Human Resources for Health in 2030 (HRH2030) - PowerPoint Presentation

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Human Resources for Health in 2030 (HRH2030)

Overview on Human Resources for Health in Jordan Al-Balqa Applied University / Faculty of Medicine April, 2018

Presenter:

Dr. Raghad Hadidi

HRH Governance Component Lead

HRH2030Slide2

OUTLINE

Introduction

HRH Challenges

Country Response to HRH Challenges

Human Resources for Health 2030 (HRH2030) National HRH Strategy in Jordan (NHRHS)National HRH Observatory (NHRHO) Annual HRH Report, 2016

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Introduction

Jordan is a middle income country with limited natural resources, and thus human resources development has been made as one of the most valuable assets and strategic

pillars of the country.

The healthcare system in Jordan is evolving and has to continuously respond to the:

Changing demographic, epidemiologic and risk profile of the population; The rising expectations of a more educated population; The fast growing private health sector; The rapid changes taking place in medical technology; The desire among the government to expand services and achieve universal health coverage (UHC) and sustainable developmental goals (SDGs).Accordingly, Jordan has been remarkably investing in HRH as a key element for scaling up health interventions to achieve global, regional and national goals.

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Building Blocks of the Health System (WHO)

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A simple message: Health workers save lives!

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HRH Challenges

Governance, policy and partnership

HRH management

Absence of a national HRH strategy

Inadequate generation of evidence-based HRH decisions

Deficient endorsed national job descriptions

Absence of a national board to license/relicense healthcare fields (

LaRocco

, 2015)

Lack of nursing and midwifery up to date database (Jordan Nursing Council, 2016)

Lack of collaboration with other healthcare fields (Jordan Nursing Council, 2016)

Adoption of the Civil Service Bureau performance appraisal system represents a change from current practices

Pressure, particularly in the governorates, to hire more staff at the MOH because of the high unemployment rate in remote/underserved areas

Lack of awareness and skills on the part of top management team and other managerial levels of the critical linkages between MOH strategic/operational planning and human resources planning

Difficulty in attracting and retaining qualified health personnel

Overemphasis on tenure and credentials over performance

Weak performance management (unclear criteria, lack of transparency) system to inform career path and succession planningWeak linkages between the current performance appraisal system and incentivesRisk that employees will focus on behaviors that are rewarded and neglect other work-related behaviorsHigh stress and low job satisfaction (Hamaideh & Ammouri, 2011; Mrayyan, 2007; Nawafleh, 2014) in remote/underserved areas (Nawafleh, 2014)Workplace violence

Policy mapping and analysis identified key HRH challenges through document review and key informant interviewsCountry Response to Health Workforce challenges in Jordan

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HRH education, production and development

HRH planning

Interdependence of CPD with other HR policies (e.g., employee selection, career path planning, succession planning, and job analysis and description)

Lack of requisite skills on the technical aspects of training and development for those who work at training and development directorate

Lack of national CPD system linked with re-licensing

Lack of funding for human resources development

Weak capacity building and continuing education initiatives (Jordan Nursing Council, 2016)

Educational lags in areas related to advanced healthcare skills such as newborn resuscitation and holistic nursing care (

Kassab

,

Alnuaimi

, Mohammad,

Creedy

, &

Hamadneh

, 2016;

Shoqirat, 2015)Educational programs do not meet national, regional and international health needs and technological advancements

Clinical training lags in quality and periodFragmented research and lack of research integration into clinical practice (Jordan Nursing Council, 2016)Lack of internship opportunities Limited provision of holistic careLimited supply of specialties in the labor market as they take considerable time to developSkill-mix, gender, and facility maldistribution of human resources across the countryWeak linkages between the human resources planning system on one hand and the performance management, reward, incentive, training, and development systems Shortage of midwivesHigh turnoverWeak effective HRH information system especially that of the private sector HRH Challenges

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Main HRH Challenges

Absence of a national HRH

strategy

.

Centralized HRH decisions in the public sector.Brain drain of HRH.Variation of HRH wages and incentives between private and public sectors.In equitable distribution of health workforce among geographical areas, gender imbalance, skill mix and shortage of them in remote areas.Inefficient contribution of the HHC in the national education policy.Absence of continuous professional development system (CPD).Weak HRH information system.

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Country Response to HRH Challenges

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Main Strategic plans, initiatives and projects emphasizing HRH issues

National:

National

Agenda

and its EDP Jordan 2025 and its EDP (2016-2019)Governmental Action PlanA National Strategy for Human Resource Development (2016-2025)National Health Strategy (2016-2020)Health Sector Reform (2018-2022)Health sector strategies: MOH, RMS, UHsDonors: WHO, USAID HRH2030 Jordan Activity National Strategy for Nursing and Midwifery: A Road Map to 2025

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Regional:

Framework of Action for Health Workforce Development in the Eastern Mediterranean Region (2017-2030)Frame work for action in strengthening Nursing and Midwifery in the Eastern Mediterranean Region (2015- 2025)Regional HRH Observatory

Global:

Global strategic directions for strengthening nursing and midwifery (2016–2020)

HRH2030 Program SDGs, UHC

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Main Strategic plans, initiatives and projects emphasizing HRH issuesSlide12

Human Resources for Health in 2030 / Jordan

The USAID Human Resources for Health in 2030 program operating since

2016

to build the accessible, available, acceptable, and high-quality health workforce needed to improve health outcomes and advance universal health coverage. As HRH2030’s

first field-based activity, the Jordan project works to strengthen the health workforce for better health services. Objectives: 1. Improve human resources practices at the Ministry of Health. Strengthen human resources systems and staff capacity in order to efficiently and effectively motivate, retain, and distribute the workforce. 2. Improve health workforce competency. Train emerging health leaders and supervisors and support a national system for continuing professional development for health professionals. 3. Strengthen National Human Resources for Health Governance. Improve national HRH policies and strategic plans and improve HRH data for decision-making.

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HRH2030 Results Framework

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National HRH Strategy in Jordan

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National HRH Strategy – Vision and Mission

Vision

To have adequate, competent, and responsive health workforce to maximize the performance of the health system in Jordan towards UHC and SDGs.

Mission

To strengthen all functions of HRH (governance, policy, partnership, management, education, production, development, and planning) for better health services.

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Methodology

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One to One interviews

Priority Setting Policy Dialogue

Frontline Health Worker at Governorate Level

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National workshopSlide18

Particularity of the NHRHS

Informed by evidence (local, regional and international) Followed an engaging process though out its development

Linked the SDGs and UHC

Linked to previous and ongoing strategies and plans (like the health sector reform strategy, the MOH strategy)

Pragmatic aspect of implementationWill be monitored and evaluated on regular basis

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Strategic Pillars

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4

1

2

National HRH Strategy Framework

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Strategic Pillar 1: Strengthen

governance structure, policies, and partnerships to strengthen HRH regulation, management, and monitoring

1.1. Ensure alignment of

existing laws/policies/ legislation

to current needs and demands of community and providers 1.2. Scale up HR component in healthcare accreditation systems to include standards on education, occupational health and safety, work-life balance, clinical governance, shared decision making, privileging and credentialing and violence prevention1.3. Develop or update legislated national scope of practice for physicians, registered nurses, midwives, pharmacists, dentists, and allied healthcare professionals that are aligned with required competencies 1.4. Develop and implement interventions and policies to expand the scope of practice for areas where supply of healthcare professionals is low (as remote/underserved areas and primary healthcare centers)1.5. Establish policies to motivate and retain HR to work in remote/underserved areas 1.6. Conduct mandatory examination for licensure of clinical healthcare professionals1.7. Strengthen partnerships in HRH among stakeholders 1.8. Revise Civil Service by-law to align with HRH needs

1.9. Develop and implement policies to address

education and working abroad

to align with the national needsSlide21

Strategic Pillar 2: Establish workforce

planning based on current and emerging health service and community needs

2.1 Update human resources

registries

to integrate up to date data sources and ensure timely access to data for evidence-informed decisions2.2 Ensure mechanisms to collect, report, analyze, and use reliable workforce data to inform HRH decision making2.3 Identify priority needs of the community and burden of disease by leveraging existing national surveys to forecast the human resources needs.2.4 Predict the human resources needs for the next five years at both the national and sub-national (governorate) levels based on priority HR needs and implement strategies to respond to these needs2.5 Attract and orient youth career choices to health programs and specialties with HRH shortage 2.6 Reinforce gender balance in health institutions and within health professions2.7 Mobilize and secure adequate funding to improve the production, employment, and capacity building for all health professionals

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Strategic Pillar 3: Enhance the

competencies of the human resources for health based on current and emerging health service needs

3.1. Revise and unify current health profession

educational strategies and tools

based on the set of required profession competencies 3.2. Establish inter-profession education in universities and institutions 3.3. Develop re-licensure by-law and establish continuing professional development (CPD) system for health professionals3.4. Scale up bridging programs in health education 3.5. Establish selection criteria for target admission of students before acceptance into health profession education

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Strategic Pillar 4:

Manage HRH with a purpose to attract, deploy, retain, and motivate health workforce in both public and private sectors and especially in remote/underserved areas

4.1 Improve

work environment

for health workers4.2 Strengthen clinical governance through mentorship, clinical supervision, and preceptorship of healthcare workers 4.3 Establish shared governance (shared decision making and accountability) in hospitals and primary healthcare centers 4.4 Enhance job-person fit in all healthcare institutions and governmental positions 4.5 Conduct performance evaluation based on competencies in a manner that reflects actual performance of HR and link to credentialing and privileging in institutions4.6 Provide financial and non-financial incentives to healthcare professionals based on performance evaluation4.7 Promote women in health leadership4.8 Develop and implement succession planning in the public sector4.9 Provide

training

to HR departments and health managers on HR related topics

4.10 Ensure

equitable distribution

of health workforce throughout the country

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Wrap Up

Vision: To have adequate, competent, and responsive health workforce to maximize the performance of the health system in Jordan towards UHC and SDGs.

Mission:

To strengthen all functions of HRH (governance, policy, partnership, management, education, production, development, and planning) for better health services.

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National HRH Observatory

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Establishment of the NHRHO

Emphasis on HRH issues

Global initiatives to manage the acute HRH shortage

Need for HRH data & information for planning

Call for establishing regional & National observatoriesLatin America/Brazil: 1999

Africa:

2005

EMRO:

2006

Jordan:

2008

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- It is a

cooperative initiative among relevant stakeholders aimed at producing HRH information and knowledge.-

On-going

HRH system analysis via electronic updating and reporting

- 24/7 Sleepless eye on HRH dynamics- The main purpose is to monitor trends in patterns of the health workforce distribution to provide reliable and instant data and information needed for evidence-based decision-making and policy development.

What and Why is the NHRHO

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Objectives of

NHRHO

Establishing

a national resource

with reliable and up-to-date information pertaining to major dynamics of the health workforce in Jordan. Establishing a national platform for effective and coherent coordination among stakeholders for policy dialogue. Promoting and using evidence based planning and decision making process regarding HRH issues.Installing monitoring and evaluation system to track progress overtime according to HRH related baseline and benchmark indicators.Strengthening the

national capacities

to produce well qualified and skilled health workforce staff.

Sharing best

lessons and experiences

with regional and global HRH observatories.

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Jordan Headways on the NHRHO

Strong

commitment

to HRH evidence generation

(National Agenda, NHS): 2008Institutional ownership (Hosting at the HHC, Appointment of focal point): 2008 Allocation of resources (Seed funds from WHO, biennium & fundraising GHWA):2008Poll survey: 2008National stakeholders’ meeting: June, 2008National platform for coordination: 2008

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Jordan Headways on the NHRHO

Develop observatory

web site

: 2009

www.hhc.gov.joComprehensive mapping of HRH(HRH Country profile):2010Producing Annual HRH reports: 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016Sharing experiences at national, regional and international levels.

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Jordan Headways on the NHRHO

Producing HRH

materials

(brochures, posters and policy briefs):

“HRH Jordan's Coordination and Facilitation Policy”:2012 “Retention of MOH Physicians in remote areas of Jordan”:2013Conducting a survey on: "Distribution of private sector physicians in Amman Governorate”: 2013Conducting a survey on: "Distribution of private sector dentists in Amman Governorate”: 2016Conducting an assessment to the NHRHO with the support of HRH2030, 2017

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NHRHO Publications

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Annual HRH Report, 2016

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1. Aim and Design

Aim of the report To serve as

a tool

for providing a comprehensive picture of the

health workforce situation in Jordan at both the national and sub-national levels in a comparable way to help monitoring HRH stock and trends, and so identify in-equitable geographical distribution of the health workforce in Jordan if any.Design of the studyA cross-sectional point prevalence type of data collection method is adopted.

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2.

Study population

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3. Study Variables

Study Variables

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4. Data Sources

Components of Health Sector

International &

NGOs

Private

Public

MoH

ا

RMS

UH

Private Hospitals

ا

Private Clinics

Private

Centers

UNRWA

KUKC

NDC

NGOs Clinic

s

Institutions & Councils HHCJNCHPCJFDA

Joint Procurement JMC37Slide38

5.Study tools

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6. Methodology of data collection

Central level (reports)

Peripheral level (field)

NHRHO secretariat/HHC

Data

Focal point

Public sector FP

Private sector FP

Head of Employee Affaires Department

Head of Health Profession &

Institutions Licensing

Health Directorates

(14)

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7. Data entry, cleaning, analysis & report writing & dissemination

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Key findings of the HRH Annual Report, 2016

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Distribution of health workforce in the public sector by category, 2016

Cadre

MOH

Prince Hamzeh

RMS

JUH

KAUH

FDA

JPD

NCDE

JNC

JMC

HHC

Total

Physicians

4697

3391822

78554450

370138233

Dentists 7996

460412200

0001

1329Pharmacists 708

40280

2938

96

15160001222

Registered nurses 5053

34838104887644

1244

0010496 Midwives 

1469 0304816

000000

179742Slide43

Health workforce in the Private Sector, 2016

Cadre

Private

hospital & clinics

UNRWA

King Hussein Foundation

JAFPP

KHCC

Total

Physicians

5336

103

11

26

3645840 

Dentists 5435 

30005

5470 Pharmacists 13917 2

0060

13979 Registered nurses 5045 

461224564

5691 Midwives 

315 

342

00

351 43Slide44

Distribution of National Health Workforce by category in Jordan, 2016

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Distribution of National Health workforce by Sector, 2016

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Ratio of physicians per 10000 population by governorate, 2016

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Ratio of dentists per 10000 population by governorate, 2016

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Ratio of Pharmacists per 10000 population by governorate, 2016

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Ratio of Registered Nurses per 10000 population by governorate, 2016

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Ratio of Midwives per 10000 population by governorate, 2016

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Graduates and Enrollees from Dentistry Faculties by gender, 2016

Graduates:

450

Enrollees : 2802

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Recommendations

Improved HRH

data production and utilization

for decision making

Improve health workforce distribution all over the kingdomEnsure adequate health workforce production to respond to growing population needs

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Thank you!

شكرا!

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