Regional Strategy on Human Resources for Health (WHO Western Pacific Region) Presentation by Dr Ezekiel Nukuro Regional Adviser, Human Resources for Health The First Conference of the Asia-Pacific Action Alliance on Human Resources for Health (AAAH) October 2006, Bangkok, Thailand Purpose of the regional strategy on HRH Process of development Endorsement resolution /relevance for countries Components /contents Implementation – countries & WHO support

Shigeru Omi, MD, Ph.D. WHO Regional Director for the Western Pacific Purpose of the Regional Strategy on HRH “.. is intended to provide policy options and practical guidance to Member States in developing and sustaining health workforces that enhance health systems performance and service quality and improve health outcomes…it cannot and should not replace the need for country- specific health workforce strategies..” “..human resources for health is a priority area of work for WHO...the strategy will guide WHO’s work and collaboration in strengthening the capacity of countries and areas to ensure that their health workforces are responsive to population health needs…”

HRH strategy development: Process & Timeline Presentation to the RCM September 2006 Oct March 2005 Brainstorming Technical consultations Nov 2005 HRH situational assessment /review & draft strategic framework dev. Draft revisions Feb/Mar. 2006

Endorsement by the Regional Committee Resolution: WPR/RC57.R7 All Member States found that the strategy provides sound policy options and practical guidance for developing and sustaining health workforces – they welcomed and endorsed it.

Sample statements by Member States about the relevance of the strategy to countries and areas.. China…” valuable framework to guide Member States in overcoming challenges in developing their human resources…” Palau – “.timely and relevant..” Japan – “..the 5 strategic objectives and 3 KRAs are realistic “ Samoa – “ the organization of strategic objectives under 3 KRAs, each with specific monitoring and evaluation indicators, would be helpful for country-level application of the strategy..” USA – “ provides sound policy options and guidance” NZ – “ useful guidance for national actions..”

Structure & components.. Vision; mission; & goal Strategic objectives (5) Guiding principles Framework for action – 3 key result areas (KRA): Issues & challenges; strategic responses & key outcomes - suggested national actions and WHO enabling responses Strategy implementation Monitoring & evaluation.

Vision Achieve equitable access to quality health services for all and effective health system performance through a balanced distribution of a competent and supported health workforce.

Mission Statement Cognizant of the role of WHO in leadership and partnerships for health, the WHO in the Western Pacific Region supports its Member States in strengthening their capacity to plan, educate, manage and develop their health workforces to equitably meet their population health needs.

Goal The health workforce in countries and areas will be responsive to population health needs and will promote equitable access to quality health services and improved health outcomes.

Five Strategic Objectives :.Ensure that health workforce planning and development is an integral part of the national policy and responsive to population and service needs.

Five Strategic Objectives..(cont’d) Enable the delivery of effective health services by addressing workforce size, distribution and skill mix. Address workforce needs including workplace environment, to ensure optimal workforce retention and participation.

Five Strategic Objectives..(cont’d) Improve the quality of education and training to meet the skill and development needs of the workforce in changing service environments. Strengthen health workforce governance and management to ensure the delivery of cost- effective, evidence-based and safe programmes and services.

Guiding Principles: Workforce development: PHC focused (supported by secondary and tertiary care) & responsive to population needs; Contributes to equitable delivery of health services; agreed core competencies and professional standards.

Guiding Principles..(cont’d) Workforce development: balanced health workforce -> attention to developing country needs; achievement of goals (health-related MDGs); needs of vulnerable population groups;

Guiding Principles..(cont’d) Workforce development: Recognizes local political, socio-cultural and economic circumstances; and Enables occupational and professional advancement, which carries responsibilities in regard to health service improvement.

Guiding Principles..(cont’d) The integrated human resource development framework for action should be: Country based and country led; Carried out in partnership with planners and policy-makers; finance, trade, labour and educational institutions and sectors; professional organizations; and other key stakeholders;

Guiding Principles..(cont’d) The integrated human resource development framework for action should be: Based on best practices, to ensure optimal chances of success in HRH initiatives; Formulated according to prioritized population health needs of the country; Realistic and acceptable to the country’s culture, values and socio-economic development;

Guiding Principles..(cont’d) The integrated human resource development framework for action should be: Approached systematically and flexibly, enabling adaptation to changing circumstances; and Based on evidence and accurate national and regional HRH information systems, and national health and development processes.

Framework for Action The 5 interrelated strategic objectives are organized within 3 key result areas (KRA): 1.Health workforce response to population health needs (demand); 2.Health workforce development, deployment and retention (supply); 3.Sound stewardship, good governance and effective health workforce management.

Framework for Action Within each KRA: Issues & challenges; Strategic responses; Strategic objective & corresponding desired results (outcomes); and Suggested national actions & WHO enabling responses for each key outcome, including monitoring & evaluation indicators (Tables).

Implementation – country level National leadership & coordination HRH planning & management unit Advocacy & resource mobilization Partnerships & coordination

WHO Role Supporting Member States in developing country-specific strategies (using regional strategy as guide). Provide needed technical support – tools, guides, evidence / best practices, etc.. – and collaboration (based on SO 13 MTSP) Engage in dialogue with partners for a coordinated approach to overcome workforce challenges (scaling up production, improve performance, managing migration, etc..)

Monitoring & Evaluation Based on relevant indicators in the regional strategy & other appropriate mechanism (at national, regional and global levels) Assessments/ reports Reporting back to the Regional Committee