Health Workforce development initiatives in WHO South East Asia

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					Health Workforce development
      initiatives in WHO
   South East Asia Region



      Thushara Fernando
               SEARO’s action

RC Resolutions

• Training of voluntary health workers (SEA/RC29/R9-
  1976

•    Strengthen resource policies for health systems
    and development of appropriate HRH for PHC
    (SEA/RC30/R12-1977)

• Community based orientation in medical education
  (SEA/RC29/R9/1976) and SEA/RC42/R5-1989)
                SEARO’s action
• The Calcutta Declaration on strengthening and reforming
  public health education, training and research 1999

• Development of accreditation guidelines for Public
  Health Institutes - 2002

• Consultation on ‘Future Directions in Public Health –
  Calcutta and Beyond – 2003

• International Forum of South-East Asia Public Health
  Education Institutes Network (SEAPHEIN) - 2004

• Launching the South-East Asia Public Health Initiative
  2004 to assist the countries in strengthening public
  health
       Burden of disease in DALYs by WHO region, 2002
                        (all Diseases)
                             WPR
                             18%                                       AFR
                                                                       24%




                 EMR
                  9%

                                                                         AMR
                                                                         10%


                     EUR
                     10%



                                                                SEAR
                                                                 29%

Source : Adapted from (WHO Geneva, World Health Report 2004 )
                        Health Service Providers (per 10,000 population) by WHO Region, 2005
  Number per 10,000 population
160

                                                                                                                                                                       142
140
                                                                                                                                                131


120


100


 80

                                                                                                                       62
 60
                                                                                             45

 40
                                         29                        30

               19
 20


  0
             Africa              South-East Asia        Eastern Mediterranean         Western Pacific                World                     Europe                Americas
      Note:
      1. Data as reported by countries (compiled at WHO Regional offices and the Headquarter)
      2. Reference year of data for some countries may differ from the reported year 2005
      3. Health service providers include : (i) Physicians (ii) Nurses (iii) Midwives (iv) Dentists (v) Phramacists (vi) Environmental and public health personnel
                                          (vii) Lab workers (viii) Community health workers (ix) other health workers
    HRH related problems and causes
              of the SEAR
    Shortages                                 Imbalances
•    Lack of effective HRH policies       •    Lack of HRH deployment policies
•    Lack of norms and standards          •    Lack of basic facilities
•    Inadequate production capacity       •    Migration
•    Out-Migration                        •    Over production of some categories




    Lack of competency &                      Ineffective HW
    passion                                   management capacity
• inadequate pre-service training         • Shortage of managers
                                          • Week incentive systems
• Lack of public health orientation
                                          • Week management policies and
• Inadequate in service training            practices
• Lack of quality control mechanisms in   • Dual employment
  training
  SEARO’s Response (2006)
“Dhaka Declaration”, August 2006

SEA/RC59/R6: “Strengthening the
 Health workforce in South-East Asia”

SEA/RC59 endorsed “SEA Regional
 Strategic Plan for Human Resource
 Development”
 Dhaka Declaration aimed at…
 Developing national policies and
  regulations
 Developing and implementing national
  HRH strategic plans
 Increasing training capacity
 Strengthening HR monitoring capacity
 Involving global and regional
  networks
 Mobilizing adequate resources
             Strategic areas
1. Strengthening collection, sharing, analysis and
  utilization of data at country & regional levels
2. Policy development, regulation & legislation
3. Scaling up HWF production
4. Knowledge generation and management
5. Capacity building on HWF management
6. Regional and global partnership building
7. Quality assurance of training
8. Increase investment in HWF development
9. Improving the work environment of HWF
10.Development of a community based HWF
Regional Strategic Directions for
        development of
       CBHW and CHV
               October 2007
•   Who are they?
•   What were they doing in the past?
•   What can they do now?
•   Why do we need them now?
    Who are CBHW? CHV?
 Community Based         Community Health
 Health Care Worker         Volunteer


A paid health worker,    Does not receive a
                             formal salary,
  undergone a formal
 training programme,    May or may not have
                           undergone formal
 employed by the Gov             training,
 or by a NGO, work is
                        work in the community
   based in the field
     Regional Guidelines for Health
          Workforce Planning

•   Draft developed in house
•   Discussed in an expert group
•   Finalized
•   To be published and advocated
 Development of a Regional HRH
          Data Base
• A set of core data indentified in
  consultation with experts from member
  countries
• Definitions of selected categories of HRH
  agreed upon
• A template for a mini health workforce
  survey has been developed
Thank You