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Republic of Vanuatu WHO Library Cataloguing-In-Publication Data Human Resources for Health Country Profiles Republic of Vanuatu WHO Library Cataloguing-in-Publication Data Human resources for health country profiles: Republic of Vanuatu 1. Delivery of healthcare – manpower. 2. Health manpower. 3. Health resources - utilization. I. World Health Organization Regional Office for the Western Pacific. ISBN 978 92 9061 626 9 (NLM Classification: W 76) © World Health Organization 2013 All rights reserved. Publications of the World Health Organization are available on the WHO web site (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications –whether for sale or for non-commercial distribution– should be addressed to WHO Press through the WHO web site (www.who.int/about/licensing/ copyright_form/en/index.html). For WHO Western Pacific Regional Publications, request for permission to reproduce should be addressed to Publications Office, World Health Organization, Regional Office for the Western Pacific, P.O. Box 2932, 1000, Manila, Philippines, fax: +632 521 1036, e-mail: [email protected] The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. Table of contents Acronyms v Acknowledgements vi Executive summary vii 1. Introduction 1 1.1 Demographic, social and political background 1 1.2 Current economic situation and macroeconomic indicators 2 1.3 Summary of health indicators 2 1.4 Health system 3 2. Health workforce supply and trends 6 3. Health workforce distribution 8 3.1 Gender distribution 8 3.2 Age distribution 8 3.3 Geographical distribution 10 3.4 Distribution of health workers by urban/rural areas 10 3.5 Sectoral distribution 10 3.6 Distribution of health workers by citizenship 11 3.7 Skills distribution 11 4. Health professions education 12 4.1 Medical education 12 4.2 Nursing education 12 4.3 Other allied health education 14 4.4 Educational capacities 14 4.5 Physical infrastructure 17 4.6 Technical infrastructure 18 4.7 Accreditation mechanisms 18 4.8 In-service and continuing professional education 18 5. Human resources for health (HRH) utilization 19 5.1 Recruitment 19 5.2 Deployment and distribution policies and mechanisms 19 5.3 Unemployment 22 5.4 Employment of health workers in the private sector 22 6. Financing HRH 23 6.1 HRH expenditure 23 6.2 Health workers’ remuneration 23 7. Governance of HRH 25 7.1 HRH policies and plans 25 7.2 Policy development, planning and managing for HRH 25 7.3 Professional regulation 26 7.4 HRH information systems 26 7.5 Health workforce requirements 27 8. Concluding remarks 28 References 29 Republic of Vanuatu iii Annexes 31 Annex A. Ministry of Health organizational chart 31 Annex B. Distribution of public sector health workers by category/cadre and gender, 2012 32 Annex C. Distribution of public sector health workers by category/cadre and age, 2012 33 Annex D. Distribution of public sector health workers by category/cadre and by urban/rural areas, 2012 34 List of tables Table 1. Selected sociodemographic indicators 1 Table 2. Selected economic indicators 2 Table 3. Selected health indicators 3 Table 4. Public health facilities in Vanuatu, 2010 5 Table 5. Number of public sector health workers by occupational category/cadre per 1000 population, 2010 and 2012 7 Table 6. Distribution of public sector health workers by category/cadre and by region, 2012 9 Table 7. Estimated number of private practice health facilities and health workers 11 Table 8. Distribution of skilled/unskilled health workers, 2012 11 Table 9. Number and type of health professions training institutions, by sector, 2012 13 Table 10. Number of enrolments by training institution and health profession category, 2008–2012 15 Table 11. Number of health professional graduates by training institution and category/cadre, 2008–2011 16 Table 12. Average cost of student training, by type of training institution, donor support and number of scholarships, 2012 16 Table 13. Number of health professional scholarships by donors, study institutions and category/cadre, 2008–2011 17 Table 14. Selected allowances and leave for public health-service staff 21 Table 15. Average monthly income, by professional category/cadre, 2012 24 Table 16. Projected health professional category/cadre workforce needs to maintain 2012 levels in the next 10 and 20 years 27 List of figures Figure 1. Distribution of health workers by gender in selected categories (%), 2012 8 Figure 2. Distribution of health workers by age in selected categories (%), 2012 8 Figure 3. Distribution of health workers by selected categories and by urban/rural areas (%), 2012 10 iv Human Resources for Health Country Profiles Acronyms AusAID Australian Agency for International Development AUT Auckland University of Technology (New Zealand) CPE Continuing professional education FNU Fiji National University GDP Gross domestic product HRD Human Resources Development (Ministry of Health) HRH Human Resources for Health HRMIS Human Resource Management Information System JCU James Cook University (Australia) JICA Japan International Cooperation Agency MoH Ministry of Health NDH Northern District Hospital (Vanuatu) NGO Nongovernmental organization NZAID New Zealand Agency for International Development Otago University of Otago, New Zealand PAU Pacific Adventist University (Papua New Guinea) PEI Pacific Eye Institute (Fiji) PSC Public Service Commission QUT Queensland University of Technology (Australia) SICHE Solomon Islands College of Higher Education UPNG University of Papua New Guinea US$ United States dollar VCH Vila Central Hospital (Vanuatu) VCNE Vanuatu College of Nursing Education VHTI Vanuatu Health Training Institute VUV Vanuatu Vatu WHO World Health Organization Republic of Vanuatu v Acknowledgements The Vanuatu Human Resources for Health Country The Human Resources for Health country profiles in Profile was developed by a team comprising Maturine the Western Pacific Region are prepared under the Tary (Director General), Katimal Kaun (Officer-in-Charge, logistical and editorial support of WHO Western Pacific Human Resources Development Unit), and Liency Ala Regional Office Human Resources for Health Unit and (Acting Manager, Human Resource Management Unit) coordinated by a team composed of Gulin Gedik, from the Ministry of Health of the Republic of Vanuatu; Ezekiel Nukuro, Rodel Nodora, Rufina Latu, Jose Aguín and Richard Taylor (Director), Graham Roberts (Deputy and Dyann Severo. Director), and Sophia Lin (Research Officer) of the Human Resources for Health Knowledge Hub1 at the University of New South Wales (UNSW), Australia. 1 The Human Resources for Health Knowledge Hub was funded through a grant from the Australian Agency for International Development (AusAID) under the Strategic Partnerships Initiative. vi Human Resources for Health Country Profiles Executive summary Background Current health personnel stock levels and distribution Vanuatu’s population of 245 619 (2011) (World Bank, 2012) live mostly in rural areas, dispersed across There is no functional human resources information 83 islands. There are two urban centres, the capital, system, which has made it difficult to determine Port Vila, with a population of 44 039 (2009), and the current health workforce situation. Data for this Luganville with 13 156 people (National Statistics report were sourced from payroll databases, and from Office, 2010). The country is divided into six provinces, nongovernmental organizations (NGOs) and private Torba, Sanma, Penama, Malampa, Shefa and Tafea. The health facilities that were contacted directly for health population is very young with almost 40% under 15 worker information. However, the data acquired and years of age. External migration is low but movement presented in this report are a best estimate and from rural to urban areas is increasing. Access to results need to be interpreted with caution. Little is health services is difficult for many ni-Vanuatu (name known about the utilization of traditional medicine generally given to nationals and citizens of Vanuatu) practitioners in Vanuatu. due to the wide dispersion of the population. An estimated 20% of the population have no access to It is estimated there were 1261 government health health services. workers in April 2012, including 46 medical practitioners, 335 nurses and 62 midwives. There The Vanuatu economy is driven by exports of copra, were also 206 village health workers spread across timber, beef and cocoa (20% of gross domestic product rural Vanuatu in aid posts. – GDP), tourism (20%) and foreign aid contributions, with the biggest donors being Australia, France, Main human resources for health (HRH) New Zealand and the United Kingdom. However, it is issues not expected that these sources of revenue will be sustainable in the future. As external migration is The main HRH problem is the severe and critical minimal, remittances flowing into the country make health worker shortages. Vanuatu has the third lowest up only a small portion of GDP.
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