Making HRH the Centerpiece of Program Management and Improving

Productivity

The Ethiopia Experience

Meeting the FP Demand to Achieve MDGs: Vision 2015

Total number of available human resource for health during HSDP I, II, and III

HR Category End HSDP-I (2001/02)

End HSDP-II (2004/05)

HSDP-III (2008/09)

Total No Total No Total No Ratio to Population

All Physicians 1,888 1,996 2,218 1:34,986

Specialists 652 775 1236 1:62,783

General Practitioners 1,236 1,221 1,017 1:76302

Public Health Officers 484 683 3,760 1:20,638

Nurses BSc and Diploma (except Midwifes)

11,976 14,270 15,852 1:4,895

Midwifes 862 1,274 ,1353 1:57,345

Health Extension Workers - 2,737 31,831 1:2,437

HRH Framework• HRH Strategy developed– to improve the quality of training and HR

management–HR Directorate established

• It is an all-inclusive strategy– Flooding and retention–Training–Remuneration and condition of work–Incentives

–Workforce planning – HR 2020–Management and other issues related to

HRH development.

HRH Strategic Approach- Flooding• Expansion of Training

– Universities from 2 to 22 (medical schools

increased from 3 to 10)

– 23 Public Midwifery Schools

– Private Health training colleges including 2

medical schools

– Annual medical students enrollment increased

from 250 to 1400

– Accelerated Training of Health Officers-5000

– Training of Non-Physician clinicians

– 33,000 HEWs and 3,200 Supervisors

HRH Strategic Approach- Retention• Career Development• Creating enabling environment• Incentives– Monetary• Point rating system• Anniversary Scheme• Better remuneration compared to other civil servants

– Non-Monetary • Accommodation• Recognition

Retention of HEWs- Career Development

HEWs In-Service Training

• New Skills Training

–Implanon Insertion

–Clean and Safe Delivery

–Community Case Management of

Pneumonia

• Integrated Refresher Training

TASK SHIFTING

CPR

4%

7%

15%

%

Lessons learned• Access and utilization of Family Planning

increased by bringing services closer to the community

• Task shifting has facilitated the above and encourages and motivates providers/HEWs

• Model families create peer/ client to client influence , particularly in the use of LAFP

• Promotion of voluntary community health workers to support HEWs encourages volunteerism

• HRH strategy encourages the provision of integrated PHC services at all levels

Challenges• Delay in implementing comprehensive HRH

strategy• High turnover and shortage of staff at all levels

particularly high level health professionals• The new HEP supervisory structure needs more

support• Uneven distribution of mid and high level

professionals Urban vs rural, Public vs private• Weak HR information system• Information Gap between supplier(MOE) and

consumer( MOH)

Way Forward• Mobilize resources to implement the

Compressive HRH strategy• Use the opportunity of having training

institutions graduate the needed cadres with key competencies

• Strengthen the supervisory structure of the HEP

• Establish HR management information system

• Strengthen coordination between MOH and MOE