Health Human Resources
Encyclopedia
Health human resources — also known as “human resources for health” (“HRH”) or “health workforce” — is defined as “all people engaged in actions whose primary intent is to enhance health”, according to the World Health Organization
's World Health Report 2006
. Human resources for health are identified as one of the core building blocks of a health system
. They include physicians, nurses, midwives, dentists, allied health professions
, community health worker
s, social health workers and other health care provider
s, as well as health management and support personnel – those who may not deliver services directly but are essential to effective health system functioning, including health services managers
, medical records and health information technicians
, health economists, health supply chain managers, medical secretaries, and others.
The field of HRH deals with issues such as planning
, development, performance, management
, retention
, information, and research on human resources
for the health care
sector. In recent years, raising awareness of the critical role of HRH in strengthening health system performance and improving population health outcomes has placed the health workforce high on the global health
agenda.
as a "health workforce crisis" – the result of decades of underinvestment in health worker education, training, wage
s, working environment and management.
Shortages of skilled health workers are also reported in many specific care areas. For example, there is an estimated shortage of 1.18 million mental health professional
s, including 55,000 psychiatrists, 628,000 nurses in mental health settings, and 493,000 psychosocial care providers needed to treat mental disorders in 144 low- and middle-income countries. Shortages of skilled birth attendants
in many developing countries remains an important barrier to improving maternal health
outcomes. Many countries, both developed and developing, report maldistribution of skilled health workers leading to shortages in rural and underserved areas.
Regular statistical updates on the global HHR situation are collated in the WHO Global Atlas of the Health Workforce. However the evidence base remains fragmented and incomplete, largely related to weaknesses in the underlying human resource information systems
(HRIS) within countries.
In order to learn from best practices in addressing health workforce challenges and strengthening the evidence base, an increasing number of HHR practitioners from around the world are focusing on issues such as HHR advocacy, surveillance and collaborative practice. Some examples of global HRH partnerships include:
, and costs.
Many government health department
s, academic institutions and related agencies have established research programs to identify and quantify the scope and nature of HHR problems leading to health policy in building an innovative and sustainable health services workforce in their jurisdiction. Some examples of HRH information and research dissemination programs include:
participants. In others, there is an explicit policy or strategy adopted by governments and systems to plan for adequate numbers, distribution and quality of health workers to meet health care goals. For one, the International Council of Nurses
reports:
An essential component of planned HRH targets is supply and demand
modeling, or the use of appropriate data to link population health needs and/or health care delivery targets with human resources supply, distribution and productivity. The results are intended to be used to generate evidence-based policies to guide workforce sustainability. In resource-limited countries, HRH planning approaches are often driven by the needs of targeted programmes or projects, for example those responding to the Millennium Development Goals
.
The WHO Workload Indicators of Staffing Need (WISN) is an HRH planning and management tool that can be adapted to local circumstances. It provides health managers a systematic way to make staffing decisions in order to better manage their human resources, based on a health worker’s workload
, with activity (time) standards applied for each workload component at a given health facility.
in 2010. The Code was developed in a context of increasing debate on international health worker recruitment, especially in some higher income countries, and its impact on the ability of many developing countries to deliver primary health care
services. Although non-binding on Member States and recruitment agencies, the Code promotes principles and practices for the ethical international recruitment of health personnel. It also advocates the strengthening of health personnel information systems to support effective health workforce policies and planning in countries.
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
's World Health Report 2006
World Health Report
The World Health Report is a series of reports produced regularly by the World Health Organization . First published in 1995, the World Health Report is WHO's leading publication...
. Human resources for health are identified as one of the core building blocks of a health system
Health system
A health system can be defined as the structured and interrelated set of all actors and institutions contributing to health improvement. The health system boundaries could then be referred to the concept of health action, which is "any set of activities whose primary intent is to improve or...
. They include physicians, nurses, midwives, dentists, allied health professions
Allied health professions
Allied health professions are clinical health care professions distinct from dentistry, nursing and medicine. One estimate reported allied health professionals make up 60 percent of the total health workforce...
, community health worker
Community health worker
Community health workers are members of a community who are chosen by community members or organizations to provide basic health and medical care to their community...
s, social health workers and other health care provider
Health care provider
A health care provider is an individual or an institution that provides preventive, curative, promotional or rehabilitative health care services in a systematic way to individuals, families or communities....
s, as well as health management and support personnel – those who may not deliver services directly but are essential to effective health system functioning, including health services managers
Health administration
Health administration or healthcare administration is the field relating to leadership, management, and administration of hospitals, hospital networks, health care systems, and public health systems...
, medical records and health information technicians
Health Information Management
Health information management is the practice of maintenance and care of health records by traditional and electronic means in hospitals, physician's office clinics, health departments, health insurance companies, and other facilities that provide health care or maintenance of health records...
, health economists, health supply chain managers, medical secretaries, and others.
The field of HRH deals with issues such as planning
Workforce planning
Workforce Planning is a continual process used to align the needs and priorities of the organisation with those of its workforce to ensure it can meet its legislative, regulatory, service and production requirements and organizational objectives...
, development, performance, management
Human resource management
Human Resource Management is the management of an organization's employees. While human resource management is sometimes referred to as a "soft" management skill, effective practice within an organization requires a strategic focus to ensure that people resources can facilitate the achievement of...
, retention
Employee retention
Employee retention refers to the ability of an organization to retain its employees. Employee retention can be represented by a simple statistic...
, information, and research on human resources
Human resources
Human resources is a term used to describe the individuals who make up the workforce of an organization, although it is also applied in labor economics to, for example, business sectors or even whole nations...
for the health care
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...
sector. In recent years, raising awareness of the critical role of HRH in strengthening health system performance and improving population health outcomes has placed the health workforce high on the global health
Global health
Global health is the health of populations in a global context and transcends the perspectives and concerns of individual nations. Health problems that transcend national borders or have a global political and economic impact, are often emphasized...
agenda.
Global situation
The World Health Organization (WHO) estimates a shortage of almost 4.3 million physicians, midwives, nurses and support workers worldwide.”. The shortage is most severe in 57 of the poorest countries, especially in sub-Saharan Africa. The situation was declared on World Health Day 2006World Health Day
World Health Day is celebrated every year on 7 April, under the sponsorship of the World Health Organization .In 1948, the World Health Organization held the First World Health Assembly. The Assembly decided to celebrate 7 April of each year, with effect from 1950, as the World Health Day...
as a "health workforce crisis" – the result of decades of underinvestment in health worker education, training, wage
Wage
A wage is a compensation, usually financial, received by workers in exchange for their labor.Compensation in terms of wages is given to workers and compensation in terms of salary is given to employees...
s, working environment and management.
Shortages of skilled health workers are also reported in many specific care areas. For example, there is an estimated shortage of 1.18 million mental health professional
Mental health professional
A mental health professional is a health care practitioner who offers services for the purpose of improving an individual's mental health or to treat mental illness. This broad category includes psychiatrists, clinical psychologists, clinical social workers, psychiatric nurses, mental health...
s, including 55,000 psychiatrists, 628,000 nurses in mental health settings, and 493,000 psychosocial care providers needed to treat mental disorders in 144 low- and middle-income countries. Shortages of skilled birth attendants
Birth attendant
A birth attendant, also known as “skilled birth attendant” , is a midwife, physician, obstetrician, nurse, or other health care professional who provides basic and emergency health care services to women and their newborns during pregnancy, childbirth and the postpartum period...
in many developing countries remains an important barrier to improving maternal health
Maternal health
Maternal health refers to the health of women during pregnancy, childbirth, and the postpartum period. It encompasses the health care dimensions of family planning, preconception, prenatal, and postnatal care in order to reduce maternal morbidity and mortality.Preconception care can include...
outcomes. Many countries, both developed and developing, report maldistribution of skilled health workers leading to shortages in rural and underserved areas.
Regular statistical updates on the global HHR situation are collated in the WHO Global Atlas of the Health Workforce. However the evidence base remains fragmented and incomplete, largely related to weaknesses in the underlying human resource information systems
HRHIS
A “Human Resource for Health Information System” — also known within the health care sector as “human resource information system” — is a system for collecting, processing, managing and disseminating data and information on human resource for health...
(HRIS) within countries.
In order to learn from best practices in addressing health workforce challenges and strengthening the evidence base, an increasing number of HHR practitioners from around the world are focusing on issues such as HHR advocacy, surveillance and collaborative practice. Some examples of global HRH partnerships include:
Health workforce research
Health workforce research is the investigation of how social, economic, organizational, political and policy factors affect access to health care professionals, and how the organization and composition of the workforce itself can affect health care delivery, quality, equityHealth equity
Health equity refers to the study of differences in the quality of health and health care across different populations....
, and costs.
Many government health department
Health department
A health department or health ministry is a part of government which focuses on issues related to the general health of the citizenry. Subnational entities, such as states, counties and cities, often also operate a health department of their own...
s, academic institutions and related agencies have established research programs to identify and quantify the scope and nature of HHR problems leading to health policy in building an innovative and sustainable health services workforce in their jurisdiction. Some examples of HRH information and research dissemination programs include:
- Human Resources for Health journal
- HRH Knowledge Hub, University of New South Wales, Australia
- Center for Health Workforce Studies, University of Albany, New York
- Canadian Institute for Health Information: Spending and Health Workforce
- Public Health Foundation of India: Human Resources for Health in India
- National Human Resources for Health Observatory of Sudan
- OECD Human Resources for Health Care Study
Health workforce policy and planning
In some countries and jurisdictions, health workforce planning is distributed among labour marketLabour economics
Labor economics seeks to understand the functioning and dynamics of the market for labor. Labor markets function through the interaction of workers and employers...
participants. In others, there is an explicit policy or strategy adopted by governments and systems to plan for adequate numbers, distribution and quality of health workers to meet health care goals. For one, the International Council of Nurses
International Council of Nurses
The International Council of Nurses is a federation of more than 130 national nurses associations. It was founded in 1899 and was the first international organization for health care professionals...
reports:
The objective of HHRP [health human resources planning] is to provide the right number of health care workers with the right knowledge, skills, attitudes and qualifications, performing the right tasks in the right place at the right time to achieve the right predetermined health targets.
An essential component of planned HRH targets is supply and demand
Supply and demand
Supply and demand is an economic model of price determination in a market. It concludes that in a competitive market, the unit price for a particular good will vary until it settles at a point where the quantity demanded by consumers will equal the quantity supplied by producers , resulting in an...
modeling, or the use of appropriate data to link population health needs and/or health care delivery targets with human resources supply, distribution and productivity. The results are intended to be used to generate evidence-based policies to guide workforce sustainability. In resource-limited countries, HRH planning approaches are often driven by the needs of targeted programmes or projects, for example those responding to the Millennium Development Goals
Millennium Development Goals
The Millennium Development Goals are eight international development goals that all 193 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015...
.
The WHO Workload Indicators of Staffing Need (WISN) is an HRH planning and management tool that can be adapted to local circumstances. It provides health managers a systematic way to make staffing decisions in order to better manage their human resources, based on a health worker’s workload
Workload
-An amount of labor:While a precise definition of a workload is elusive, a commonly accepted definition is the hypothetical relationship between a group or individual human operator and task demands....
, with activity (time) standards applied for each workload component at a given health facility.
Global Code of Practice on the International Recruitment of Health Personnel
The main international policy framework for addressing shortages and maldistribution of health professionals is the Global Code of Practice on the International Recruitment of Health Personnel, adopted by the WHO's 63rd World Health AssemblyWorld Health Assembly
The World Health Assembly is the forum through which the World Health Organization is governed by its 194 member states. It is the world's highest health policy setting body and is composed of health ministers from member states....
in 2010. The Code was developed in a context of increasing debate on international health worker recruitment, especially in some higher income countries, and its impact on the ability of many developing countries to deliver primary health care
Primary health care
Primary health care, often abbreviated as “PHC”, has been defined as "essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost...
services. Although non-binding on Member States and recruitment agencies, the Code promotes principles and practices for the ethical international recruitment of health personnel. It also advocates the strengthening of health personnel information systems to support effective health workforce policies and planning in countries.
See also
- Health systems
- Health care providers
- Human resources for health information systemHRHISA “Human Resource for Health Information System” — also known within the health care sector as “human resource information system” — is a system for collecting, processing, managing and disseminating data and information on human resource for health...
s - Interprofessional education and collaborative practiceInterprofessional educationInterprofessional education refers to occasions when students from two or more professions in health and social care learn together during all or part of their professional training with the object of cultivating collaborative practice for providing client- or patient-centered health...
in health care - Doctor shortageDoctor shortagePhysician supply refers to the number of trained physicians working in a health care system or active in the labour market. The supply depends primarily on the number of graduates of medical schools in a country or jurisdiction, but also on the number who continue to practice medicine as a career...
/ Nursing shortageNursing shortageNursing shortage refers to a situation where the demand for nursing professionals, such as Registered Nurses , exceeds the supply, either locally , nationally or globally... - Human Resources for HealthHuman Resources for HealthHuman Resources for Health is a peer-reviewed, open-access, public health journal publishing original research and case studies on issues of information, planning, production, management, and governance of the health workforce, and their links with health care delivery and health outcomes,...
, open access journal - Canada’s Health Care Providers, 2007Canada's Health Care providers, 2007Canada’s Health Care Providers, 2007 is a reference on the country’s health care workforce. It looks at how the health provider landscape has evolved, examines the complexities of health human resources planning and management in the current environment and provides the latest information on supply...
, published by the Canadian Institute for Health Information - NHS National Workforce ProjectsNHS National Workforce ProjectsNHS National Workforce Projects was part of the English National Health Service . It provided support to all NHS organisations in planning their workforce to ensure they had the right staff in the right jobs to provide care to patients....
, part of the English National Health Service
External links
- World Health Organization programme of work on health human resources
- Human Resources for Health Databases, Canadian Institute for Health Information
- Human resources for health in developing countries – a dossier from the Institute for Development Studies
- Compendium of tools and guidelines for HRH situation analysis, planning, policies and management systems
- Online community of practice for HRH practitioners on strengthening health workforce information systems
- Human Resources for Health Global Resource Center- largest online collection of HRH research and materials, supported by the IntraHealth International-led CapacityPlus project
- HRIS strengthening implementation toolkit
- Africa Health Workforce Observatory
- CapacityPlus--the USAID-funded global project uniquely focused on the health workforce needed to achieve the Millennium Development Goals.