HRH

1. Human resource for
health
SAID MOALIM MBBS, MPH.
December, 2020

2. Lecture objective
At the end of this lecturer, the student should be able to:
 Define human resources management
 Explain the mechanisms the components of HRM
 Theories related motivation of employee

3. Definition
 Human Resources for Health (HRH) is defined by the
World Health Organization as "all people engaged in
actions whose primary intent is to enhance health."
Health workforce is another way to refer to HRH.
 The HRM is the process of planning, attracting,
developing, and retaining the human resources
(employees) of an organization.

4. Health workers cadres
 Health worker cadres include physicians, nurses,
midwives, dentists, allied health professionals such as
pharmacy and laboratory technicians, and community
health workers.
 In addition to these health service providers, it also
includes health managers, medical records managers,
health informaticians, health economists, health supply
chain managers, and other health management and
support workers, as well as private-sector workers and
owners of small drug shops and pharmacies who may
provide access to health services.

5. The value of investing the
health workforce
 Improved health outcomes Health workers drive health
systems to deliver health care services
 Global health security skilled health workers improve
health systems resilience and responsiveness
 Economic growth: A community's productivity is greater
when it is healthy

6. Human Resources Management
components
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HR Planning
strategic HR planning;
job design
Attracting
employees
recruiting; selecting
Developing
employees
training & development;
performance appraisal
Retaining
employees
compensation;
maintenance; labor
relations; separation

7. HR Planning
 Estimating requirement of human resources for health
 Human resource planning includes the estimation of
numbers and categories of personnel required both in the
immediate and long term and the allocation of resources to
train and pay these staff. There are four methods used in
calculating health personnel requirements. These are:
 Health-needs approach
 The approach is based on assessments by experts of the
future health needs of a population that is based on
demographic and epidemiological forecasts.
 Health care demands or utilization method
 The health staff requirement is estimated by taking into
account the effective demand, i.e. utilization of services.

8. HR planning
 Human resource to population ratios
 The number of health workers required is calculated
taking into account the population to be served, based
on desired empirical or normative population to health
worker ratios.
 Service targets
 The approach involves the setting up of specific health-
service targets and then assesses the personnel
requirement to accomplish each of these by taking into
account priorities, health needs and technical and
financial feasibility of providing the services.

9. HRH strategy

10. Providing job description
and contracts
 Every employee should be provided with a job
description. This is a valuable tool for management of
work.
 Job descriptions state clearly what each worker is
expected to do and prevent arguments on who should
do what.
 They also facilitate the process of staff appraisal.
 A job description will contain the following:

11. CONTENTS OF A JOB DESCRIPTION
Job title Title of person doing the job, for example:
“Nurse”.
Date The date the job description is approved, since it will be
revised with time.
Job summary This is a list of the main responsibilities.
Duties Each duty should be an identifiable entry, a
recognizable part of the job. Each duty should
correspond to one or more programme
objectives.
Relations This is related to the position to which the
holder is accountable, as well as the positions, if
any, he is to supervise.
Qualifications Describes required qualifications and level of
experience.
Training and
development
Indicates training needs as worked out with job
holder.

12. Contract
 This is a binding agreement between two or more parties, e.g. an
employee and an employer to perform given tasks. A contract indicates
conditions to be fulfilled by both parties. In the HRH management context
it entails the employee to fulfill job performance conditions and the
employer to abide to remuneration and other motivational aspects. All
these are regulated by legal and civil service regulations in most
countries.
 Components of a contract may include:
 Terms of service;
 Expected output;
 Remuneration package;
 Contract period;
 Consequences and arbitration in case of breach of contract.

13. Job induction and orientation
 Job orientation is familiarization of a health worker to the new working
environment.
 This is necessary for the fact that performing one’s duties is determined
by training and also by tradition and experience.
 For example, a midwife who operates in a village will operate differently
from the one in the hospital.
 The requirements of the programme will also determine the desired
duties and responsibilities.
 Each worker should be provided with norms and standards to be applied
when carrying out the tasks expected of him or her.
 Norms and standards translate health objectives and targets of health
teams to the amount of work and quality of care expected of each health
worker.

14. Recruitment and selection
for vacant posts
 Recruitment is the process of finding and attracting the
right people to fill jobs that are vacant. Selection is
filling the position with the right person.
 The administration should use the following steps for
selection and recruitment:

15. - Teachers
Pipeline to generate and recruit
the health workforce
Attract Retain Educate Train Certify Recruit Deploy Retain
Quality Quality

16. Attracting Employees
 Selection
the mutual process whereby the
organization decides to make a
job offer and the candidate
decides whether or not to accept
it.
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17. Process of selection
Preliminary Interview
Selection tests
Employment Interview
Reference & background
Selection Decision
Medical Examination
Job Offer
Employment Contract
Evaluation
R
E
J
C
T
E
D

18. Steps in selection
18Job Application
Initial Interview
Testing
Background Investigation
In-depth Interview
Physical Exam
Job Offer

19. Developing Employees
 Orientation
a program designed to help
employees fit smoothly into an
organization
 Development
 a process designed to develop skills and attitudes
necessary for future work
 Training
 a process designed to maintain or improve current
employee performance
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20. Developing Employees
Types of training
Newly hired staff basic skills for their new position
Existing staff of growing orgs more training/new skills
Refresher training reinforce and update skills.
motivation /development
Training can be
FORMAL Away from the job (one day - months)
INFORMAL On the job instruction (continuous)
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21. Performance Appraisal
 Staff performance is appraised in order that staff may
learn from experience and therefore improve or
maintain satisfactory levels of performance.
 The purpose of Appraisal is to:
 Identify employees’ current levels of job performance.
 Identify employees’ strengths and weaknesses in order
to determine individual’s and organization’s training
needs.
 Assess the employee’s level of contribution as a basis
for determining salary/wage increments.

22. Performance Appraisal
cont…d
 The appraisal process involves the following steps:
 Deciding what aspects of performance to appraise;
 Collecting the information needed to measure
performance;
 Comparing the results with relevant norms;
 Judging the degree to which norms are met;
 Deciding what to do next.

23. Performance development
 The following promising practices describe approaches and interventions
that can optimize health worker performance, quality, and impact based
on where currently practicing health workers are located.
 Identify health needs and service coverage
 Address HRH productivity and performance at the district and service
delivery levels
 Implement supportive supervision
 Extend services through task sharing and/or differentiated care
 Harness appropriate technologies

24. Retaining Employees
Compensation
 the adequate and equitable remuneration of personnel for their contribution in
the achievement of organization objectives.
Maintenance
 the process of providing the following services to employees:
 career counselling
 safety & health programs
 Also involves the minimization of absenteeism and tardiness
Separation
 the process of reintregrating employees to society
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25. Intervention
type
Examples
Education •Recruit students from rural backgrounds
•Locate health professional schools outside of major cities
•Conduct clinical rotations in rural areas during studies
•Develop/revise curricula to reflect rural health issues
•Promote continuous professional development for rural health
workers
Regulation • Enhance rural health workers’ scope of practice to empower
and satisfy them at their jobs
• Scale up the training of different (less specialized) health
workers
• Introduce compulsory service schemes to work in underserved
areas
• Subsidized education for return of service in underserved areas
• Ensure job security
Financial
incentives
• Provide appropriate financial incentives, such as hardship
allowances, housing grants, or transport to outweigh perceived
opportunity costs associated with rural posts
Professional and
personal
support
• Provide better living conditions, including sanitation, electricity,
telecommunications, and schools for children and family
• Provide career development programs and continuing
professional development so rural health workers can advance

26. Career pathways

27. Organizational-level
interventions to improve staffing
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Increase entrants Reduce losses
Improve distribution
Develop partnerships
(MoH, other sectors,
NGOs, FBOs
non-formal providers)
Improve productivity
Change skills mix
(inc. volunteers)

28. Theory of Workforce Motivation
Motivator Factors
 Achievement
 Recognition
 Work Itself
 Responsibility
 Promotion
 Growth

29. Theory of Workforce Motivation
Hygiene Factors
 Pay and Benefits
 Company Policy and Administration
 Relationships with co-workers
 Physical Environment
 Supervision
 Status
 Job Security

30. What an employee expects
1. Work that enables me to learn and grow
2. Work that is personally stimulating
3. Workplace that is enjoyable
4. Comprehensive benefits package
5. Flexible work schedule
6. Work that is worthwhile to society
7. Increment in compensation
8. Flexible workplace
9. Paid vacation
10. Comprehensive retirement package
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31. Thank you