Towards a Health Workforce science

Session 3: What systems are needed to monitor the SDG health goals?

Development of a roadmap for the post-2015 health SDGs15-16 January, 2015Glion-sur-Montreux

Jim CampbellDirector, Health Workforce, WHO

Executive Director, Global Health Workforce Alliance

Quick Context: Health Workforce 2030

What are the health workforce implications of UHC & post-2015?

Health workforce: 2014-2016

2014 2015 2016Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep

May

201

6 69th World Health Assembly:Global Strategy on HRH

UNGA High-Level Meeting:Post-2015 development agenda adopted

WHO/WB/USAIDMeasurement Summit on post-2015

Sept

- O

ct 2

015 WHO Regional

Committees:Member States review of national/regional progress

Sep

2015

GHWA Board:Adopts recommendations on Global Strategy HRHFe

b 20

15

Jan

201

5

Global Strategy on HRH :Draft strategy developed

Code of Practice – National reportingDesignated National Authorities

Health Professional EducationNational assessments and reporting

Nursing and MidwiferyNational reporting

Jan

2016 WHO Executive

Board:Global Strategy on HRHWHO Code of Practice , Progress reports WHA64.7, WHA66.23

WHO Executive Board:Code of Practice – “relevance" and “effectiveness”

68th World Health Assembly:Code of Practice – “relevance" and “effectiveness” WHO

Global

GHWA synthesis paper reflecting outcome of Global ConsultationN

ov 2

014

– Ja

n 20

15

Populationcoverage

Financial protection

People-centred, integrated health services (AAAQ / right to health)

wealth quintiles

“UHC”

UHC: The health workforce implications….

A

B

B1

B2

B3

Populationcoverage

Financial protection

People-centred, integrated health services (AAAQ / right to health)

wealth quintiles

“UHC”

UHC: The health workforce implications….

A

B

B1

B2

B3

Post-2015: The Health Workforce implications….

Goal 3: Ensure healthy lives and promote well-being for all at all ages

• Reduce maternal mortality and end preventable deaths of newborns and U5 children and ensure universal access to SRH care services• End the epidemics AIDS, tuberculosis, malaria, and NTDs and combat hepatitis,

water-borne diseases, and other CDs• Reduce by 1/3 premature mortality from NCDs through prevention and

treatment, and promote mental health and wellbeing• Strengthen prevention and treatment of substance abuse, including narcotic drug

abuse and harmful use of alcohol• Halve global deaths and injuries from RTAs• Achieve UHC, including financial risk protection, access to quality essential health

care services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all• Reduce the number of deaths and illnesses from hazardous chemicals and air,

water, and soil pollution and contamination

Post-2015: ‘zero’ targets…

• …..reduce maternal mortality...(70 per 100,000 live births)…

• …..end preventable deaths of newborns….

• …..end preventable deaths of U5 children…..

• …..ensure universal access to SRH care services…..

• …..end the epidemics AIDS, tuberculosis, malaria, and NTDs

Post-2015: ‘zero’ targets…but weak on ‘how?’

• …..reduce maternal mortality...(70 per 100,000 live births)…

• …..end preventable deaths of newborns….

• …..end preventable deaths of U5 children…..

• …..ensure universal access to SRH care services…..

• …..end the epidemics AIDS, tuberculosis, malaria, and NTDs

• increase substantially …..the recruitment, development and training and retention of the health workforce……

The health workforce implications ……

Sexual & Reproductive

Maternal/Newborn

Child Health

CDs

NCDs

Mental Health

Trauma

Public Health & Global Health Security

BUT the HEALTH & SOCIAL CARE WORKFORCE has impact beyond Goal 3.

They are AGENTS OF SUSTAINABLE DEVELOPMENT

GHWA: 8 Thematic papers

http://www.who.int/workforcealliance/media/news/2014/consultation_globstrat_hrh/en/

# 1: The drivers of change in health labour markets;

# 2: The role of transformative education;

# 3: Data and measurement of HRH availability, accessibility, acceptability and quality;

# 4: Accountability and alignment for post-2015: the roles and responsibilities of state and non-state actors; Paper for consultation (will be available shortly);

# 5: Leadership, governance and policy alignment in public/ private health systems;

# 6: The drivers of change in Fragile States;

# 7: Improving health worker productivity and performance in the context of universal health coverage: the roles of standards, quality improvement, and regulation;

# 8: Building on human capability beyond the health sector;

Supplementary: REF # A: What are the health workforce and service implications of the Global Framework for Public Health?

Data & measurement of HRH

http://www.who.int/workforcealliance/media/news/2014/consultation_globstrat_hrh/en/

2013 2014 2015 2016Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

Recife Conferencex

Thematic Paper – Data & Measurementx

WHO Global Strategy on HRH (DRAFT)x

Measurement & Accountability Summitx

GHWA Synthesis document and Board Statementx

UNGA Post-2015x

OWG SDGs – goals/ targetsx

HRH: What do we need to measure?

Source: Sousa, Boerma et al, 2013.

HRH: What indicators are being used?

• from existing literature?

HRH: What is being measured and reported?

HRH: So, what next?

Goal 3c: increase substantially …..the recruitment, development and training and retention of the health workforce……

“increase” -> requires a baseline and progress over time -> increase numbers (but not density/pop)

-> increase numbers (but more of the same)-> increase density (but not equity)-> increase density (but not effective coverage)

“substantially” -> vs. need? -> vs. demand?

HRH: So, what next?

Goal 3c: increase substantially …..the recruitment, development and training and retention of the health workforce……

ASSUMING NO CHANGE:

-> Baseline, Baseline, Baseline-> “2 x 10 x 100”-> Create demand for data-> Create demand for workforce science

2: Who/where are they? What education? 10: Minimum Data Set100: National Health Workforce Account

MDS and National Health Workforce Account

M1

M2

M3

M4

National Health Workforce Account

Modular: from MDS to HLM

Stocks / Flows

Education

MDS – 10 key fields

MDS – standardized metadata

MDS…

Minimum Data Set Data ElementsIdentification Number Unique Identification Number, Date of Issue, Date of Expiration, Place

of IssueFull Name First name, last name, middle name, maiden name, other names

Birth History Date of Birth, Sex at Birth, Place of Birth, father's name and mother's name, photograph

Citizenship, Country of Residence, and Language

Citizenship at birth, citizenship at present, country of residence, ability in spoken and written languages

Address Physical addressContact Information Telephone number, email address, emergency contact name

Professional License and Certification

License and certification name, issuing institution, date of issue and date of expiration, photograph

Employment Status Employment status, employment title and occupational category

Employment Address Full address of current employerData Submission Institution Name of the institution submitting data; date and time of submission

HW data sources….

MedicalCouncil

MoHPayroll,

Retirement

NationalUniversity

Ministry of Defense

ImmigrationXpat Online

PrivateHospital

Board of HealthSciences

NursingCouncil

CivilService

Commission

An example: Multiple data sources

The HW Registry - concept

MedicalCouncil

MoHPayroll,

Retirement

NationalUniversity

Ministry of Defense

ImmigrationXpat Online

PrivateHospital

Board of HealthSciences

NursingCouncil

CivilService

Commission

HealthWorkforce

Registry

Need for Unique Person

ID system(NCIT)

*using Minimum Data Set

Creating a workforce science: “National HW Account”

National Health Workforce Accounts

(NHWA)

National capacity building

Improved national

reporting

GHO

Improved national planning

Overview

Campbell J, Dussault G, Buchan J, Pozo-Martin F, Guerra Arias M, Leone C, Siyam A, Cometto G.

A universal truth: no health without a workforce.

Forum Report, Third Global Forum on Human Resources for Health, Recife, Brazil. Geneva, Global Health Workforce Alliance and World Health Organization, 2013. Campbell J, Dussault G, Buchan J, Pozo-Martin F, Guerra Arias

M, Leone C, Siyam A, Cometto G. A universal truth: no health without a workforce. Global Health Workforce Alliance and World Health Organization, 2013.

A universal truth….

THANK YOU!

- who.int/workforcealliance- @GHWAlliance #hrhstrategy- facebook.com/healthworkforce