AAAH meeting, Beijing, China | October, 20071 |

Dr Jean YanCoordinator, Nursing, Midwifery and Health Professions,

Department of Human Resources for HealthBeijing, China, 12-13 October 2007

The World Health Report 2006 The World Health Report 2006

On ward.…

AAAH meeting, Beijing, China | October 20072 |

we're here with the health workers who are with the people they serve

April 2006

AAAH meeting, Beijing, China | October 20073 |

Global Commitments to address critical shortage of health workforce ( May 2006)

Global Commitments to address critical shortage of health workforce ( May 2006)

WHA Resolution 59.23 Rapid Scaling-up of Health Workforce Production

WHA Resolution 59.27 Strengthening Nursing and Midwifery

AAAH meeting, Beijing, China | October 20074 |

WHA Resolution 59.23 Rapid Scaling up of health workforce production

WHA Resolution 59.23 Rapid Scaling up of health workforce production

Revitalize health training institutions and rapidly increase the health workforce

Encourage global partners to support health training institutions

Engage in training partnerships to improve capacity and quality of health professional education in developing countries

Development of health workforce planning teams, use of innovative approaches to teaching in developing countries, state of the art teaching materials, continuing education through innovative use of information and communications technology

AAAH meeting, Beijing, China | October 20075 |

WHA Resolution 59.27Strengthening Nursing and Midwifery

WHA Resolution 59.27Strengthening Nursing and Midwifery

- N&M involvement in integrated planning of HRH – re.

strategies for maintaining adequate numbers of competent N&M

personnel

- to recruit N&M in all relevant WHO programs to ensure the

contributions of nursing and midwifery in the development and

implementation of WHO’s policy and programs

- support to Member States in optimizing the contribution of

N&M to meeting national heath policies and the MDGs

- encourage and support Member States in the provision of

workplace environments that are safe and support the retention

of nurses and midwives

AAAH meeting, Beijing, China | October 20076 |

Improved national capacities to plan, train,

deploy, retain and manage the health workforce

Policy options

Strengthened institutions

Country impactWork cycles Activities/products

Strategic information

Country work

WHO/HRH Strategic directions and work streamsWHO/HRH Strategic directions and work streams

Strengthened HRH agenda at country, regional and

global level

Access to motivated, skilled, and supported

health workforce

Health systems/country work:• GAVI-HSS, GF• Integration with priority diseases• PHC

Institutions strengthened:• regional offices and partnerships• accreditation mechanisms• governance for HRH• regulation

Strategic information: • Core indicators• Global databases• Observatories, CoP

Policy options/good practices: • education, retention, migration

Mon

itorin

g an

d ev

alua

tion

AAAH meeting, Beijing, China | October 20077 |

Norms and standards settingNorms and standards setting

HRH Action Framework

Tools and guidelines for health workforce monitoring (core indicators and benchmarks)

Standards for practice in nursing and midwifery

Guidelines for task shifting for achieving universal access to HIV/AIDS treatment and care

AAAH meeting, Beijing, China | October 20078 |

Regional and country supportRegional and country support

Support the development of country and regional HRH Observatories as mechanisms for policy development and information sharing

Provide country support for HRH assessment, planning and implementation

Provide technical support for scaling up the health workforce production

AAAH meeting, Beijing, China | October 20079 |

• Visibility• Evidence• Political

Advocacy

Stronger health systems

• Adequate/available• Competent• Motivated• Supported

• Fiscal space• Migration• Alignment

Addressing global issues

• Observatories: National, regional, global

• Research• Sharing• Learning

Knowledge

Health Workforce

Bet

ter

Hea

lth

• Leadership/management • Education / training• Recruitment /deployment• Incentives/retention• Regional support

Country Action

AAAH meeting, Beijing, China | October 200710 |

Structure of the Department of Human Resources for Health

Structure of the Department of Human Resources for Health

AAAH meeting, Beijing, China | October 200711 |

Global Health Workforce AllianceGlobal Health Workforce Alliance

GHWA GHWA Members’ ForumMembers’ Forum

GHWA BoardGHWA Board

Migration AdvocacyScale up Ed.

& Training

Tools &

Guidelines

Executive committee

Nominating committee

Program / policy

committee

GHWA SecretariatGHWA Secretariat

FinancingUniv. access

to HIV treat.

Working Groups / Task Forces

AAAH meeting, Beijing, China | October 200712 |

Death from HIV – largest cause of attritionDeath from HIV – largest cause of attrition

Zambia:- 1980: 2 nurses out of 1000 died- 2001: 27 nurses out of 1000 died

Botswana:- 1999-2005: 17% of health workforce died- 1999-2010: 40% of health workforce will die (projection if no action)

HIV prevalence = 15% up to 33 % loss of health workers in 10 years

AAAH meeting, Beijing, China | October 200713 |

Treat (prevent, care, and support) A package of HIV/AIDS prevention, care, treatment, and support for health workers

Train (and planning for HRH)Measures to empower HRH towards UA

Retain Strategies to enable health systems to retain health workers

Universal Access to HIV Treatment:The TTR plan

Universal Access to HIV Treatment:The TTR plan

Task shifting

AAAH meeting, Beijing, China | October 200714 |

Scaling-up Education and TrainingScaling-up Education and Training

Case studies ( indicators and benchmarks)

Roadmap for countries to scale –up

Setting –up educational system

Guide for international partners to support countries to scale-up

AAAH meeting, Beijing, China | October 200715 |

BETTER HEALTH

SERVICES Equity

EffectivenessEfficiency

Accessibility

BETTER HEALTH

OUTCOMES

other healthsystem

components

country specific context

including labour market

Improved Health

Workforce Outcomes

Situation analysis

Preparation & Planning

Implementation

M & E

Policy

Leadership

Partnership Education

FinanceH R M

Systems

Critical Success Factors

HRH Action Frameworktools for an effective and sustainable health workforce

HRH Action Frameworktools for an effective and sustainable health workforce

AAAH meeting, Beijing, China | October 200716 |

Migration of Health WorkersMigration of Health Workers

Review of Codes of Practice, bilateral agreements, MRAs ( Commonwealth COP, ASEAN MRA, Caribbean Single Market and Economy, South Pacific Code of Practice, Namibia-Kenya MOU, Philippines-Spain MOU, UK-South Africa MOU)

Framework for Global Code of Practice : principles Opportunities for collaboration and monitoring impact

Information on Health worker Migration ( WHO-OECD) core dataset

Effective Policy response to Migration of Health workers ( WHO,ILO,IOM in 5 countries : Romania, Senegal, Costa Rica, Trinidad and Tobago, Kenya)

AAAH meeting, Beijing, China | October 200717 |

Migration of Health workersMigration of Health workers

Policy AdvocacyCouncil

Technical WorkingGroup

EB andWHA2008

UN GlobalMigration

Forum

WHO

GHWARR

High –levelMigration

Forum

WHO/OECD

WHA 2008

AAAH meeting, Beijing, China | October 200718 |

Primary Health CarePrimary Health Care

Commissioned study of PHC and HRH Framework

Three – country case study on CHW: Uganda, Kosovo

Literature review on contributions of health professions in PHC

Good Practices on PHC ( 2-3 cases from each region)

AAAH meeting, Beijing, China | October 200719 |

Commitments to address critical shortage ofhealth workforce ( May 2006)

Commitments to address critical shortage ofhealth workforce ( May 2006)

WHA Resolution 59.23 Rapid Scaling-up of Health Workforce Production

WHA Resolution 59.27 Strengthening Nursing and Midwifery

AAAH meeting, Beijing, China | October 200720 |

Regional ResponseRegional Response

AFRO

High level inter-ministerial technical consultation (MOH, Finance, Education and Public Service) - 48 countries

Consensus on the priority actions to address health workforce crisis reached and supported at the 3rd Conference of AU Ministers

PAHO

Decade for Human Resources

EURO

RC Resolution (EUR/RC57/R1)

EMRO

Human Resource Observatory

AAAH meeting, Beijing, China | October 200721 |

HRH Priority Action AreasHRH Priority Action Areas

Priority Areas AFRO EURO EMRO

Health workforce policy, planning and management

X X X

Migration and Code of Practice

X X

Better intelligence ( info and knowledge base) HS/HR Observatory

X X X

Governance, stewardship, partnership

X X

Scaling-up production Financing

X X

AAAH meeting, Beijing, China | October 200722 |

http://www.who.int/hrhhttp://www.who.int/hrh