1. Planning for Shifting HR Needs Malik Jaffer June 19, 2012

2. Overview Using a systems thinking approach to shifting HR needs Considering the HSS building blocks Lots of questions to think about but you will have to consider the “best” answer for your situation

3. Health Systems Thinking Thinking about how changes in one HSS building block has an effect/impact on other HSS building blocks

4. Health Systems Strengthening GOAL: Improve health outcomes 6 Pillars ▫HR ▫Information ▫Medical products ▫Service delivery ▫Finance ▫Leadership and governance

5. Things to Consider-HR Do we have enough human resources? Are they being used appropriately? Are they in the right place?

6. Things to Consider-HR Can (should) roles and scopes be shifted? ▫To who ▫For what? What in-service training will be required to shift to a B/B+ model? What pre-service curriculum needs to change based on new intervention models?

7. Focus on Task Shifting….

8. CHW 2012 Model No GR82-PUT-5TUF-ON Community Mobilization Community Education HCT Palliative Care Psychosocial Support Referral to clinics Referral to Support Groups Supportive Care Nutritional Assessment Home Gardens Linkage to Social Development Promotion of clean water and sanitation Condom promotion and distribution Family assessment

9. For a limited time….. if you order now…..

10. FREE at no additional cost…monitoring and support for… ARV Adherence Diabetes Hypertension Obesity Mental Health BUT WAIT……

11. What about EMTCT? Referral for EMTCT Adherence to ANC counseling Partner HIV Testing Counseling for safe pregnancy Infant Feeding counseling Defaulter tracking Exposed infant follow-upAND

12. As a Bonus….. TB Screening TB referral DOTS and Adherence monitoring

13. Things to Consider-Supply Chain If roles are changed and demand for services increases, is financing available? Is the supply chain ready for increased demand? Is there money to pay for more “stuff”? Do aspects of the supply chain require increased HR?

14. Things to Consider-Lab If there is increased demand, are you performing more “tests”? Is the lab infrastructure capable of handling increased volume? Is there financing for it? Does it require additional HR?

15. Things to Consider-Information Do you need new information for a new model? Can the current systems deliver? If not, what needs to be done? Who will collect and who will process all the new information, analyze and provide feedback? Who will do the training and who will be trained?

16. Things to Consider-Clinical Pharmacovigilance systems Birth Defect monitoring systems Drug Resistance monitoring systems Retention in Care/Treatment Defaulter Tracking Systems Linkage between MCH/ANC and ART TB Screening and Treatment Supportive Supervision and Mentorship of HCWs

17. Things to Consider-Leadership If roles are changed and support services are ready, is management ready to handle increased client load? Patient waiting times? Patient flow in clinics? Infection control? Communication and coordination within health programs (e.g MCH and ART)

18. Things to Consider-Policy If you want to make changes, is there the legal or regulatory framework for your changes? Is there political will to make changes? ▫National ▫Provincial ▫District ▫Within the clinic ▫Among stakeholders

19. How is this sustainable? How are changes integrated into a public or private system that is not reliant on donor resources? Are we pushing or are we being pulled?

20. Thank You Questions will be taken by the CHW Model No GR82-PUT-5TUF-ON