Human Resources

in Health Care

Keerti Bhusan Pradhan

keerti@aravind.org
 Healthcare as Service Sector
 Healthcare more than any other sector
depends on people to carry out its mission
 HR accounts for a high proportion of
budgets assigned to the health sector
 Globally 35 million persons are employed
in health sector (ILO)
 The economic and human costs of poor HR
are high in the health sector
 Health services mission, strategic plans
and quality improvement initiatives are
useless unless there is appropriate policies
and procedures for managing people
 Health care key stakeholders are people
and despite changes in the way care is
provided people are always central in the
provision of care whether the care is
preventive, promotive, diagnostic,
curative, chronic or rehabilitative
Healthcare-Science or Art
 The Science of Healthcare
That is achieving and delivering
high quality health care
products and services through
use of scientific and innovative
technology
 The Art of Healthcare

Managing the human beings who

provide the services and
improve the products
Challenge for health systems

 Physical Infrastructure
 Governance
 Financing

 Human Resources (Work Force)

 Insufficient Human Capacity

 In many developing countries there is

insufficient human capacity to make
use of the newly available resources
 New Opportunities are due to:
Scientific Advances (Vaccines…)
Infusion of new money
New drugs
Without a motivated, competent,
well distributed and well supported
workforce-Waste/Misuse of resources
 Dimensions of HRH performance
 Coverage: the extent to which the allocation of
the workforce corresponds to needed services in
terms of type of services and geographical
access
 Productivity: the ratio of outputs relative to
inputs
 Technical quality: the extent to which services
have a positive impact on health status
 Sociocultural quality: the extent to which
services are acceptable to users and meet their
expectations
 Organisation stability: the use of the
workforce so as to guarantee the viability of
services and their capacity to adapt to changing
needs
 Challenge of HSR on HR
Changes Implications for WF
 Cost Reduction  Staff planning, Staff
 Improvement in distribution, Working
Performance conditions
 Improvement of  Incentive System, Work
Equity of access organization, Professional
to services Development Process,
 Decentralization Training
of services  Deployment of personnel,
 Changes in the Methods of recruiting and
health model retaining staff
 Transfer of authority,
Skills needed
 Redefinition of
professional roles,
Integration of services
 Workforce Imbalances
 Imbalances between HR management
practices and national policy objectives.
Ex: Where Health Policies aim at developing
PHCare while training programs continue to
prioritize the training of specialized doctors
 Mismatches of numbers:
Shortages/surpluses
 Qualitative disparity:
resulting from gaps between the training
programs and the requirements of the
country’s health policy
 Unequal distribution of workforce:
b/w Geographical areas, professions and
categories, health establishments and
specialities
 Characteristics of HR activities
in the health sector
 The Intersectoral nature of Health Services
 The time-lag between decision making and
outcome
 Strong Professional Dominance
 Interdependence of the different professional
categories
 The role of the state as the principal
employer
 The high proportion of the women employed
in health services (Thai study)
 The ambiguity of the relationship b/w health
needs, service requirements and resource
needs in the supply of these services
 Deficiencies of the market
 Policy Issues

 Link between effectiveness of health

workforce and improved performance
of health system
 Nature of Health workforce
Size, composition, skills, training
needs, current functions and
performance, appropriate roles,
adaptation to changing priorities
 Lack of data for evidence
 Evidence on the effectiveness of HR
training
 Framework for assisting countries for
HR planning and development
THANK YOU