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Making HRH the Centerpiece of Program Management and Improving
Productivity
The Ethiopia Experience
Meeting the FP Demand to Achieve MDGs: Vision 2015
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Total number of available human resource for health during HSDP I, II, and III
HR Category End HSDP-I (2001/02)
End HSDP-II (2004/05)
HSDP-III (2008/09)
Total No Total No Total No Ratio to Population
All Physicians 1,888 1,996 2,218 1:34,986
Specialists 652 775 1236 1:62,783
General Practitioners 1,236 1,221 1,017 1:76302
Public Health Officers 484 683 3,760 1:20,638
Nurses BSc and Diploma (except Midwifes)
11,976 14,270 15,852 1:4,895
Midwifes 862 1,274 ,1353 1:57,345
Health Extension Workers - 2,737 31,831 1:2,437
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HRH Framework• HRH Strategy developed– to improve the quality of training and HR
management–HR Directorate established
• It is an all-inclusive strategy– Flooding and retention–Training–Remuneration and condition of work–Incentives
–Workforce planning – HR 2020–Management and other issues related to
HRH development.
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HRH Strategic Approach- Flooding• Expansion of Training
– Universities from 2 to 22 (medical schools
increased from 3 to 10)
– 23 Public Midwifery Schools
– Private Health training colleges including 2
medical schools
– Annual medical students enrollment increased
from 250 to 1400
– Accelerated Training of Health Officers-5000
– Training of Non-Physician clinicians
– 33,000 HEWs and 3,200 Supervisors
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HRH Strategic Approach- Retention• Career Development• Creating enabling environment• Incentives– Monetary• Point rating system• Anniversary Scheme• Better remuneration compared to other civil servants
– Non-Monetary • Accommodation• Recognition
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Retention of HEWs- Career Development
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HEWs In-Service Training
• New Skills Training
–Implanon Insertion
–Clean and Safe Delivery
–Community Case Management of
Pneumonia
• Integrated Refresher Training
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TASK SHIFTING
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CPR
4%
7%
15%
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%
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Lessons learned• Access and utilization of Family Planning
increased by bringing services closer to the community
• Task shifting has facilitated the above and encourages and motivates providers/HEWs
• Model families create peer/ client to client influence , particularly in the use of LAFP
• Promotion of voluntary community health workers to support HEWs encourages volunteerism
• HRH strategy encourages the provision of integrated PHC services at all levels
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Challenges• Delay in implementing comprehensive HRH
strategy• High turnover and shortage of staff at all levels
particularly high level health professionals• The new HEP supervisory structure needs more
support• Uneven distribution of mid and high level
professionals Urban vs rural, Public vs private• Weak HR information system• Information Gap between supplier(MOE) and
consumer( MOH)
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Way Forward• Mobilize resources to implement the
Compressive HRH strategy• Use the opportunity of having training
institutions graduate the needed cadres with key competencies
• Strengthen the supervisory structure of the HEP
• Establish HR management information system
• Strengthen coordination between MOH and MOE