Ms. Dorothy

HUMAN RESOURCE:

STAFFING: Human Resources (HR) staffing refers to managing the people aspect of running a business by having adequate employees on hand to perform tasks. Human resources management is often accomplished by an internal team of recruitment and employment specialists. However, human capital management is also often handled by an outsourced staffing company that provides services to source, screen, test, and evaluate new employees in advance of placement into critical roles within a corporate environment. Health human resources (“HHR”) — also known as “human resources for health” (“HRH”) or “health workforce” — is defined as “all people engaged in actions whose primary intent is to enhance health”, according to the World Health Organization's 2006. Human resources for health are identified as one of the core building blocks of a . They include physicians, nurses, midwives, dentists, allied health professions, community health workers, social health workers and other providers, as well as health management and support personnel – those who may not deliver services directly but are essential to effective health system functioning, including health services managers, medical records and health information technicians, health economists, health supply chain managers, medical secretaries, and others. The field of health human resources deals with issues such as planning, development, performance, management, retention, information, and research on human resources for the health care sector. In recent years, raising awareness of the critical role of HRH in strengthening health system performance and improving population health outcomes has placed the health workforce high on the agenda.

Global situation The World Health Organization (WHO) estimates a shortage of almost 4.3 million physicians, midwives, nurses and support workers worldwide. The shortage is most severe in 57 of the poorest countries, especially in sub-Saharan Africa. The situation was declared on 2006 as a "health workforce crisis" – the result of decades of underinvestment in health worker education, training, wages, working environment and management. Shortages of skilled for health workers are also reported in many specific care areas. For example, there is an estimated shortage of 1.18 million mental health professionals, including 55,000 psychiatrists, 628,000 nurses in mental health settings, and 493,000 psychosocial care providers needed to treat mental disorders in 144 low- and middle-income countries. Shortages of skilled birth attendants in many developing countries remains an important barrier to improving outcomes. Many countries, both developed and developing, report mal distribution of skilled health workers.

THE HEALTH WORKER CRISIS IN KENYA

Kenya’s human resources for health (HRH) crisis is characterized by a severe shortage of health workers, with an average of 1.3 health workers per 1,000 population, 43% below the WHO benchmark of 2.3i. In addition, Kenya is challenged with an inability to attract and retain health workers—especially in the public sector—as well as with performance management issues, unequal distribution of staff, and diminishing productivity among the health workforce. This situation is further aggravated by the migration of health workers to countries in the region and internationally. Despite these challenges, a fundamental transformation is underway in Kenya with the advent of the new Constitution, which is expected to significantly change the landscape in the health sector– with major implications for HRH. The Government of Kenya is committed to improving access and equity of essential health care services and has set critical and ambitious targets for providing health services to its population. In order to achieve these national goals and objectives, provision of an optimum and well managed health workforce with appropriate skills, equitably distributed across the country, is critical. As in most developing countries, the HRH challenges in Kenya have continued to impede health sector planning, service delivery, and achievement of expected national health outcomes. The National HRH Strategic Plan 2009-2012 identified five key outputs to address this crisis:

• To have the appropriate number and type of health workers in post and equitably distributed

• Improve retention of health workers in post at all levels

• Improve institutional and health worker performance

• Strengthen human resource development systems and practices

• Strengthen human resource planning and management at all levels.

Regular statistical updates on the global HHR situation are collated in the WHO Global Atlas of the Health Workforce. However the evidence base remains fragmented and incomplete, largely related to weaknesses in the underlying human resource information systems (HRIS) within countries. In order to learn from best practices in addressing health workforce challenges and strengthening the evidence base, an increasing number of HHR practitioners from around the world are focusing on issues such as HHR advocacy, surveillance and collaborative practice.

Health workforce research

Health workforce research is the investigation of how social, economic, organizational, political and policy factors affect access to health care professionals, and how the organization and composition of the workforce itself can affect health care delivery, quality, equity, and costs. Many government health departments, academic institutions and related agencies have established research programs to identify and quantify the scope and nature of HHR problems leading to in building an innovative and sustainable health services workforce in their jurisdiction. Some examples of HRH information and research dissemination programs include:

Health workforce policy and planning: In some countries and jurisdictions, health workforce planning is distributed among labour market participants. In others, there is an explicit policy or strategy adopted by governments and systems to plan for adequate numbers, distribution and quality of health workers to meet health care goals. For one, the International Council of Nurses reports: The objective of HHRP [health human resources planning] is to provide the right number of health care workers with the right knowledge, skills, attitudes and qualifications, performing the right tasks in the right place at the right time to achieve the right predetermined health targets.

An essential component of planned HRH targets is supply and demand modelling, or the use of appropriate data to link population health needs and/or health care delivery targets with human resources supply, distribution and productivity. The results are intended to be used to generate evidence-based policies to guide workforce sustainability. In resource-limited countries, HRH planning approaches are often driven by the needs of targeted programmes or projects, for example those responding to the Millennium Development Goals. The WHO Workload Indicators of Staffing Need (WISN) is an HRH planning and management tool that can be adapted to local circumstances. It provides health managers a systematic way to make staffing decisions in order to better manage their human resources, based on a health worker’s workload, with activity (time) standards applied for each workload component at a given health facility.

Global Code of Practice on the International Recruitment of Health Personnel

The main international policy framework for addressing shortages and maldistribution of health professionals is the Global Code of Practice on the International Recruitment of Health Personnel, adopted by the WHO's 63rd World Health Assembly in 2010.The Code was developed in a context of increasing debate on international health worker recruitment, especially in some higher income countries, and its impact on the ability of many developing countries to deliver services. Although non-binding on Member States and recruitment agencies, the Code promotes principles and practices for the ethical international recruitment of health personnel. It also advocates the strengthening of health personnel information systems to support effective health workforce policies and planning in countries.