Introduction to health workforce development

Health promotion

21 June 2021

Measuring health and disease

21 June 2021

This version of the Introduction to Health Workforce Development modules was developed in 2018.

It is in many respects a continuation of the School’s Management Strategies Masters core module. The latter introduces students to several ways of thinking about health systems and the centrality of people in health systems – such the the WHO building block model, van Olmen et al’s health systems framework, and Sheikh et al’s distinction between the hardware and the software of the system (if these ideas and concepts have slipped from your memory, just take the module of the shelf and read the first few pages of Unit 1, Session 1).

This module deepens this work by getting to know Health Workforce Development (HWD) or Human Resource Development (HRD) as a sub-discipline of health systems development and research.

Health workers are all people staffing our health systems: from the volunteer assisting sick people in her neighbourhood or teaching new mothers how to breastfeed, to the heart specialist in an academic hospital; from the nurses staffing health posts, clinics and hospital wards, to district managers and officials in the Ministry of Health; from the cleaners and general assistants to the general practitioners in private practice.

HWD is concerned with how we decide what type of health workers we entrust with our health care; how we select the women and men who become health workers; how we train them, support them, care for them and hold them to account.

Even more than the other “resources” in the health system (as in any other system), health workers need to be very carefully prepared, managed and supported. Not only is the workforce the most valuable and important asset of any health system. It also requires planning well ahead of time. And, most importantly, “human resources” are all of us: managers, frontline staff, volunteers, policy makers, educators; our colleagues, our neighbours, our husbands and wives. While we entrust them with the health of our communities and expect them to be skilled, productive, compassionate and patient, we must not forget that they have families to look after, career aspirations, their own life histories. And if we want them to be skilled, productive and compassionate, we have to ensure that their work and life environment, their training and the support they receive allow them to be so.

Health Workforce Development is a broad field of practice and of study. This module provides an introduction to and an overview of this field.

With the growing acknowledgement of the importance of HWD, there have been many debates and models, which have suggested different ways of how to conceptually think about health workers and health workforce development. For a long time the most common conceptualisation, reflected in the structural arrangements in many ministries, has been between human resource planning, human resource production, and human resource management. The 2006 World Health Report, which focussed on HRD, took a slightly different approach and has since influenced the discourse and the structure of debates. It talks about health workforce development and distinguishes between planning and preparing, managing and exiting the workforce.

A more recent development has been to think of human resources as key to “people-centred health systems, i.e. as integral to and part of the health system as a whole. You will be introduced to these concepts in the first session of the module.

This module borrowed from and married all these lenses and approaches:

Unit 1, Understanding Health workforce Development, will introduce the subject, and place HWD in the context of health systems development and health sector transformation, and the importance of HWD in acute health crises.
Units 2, Planning and Preparing the Health Workforce, introduces the “front end” of human resource processes: how to think about issues of distribution, staff and skills mix, task shifting, attrition; and capacity development.
Unit 3, on Health Workforce Monitoring, will provide an overview and introduction to M&E for health workforce development at different levels of the health system. And you will delve a bit deeper into specific HRH research topics and methodologies.

Module Outline

UNIT 1	UNDERSTANDING HUMAN RESOURCE DEVELOPMENT FOR HEALTH
Study Session 1	Thinking about the health workforce
Study Session 2	Health workforce challenges in Africa – past and present
Study Session 3	Health workforce crises and resilience (includes discussion group)
Study Session 4	Health workforce development in Cuba – a success story

UNIT 2	PLANNING AND SUPPORTING THE HEALTH WORKFORCE
Study Session 1	Mapping the HR landscape
Study Session 2	Planning the health workforce (includes discussion group)
Study Session 3	Addressing shortages and imbalances
Study Session 4	Building capacity through training and supervision (includes discussion group)

UNIT 3	HRH MONITORING AND RESEARCH
Study Session 1	Research lenses in HWD: what questions to ask? (includes discussion group)
Study Session 2	What about health workforce data? Sources, availability, use.
Study Session 3	Evaluation and research – similarities, differences, uses (includes discussion group)
Study Session 4	Skills session: how to write a policy brief
	Total estimated hours

Learning Outcomes

This module is intended to assist you in developing skills and knowledge for health workforce development for the health system.

By the end of this module, you should be able to:

Demonstrate an understanding of the key components of HWD;
Demonstrate an understanding of the role of HWD in the health system;
Discuss HWD in the context of health sector reform;
Demonstrate an understanding of HRH challenges in an international context;
Locate your own country’s HRH situation in an international context;
Appreciate the importance of and challenges faced by health workers in acute crisis situations;
Understand the key features of the Cuban health system;
Be able to discuss and debate Cuba’s approach to health workforce development;
Demonstrate a contextual understanding of health human resource policy and planning processes and elements;
Explain and critique major HR planning methods;
Conduct a human resource study for your organisation;
Understand the “size and shape” of workforce shortages within countries;
Understand the complexity and diversity of mid-level and community health worker programmes;
Be able to critically engage with the rationale, benefits and pitfalls of task shifting.
Understand the extent and training capacity shortages in Africa;
Understand some of the key reasons for these shortages;
Discuss how innovations in health worker education can address these shortages.
Explain the elements of a supportive supervisory system.
Demonstrate an insight into the rationale and scope of monitoring and evaluation of HRH
Develop some M&E questions in the context of your organization.
Distinguish HR evaluation and research;
Read HR research critically and with understanding;
Write a policy brief