries achieve 2.3 doctors/nurses/midwives per 1,000 population and strengthen primary health care

Support national health strategy, advance safe working conditions, promote codes of conduct on ethical recruitment

In-district PEPFAR meetings on health workers Law sets stage, now need successful implementation In-district meetings Appropriations!!! – Overall foreign aid, PEPFAR Ensure that PEPFAR does train and retain at least 140,000 new health workers Help countries develop and fully implement rights-based, needs-based health workforce strategies Establish policy to enable (at the least) all health workers in PEPFAR-supported programs to have access to HIV and other health services and safe working conditions Train on respecting rights and dignity of all patients New health worker legislation?

Law sets stage, now need successful implementation

In-district meetings

Appropriations!!! – Overall foreign aid, PEPFAR

Ensure that PEPFAR does train and retain at least 140,000 new health workers

Help countries develop and fully implement rights-based, needs-based health workforce strategies

Establish policy to enable (at the least) all health workers in PEPFAR-supported programs to have access to HIV and other health services and safe working conditions

Train on respecting rights and dignity of all patients

New health worker legislation?

Health care and safety for health workers Right to access health care, right to safe working conditions Improves retention Petition to have PEPFAR establish policy ensuring health care and safety for all health workers in its programs Material for endorsements: yours, friends and colleagues, professors, deans, organizations, universities

Right to access health care, right to safe working conditions

Improves retention

Petition to have PEPFAR establish policy ensuring health care and safety for all health workers in its programs

Material for endorsements: yours, friends and colleagues, professors, deans, organizations, universities

Add a comment

Related presentations

Related pages

The Right to Health and Health Workforce Planning: A guide ...

Literature Library The Right to Health and Health Workforce Planning: A guide for government officials, NGO's, health workers, and development partners
Read more

The Right to Health and Health Workforce Planning: A guide ...

Tools Library The Right to Health and Health Workforce Planning: A guide for government officials, NGO's, health workers, and development partners
Read more

Health human resources - Wikipedia, the free encyclopedia

... health workforce planning is distributed among ... [health human resources planning] is to provide the right number of health care workers ...
Read more

Right to Health and Health Workforce Planning: a Guide for ...

The purpose of this guide is to explain why it is necessary to ground health workforce planning in human rights, and how to develop a plan that does just that.
Read more

Health policy - Wikipedia, the free encyclopedia

Such increasing attention to health as a basic human right has ... to domains such as medical research and health workforce planning, ... Health policy ...
Read more

The Right to Health and Health Workforce Planning

Physicians for Human Rights: The purpose of this guide is to explain why it is necessary to ground health workforce planning in human rights, and how to ...
Read more

Home: Australia's Health Workforce Online - working ...

... provides information on national health workforce reform including updates on health workforce planning, ... to Australia's Health Workforce Online .
Read more

Workforce planning: right people right time right skills ...

Workforce planning: right people, ... Health Safety and Well-being; Learning and Development; Management and Business Skills; Performance Management ...
Read more

Workforce Planning Series - Part 1 - Planning to Plan

Workforce Planning Series. Join the Health and Community Services Workforce Council ... Planning to plan: setting off on the right foot and bringing ...
Read more