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MODELS AND TOOLS FOR HEALTH WORKFORCE PLANNING AND PROJECTIONS

Disarikan dari pustaka oleh: Yayi S. Prabandari S2 IKM FK UGM

Topik kita hari ini

Health work force Profession and professionalisme Professional behavior

Projections of future health workforce requirements and supply are based on:
Firstly:
on past and planned production, and movements of the workforce and,

Secondly:
on predictions of how the national situation, health needs and delivery of services will change in the future.

. n making such projections, however,

planners in the health ministry or other stakeholder agencies are faced with substantial uncertainties including :
!he nature of changes in the country

situation:
demographic, epidemiological, economic, etc"

!he capacity #both current and projected$ for

implementing the proposed interventions"

n making such projections, however, planners in the health ministry or other stakeholder agencies are faced with substantial uncertainties including
%onflicting priorities between various

government departments&ministries" and 'eadership turnover:

actions of government, civil society and other stakeholders that can impact on health

systems development

HRH ACTION FRAMEWORK Preparation and Planning

Country Specific context Including Labour maket

Policy
Finance Leadership Situation Analysis HRM Systems

Critical Success Factor

Implementation

Partnership

Education

Improved Health Workforce Outcomes

BETTER HEALTH SERVICES Equity Effectiveness Efficiency Accessibility

BETTER HEALTH OUTCOME

Other health System Components

Monitoring and Evaluation

!ypical questions that may need to be addressed as part of simulations include (hat are the implications for staffing numbers and mi) if salaries and benefits are increased with no budget change* (hat are training and staffing implications of Substituting one category of health worker in favour of another to alleviate particular shortages* (hat is the political feasibililty of doing this type of substitution* (hat will be the impact of an e)panding private health sector on the training and recruitment of new and e)isting staff in the public sector*

OUTLINE CONCEPT FOR LINKING HEALTH WORKFORCE REQUIREMENTSAND SUPPLY PROJCETIONS

Current population Demography and Epidemiology

Current health needs And demands

Current staff

+
Existing services Salary & benefits Terms & conditions of employment Management and motivation

New graduates

+
Tranined staff returning to wrk

Current numbers of Staff of different cadres and skills required

CHANGE

+
Returne migrants

Future population demography and epdemiology

Furue health Needs and demands CHANGE Future services

Out-migrants No. EQUAL ? Yes Future staff available

Future numbers of staff of different cadres and skillss required

CHANGE

No.

AFFORDABLE ?

No. IMPLEMENTATION Yes

!he appeal of using such models is their potential for e)ploring options about the future depending on the underlying assumptions. %omputational models can be distinguished by whether they are deterministic or stochastic. +eterministic models assume that an outcome is certain, in other words, they always deliver the same result for the same input values. s

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!hese, are by far, the most commonly used for ,-, Projections for number of reasons, including
!hey provide an unambiguous result that is easy to

understand. !hey can be developed using commonly available computer software and !hey generally do not require advanced information technology programming skills #other than what would normally be e)pected of someone working in data processing and analysis

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The determinants of workforce requirements and supply

i. !he workforce.to.population ratio method ii. !he health needs method iii. !he service demands method iv. !he service targets method /

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Selected models and tools

!he world ,ealth 0rgan1ation2s workforce and requirements projection models ii. !he (,0 western Pacific -egional 0ffice. -egional !raining %enter #(P-0&-!%$ health workforce planning model iii. !he 3nited 4ations +evelopment Programme2s integrated health model
i.

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Special Studies and applications

!he workload indicators of staffing needs #( S4$ ii. !rend analysis iii. -egression analysis iv. 5eta.analysis v. 6conometric analysis vi. Simple models for consideration of other aspects, such as the impact of , 7 on the workforce
i.

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Operationalizing the WHO model for workforce requirements and supply projections
!ypically, the data requirements are as follow
+emographics:
total population distribution in the starting #base$ year" population distribution by age and se), anticipated

average population growth rate over the plan&projection period" urban&rural distribution of the population and how it has been changing

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Operationalizing the WHO model for workforce requirements and supply projections
6pidemiology:
current major causes of morbidity and mortality" e)pected changes in patterns of sickness and disease

over the plan period

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Operationalizing the WHO model for workforce requirements and supply projections
!ypically, the data requirements are as follow ,ealth workforce stock and flows: total staff numbers for each cadre in the public and private health sectors, staff distribution by age and se), e)pected annual percentage attrition rate for each category of staff over the plan period" numbers of new graduates from health education and training institutions #both public and private institutions$" net flow of trained health workers into or out of health services industry #for both the public and and private health sectors$

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Remuneration and other recurrent costs: salary bands for each type of staff #minimally for public health sector staff$, current average annual remuneration for each of the personnel categories including all pay and other benefits" projected changes in the annual real wage costs #e)cluding any changes that are simply correcting for inflation$

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Economic growth : gross domestic product #8+P$ for the base year" average predicted annual percentage change in 8+P over the plan period" total current recurrent e)penditure for the public health sector as a whole and disaggregated between e)penditure coming from the national government and that coming from donor organi1ations #if any$" current recurrent public health sector e)penditure on personnel, again distinguishing between national versus international sources" recurrent public health sector non.personnel e)penditures over the plan period

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Private health sector economic data:

percentage allocation of public health non personnel

funding to the private health sector" estimated private sector e)penditure in health care" personnel costs a percentage of private health sector e)penditure

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Data requirements specific to the creation of projections on the development of services and institutions pertain to
,ealth facilities:
the current and projected number of health facilities of each

type, both those with in.patient beds #such as general hospitals, long.term care hospitals and mental health facilities$ and those without #health centers and sub.centers, maternal and child health centers, health posts, etc$ and across both the public and private health sectors, average capacity of each facility type #e.g. number of beds, bed occupancy rate, number of discharges per year, activity rates, e.g. ambulatory visits, surgeries, etc$.

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Data requirements specific to the creation of projections on the development of services and institutions pertain to
Facility staffing current number of staff by type

and sector of facility, and by category of staff, current staffing rations #i.e. staff to facilities, staff to beds, skills mi) ratio$" projected changes in staffing norms //

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!n addition" the health workforce is composed of a large num#er of personnel located outside health facilities$ %his includes health workers in
8overnment ministries and departments" -egional or district health offices" Public health offices 9rmed medical services" 5anagement and support of nongovernmental

organi1ations delivering health services #either for. profit or not.for.profit$ ,ome.based and community.based health services" -esearch institutions" 6ducation and training Self.employment

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(orkforce projections cannot be undertaken in isolation. !he are highly dependent on other developments in the health system and even the broader social and economic conte)t of the country. %onsequently, they are normally part of some larger strategic process.

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f the strategic planning process : one that capitali1es on plausible projections : is to be successful, among the considerations that need to be addressed and the related processes coordinate form the initial stages are :
'eadership and commitment by senior officials Priority given to ,-, development and

management 9vailability resources #human, financial and technical$ for data collection, processing and analysis 9vailability and use of appropriate data and tools for ,-, projections

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dentification of . and consensus on : ,-,

strategic objectives 9vailability of resources for implementation of the ,-, strategic plan ,armoni1ation with other national health and development plans

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nter.ministerial working group bringing together the

ministries of health, finance, education and labour as well as professional associations and the public service commission for early alignment of essential inputs. n a low.income country conte)t, inclusion of development partners and major nongovernmental organi1ations working in health services provision is also recommended. !his can be achieved by creation of a multi.stakeholder worker group which meets regularly

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PROFESSION PROFESIONALISM PROFESSIONAL BEHAVIOR

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Professional Behavior
Some definitions of

profession, professional, professionalism, behavior and behavioral sciences

#Shounkhanov, et al., 1996, cited in Sastrowijoto, 2006)

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Profession
9n occupation requiring considerable

training and speciali1ed study, e.g. the profession of law, medicine and engineering !he body of qualified person in an occupation or field, e.g. member of the teaching profession

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Professional
Professional 0f relating to, engaged in, suitable for profession, e.g professional field of medicine Professional 9 person following a profession, especially a learned profession 0ne who ear a living in a giving or implied occupation 9 skilled practitioner" an e)pert

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Professionalism
Professional status,

methods, character or standards !he use of professional performers, as in athletics of arts

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Behavior
!he manner in which one behave +efinition from Psychology : the

action or reaction of person or things in response to e)ternal or internal stimuli

Synonym: behavior, conduct,

department

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Professional Behavior
!he manner in which one behave suitable for a

profession e.g. medical, nursing profession !he action or reaction of person or things in response to e)ternal or internal stimuli that suitable for a profession

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Professionalism
nvolving continuing training or education on a

certain science or speciality 0rientation toward care Profession is determined by standardi1ed education and training Profession student learn based on e)perience that sociali1ed more than other student 'egal aspect of profession practice is conducted by giving license 'egali1ation and profession norm are issued by profession association

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PROFESSIONAL BEHAVIOR IN MEDICINE

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Professionalism Category Template

(AAM Card NBME, 2003, cited in Van Luijk, 2005)

&ltruism ,elp others without e)pecting !he best interest of others including patients, colleagues, mentors and trainees, rather than self.interest Honor and integrity ,onesty 'aring and compassion Sensitivity, tolerance, openness, communication Respect +ignity, autonomy, other health care, professional teamwork, building relationship between medical professionals, between specialties, and between professional organi1ation

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Professionalism Category Template

(AAM Card NBME, 2003, cited in Van Luijk, 2005)

Responsi#ility 9utonomy, self evaluation, motivation, insight &ccounta#ility %ommitment, dedication, duty legal&policy compliment, self regulation, services, timelines, work ethics E(cellence and scholarship 9 conscientious effort to e)ceed e)pectations and to make a commitment to life.long learning )eadership 5anagement and mentoring

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So, Professional behavior in medicine is

!he manner in which a medical doctor with his or her

e)pertise, response the problem in this or her medical practice reflecting the ability of altruism, honor, and integrity, caring and compassion, respect, responsibility and accountability, e)cellence and scholarship and leaderships" including her or his relationship with colleagues and other health professional

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The challenge of professionalism

9buse of power +iscrimination ;reach of

confidentiality 9rrogance 8reed : fame, power or money 5isrepresentation : lying, not tell the truth

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The challenge of professionalism

mpairment : impaired in their ability to carry out their professional obligations when caring patients -eluctance : to draw attention to an impaired colleagues 'ack of conscientiousness : a failure to fulfill responsibilities %onflict of interest

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Competence

Knowledge Skills
Attitude, Behavior, ethic

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Development of Competence
Beginner Advance Skillful Competent Expert Master

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COMPETENCIES FOR PUBLIC HEALTH PROFESSIONALS

Scientific Basis Methodological and Analytical Skills Management & Communications Skills Policy and Advocacy Skills Values & Ethics in Public Health Practices

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TEN (10) ESSENTIAL OF PUBLIC HEALTH FUNCTION

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Graduates degree program are expected to have entry-level competence in the following essential public health services:
1. Monitoring health status to identify and solve community health problems 2. Diagnosing and investigating health problems and health hazards in the community 3. Informing, educating, and empowering people about health issues . Mobilizing community partnerships and action to identify and solve health problems !. Developing policies and plans that support individual and community health efforts ". #sing laws and regulations that protect health and ensure safety $. %in&ing people to needed personal health services and assuring the provision of health care when otherwise unavailable '. (valuating effectiveness, accessibility, and )uality of personal and population* based health services +. ,onducting research for new insights and innovative solutions to health problems 1-. ,ommunicating effectively with public health constituencies in oral and written forms

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HOW TO BE PROFESSIONAL?

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Teaching professional behavior

*rofessional #ehavior on +ealing with tasks&work +ealing with others +ealing with oneself

How can the students learn professional behavior?

Understand self : through JOHARI WINDOW
Others and I know

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Others know, but I do not know

Others do not Others and I do not know, but I know know

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WHAT IS THE BENEFIT OF DOING PROFESSIONAL BEHAVIOR?

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Positive work attitudes such as reliability,

loyalty and cooperation are as important to success in a job as are technical skills.
-esearch studies show that <=> of all

people who lose their jobs are dismissed because they lack good work habits rather than because they lack appropriate job skills

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Thank you