Improving Human Resource Management Capacity in the

Ethiopian Public Health Sector

Shelemo Shawula (MD, MPH) Senior HRH Management Advisor

Strengthening HRH ProjectAddis Ababa, Ethiopia

Objectives

• Describe Ethiopia’s Human Resources for Health (HRH) challenges, the underlying causes & factors, and the HRH Project profile

• Highlight the process of Discovering, Designing and Delivering HRM Capacity improvement

• Discuss next steps and the way forward for HRH project

Significance of Human Resources in Health “Sufficient number of qualified and motivated health workers is a backbone to achieve our health program goals. The fact is we always have fewer health workers than we need, often inadequately trained and unmotivated. We also fail to appreciate and meet the needs of available staff. Now the time has come to put the first thing first, with support from HRH project.” (Deputy Director for Regional Health Bureau, January 2013)

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Projected Tends of Global Health Workforce Deficit

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Trends of deficits in Health Care Providers: in Millions

Source: Global Health Workforce Alliance

HRH Status: Global

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• Inadequate number of health workers • Imbalances in skill mix and geographic

distribution• poorly motivated• High attrition rates • Underinvestment in education and training

• Weak human resources management• Decentralization with no proper institutional capacity

building•Inadequate institutional capacity of Universities/Colleges•Little or no attention to HRM. •Inadequate HRM structure, staffing, plan and budget•Weak Human Resources Information System (HRIS)

Characteristics of HRH Challenges in Ethiopia

Strengthening Human Resources for Health (HRH) Project

Key Result Areas

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IR 1: Improved HRM Capacity

DiscoverDesign

Deliver

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• Strengthening the human resource management system, policies and practices at all levels of health system

Discover

• Conducted HRM Capacity Assessment– A two-day facilitated process with

institution (self-assessment, priority setting, and action planning )

– Brought together 15-20 multi-disciplinary team

– Guided by MSH’s HRM Rapid Assessment Tool for Health Organizations (3rd Edition), 5 Broad Areas & 20 Sub-themes

• HRM Capacity Assessments were conducted with 15 Institutions

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Design

• Reviewing of the challenges identified and underlying cause(s)

• Agreeing the priority areas and level

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• What works? (international & national evidence)

• What is feasible in the specific setting?

• What can actually be implemented?

(short-term, medium and long-term)

•Identifying key interventions

•Developing plans of actions

Planned ActivitiesHRM Staff and Budget

• Increase the number of HR positions at all levels

• Conduct HRM training needs assessments and HRM In-service Training

• Prepare budget plan with HR activity plan and secure approval from senior management team

HR Plan • Review and Finalize National HRH Strategic Plan and adapt the HRH Strategic Plan to the Regions

• Develop the planning skills of HR staff in order for them to forecast the staffing needs

• Build capacity of hospitals, Woredas and health science colleges to develop staffing plans

HR Data • Update the existing HR data collection tools • Train HR staff on data collection, analysis and

data use• Strengthen HRIS reporting mechanism

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Strengths of HRM RAT Process

• Created opportunities for the organizations to discover their strengths and gaps

• Involved senior staff from non-HR functions and they were able to appreciate how strong HRM would contribute to strong health programs

• Culminated with agreed plan of actions with each organization as basis for capacity improvement

• Involved senior management team of the organization throughout the process

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Strengths of HRM RAT Process (2)

“….. I have attended many trainings and workshops of several days’ duration over the last few years. But I have not gained as much I have from this two-day activity…”

(Deputy Director, Civil Service Commission Bureau, Tigray Region)

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The Obelisk of Axum, Tigray

(1,700-years-old, 24 m tall and 160 tones heavy)

Deliver: Implementation and achievements • Existing HR structure revised and 1,100 new

HR positions created (in 11 Regional health bureaus)

• HRM In-service training provided to 424 HR managers and staff (national & regional levels)

• Strengthened HR management functions (updated job descriptions and recruitment guidelines, developed orientation manuals, supported HRIS data collection and entry etc. )

• Ongoing support is underway to strengthen HR planning the Ministry and regions

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Deliver: Implementation and achievements (2)

• National Retention study conducted (first-ever in African countries)

• New national regulations were put in place for health workforce licensing and management

• Increased partnership between the ministries of health, civil service and finance for HRH is in place -- National and Regional HRH Forums

• Curriculum developed and modules writing completed to launch Master Degree HRH Management

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Way forward

• Professionalize HRM functions at all levels• Build upon the gains to improve workforce

availability, distribution, motivation and retention• Design and implement work climate improvement

programs in the health facilities • Strengthen designing, equitable delivery and

evaluation of in-service training for health workers• Strengthen systems and practices for performance

management, feedback and support at all levels

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Thank You for Attention!

Q & A

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