Human Resources Factors-Key to SustainabilityLearning from the Example of Public and Private Health services

Keerti Bhusan PradhanConsultant-Health SystemsKeerti.health@gmail.com

Outline of the presentation Definitions of Capacity Development.

Conceptual history of capacity development.

Shifts in capacity development strategies.

Steps in capacity development.

Traditional Vs Capacity oriented approaches.

Future challenges

Definitions of Capacity Development.A process that focuses on enhancing the skills, knowledge and social capabilities available to individuals, individuals, social and political systems (UN)

The sustainable creation, utilization and retention of capacity, in order to reduce poverty, enhance skills, achieve growth, equalize opportunities and enhance peoples lives(UNDP)

Conceptual history of capacity development.

9 components of systemic capacity buildingSource: Potter & Brough HPP

Technical SkillsSufficient staffBeds & clinics LabsDecentralized EquipmentSufficient staff Incentives Planning systemsSource: Potter & Brough 2004.Shifts in capacity development strategies.`

Shifts in capacity development strategies.

RequireRequireRequireEnable effective use ofEnable effective use ofEnable effective use ofSource: Potter & Brough 2004.

Steps in capacity development.Decide strategies for achieving these capacities, Implement, Monitor, reassess and plan for the future based on the results.

Traditional Vs Capacity oriented approaches.

Objectives of training is to improve performance of an organization and enhance its ability to function within a changing environment.

Traditional approaches focused on building the skills, trainee already have than dealing with real organizational problems, its basically transferring knowledge to the individuals.

Action based approach enhances the capacity to meet an organizations specific needs to bring required organizational change. It includes training plans for people who are often forgotten which is specific, short, appropriate and interdisciplinary.

Traditional Vs Capacity oriented approaches.

No individuals can single handedly change the organization. Scientific training alone is insufficient to achieve sustainable change.

Use of Non traditional approaches to capacity development is another possibility.

It includes use of advisers, consultants and resource persons.

Workshops, meetings, conferences and study tours are other options.

Establishing networking with varieties of organization at all levels and making centers of excellence is an upcoming trend, Sabbaticals is another innovation.

Future challenges

Policy makers to consider the enormous growth in knowledge about causes of ill health and the means of improving it.

The new perspectives are frequently complex and traditionally not within the health care sector.

The growth and changes in IT with its ethical issues in health.

Globalization.

HR management (isolated & under professionalized).

Inter departmental, sectoral, organizational, national continental partnerships for a wider health system.

Information and evidence from evaluation.

Persuading politicians at a policy level.

Conclusion.CD is a not a simple cause effect process.

Efforts should focus on what works at the level of individual, department, organization and system.

Activities of the ministry might change but the objectives remains the improvement (development) of the populations health.

A change from clinician managers to professional managers is inevitable.

They will enable all individuals in organizations to function at their highest potential capacity to create, in effect, a capacity releasing organization.

Eye care services-ExampleWorld Bank assistance of US$136 million was provided in 1994 to the NPCB for 7 states which accounted for more than 70% of the cataract work load.The program consisted of Infrastructure development, equipment, consumables, training and capacity building.States: AP, MP, MS, Orissa, Rajasthan, TN & UP

Conceptual model of factors

Independent variablesDependent variableIndividual related variablesGenderAgeMarital statusEducational LevelEmployment statusIncome

Utilisation of Healthcare Facility-Public-PrivateProvider related variablesLocationWaiting time/ALOSWorking hoursEquipmentSpecialised DoctorsCorrect informationTrained and Skilled staffReputation of facilityCleanlinessInternal organisation and proceduresStaff courtesy and friendlinessPrevious experience

Dhenkanal District Eye HospitalOrissa inaugurated July 2000 in district hospital campus

Govt. Eye Hospital- 9 years laterPhoto taken 2009

Ophthalmologist in the District Hospital OPD

Ophthalmologist in the District Hospital OPDSitting in the open patient waiting areaDoes not use required equipment/instruments to check the eyeEye Examination equipment-slit lamp is lying inside without any use

District Hospital Eye Unit OTBig OTAll equipment availableExpensive eqpt. availableSome are brand new but defunctOnly 254 surgeries per year

Private (NGO) Eye Hospital in a rented building in the same district hq

Private (NGO) Eye Hospital OTSmall size OT in comparison to Govt. eye unitDoing 5000 surgeries per year

Talking to the patient

What it needs to ensure in Capacity Building of HR?Not only knowledge and skillsNot just additional manpowerNot just organisational structuresNot just regular salariesNot just regular training and capacity buildingBut Strategies to keep the workforce motivated and a culture of teamwork in healthcare..

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