Follow-up on commitments at the Third Global Forum on Human Resources for Health: Indonesia, Sudan, Tanzania

Abstract

This study sought to assess actions which Indonesia, Sudan, and Tanzania took to implement the health workforce commitments they made at the Third Global Forum on Human Resources for Health (HRH) in November 2013. The study was conducted through a survey of published and gray literature in English and field research consisting of direct contacts with relevant ministries and agencies. Results show that the three countries implemented interventions to translate their commitments into actions. The three countries focused their commitments on improving the availability, geographical accessibility, quality of education, and performance of health workers. The implementation of the Recife commitments primarily entailed initiatives at the central level, such as the adoption of new legislation or the development of accreditation mechanisms. This study shows that action is more likely to take place when policy documents explicitly recognize and document HRH problems, when stakeholders are involved in the formulation and the implementation of policy changes, and when external support is available. The Recife Forum appears to have created an opportunity to advance the HRH policy agenda, and advocates of health workforce development in these three countries took advantage of it.

Human resource for health reform in peri-urban areas: a cross-sectional study of the impact of policy interventions on healthcare workers in Epworth, Zimbabwe

“…They also helped in community mobilization for interventions that include immunization, advocating for safe water and sanitation and health education and awareness [16]. The presence of CHWs not only facilitates the implementation of health interventions but also contributes towards improving the equitable distribution, availability, and accessibility of healthcare workers as prescribed by the 2030 Global Health Workforce Strategy in the pursuit of goals 3 and 11 of the 2030 Sustainable Development Agenda and the health sector reform goal of universal health coverage as prescribed through Resolution WHA 67.24 by the World Health Organization [3][4][5]. However, CHWs in peri-urban areas experience challenges that undermine their effectiveness.…”

“…This was also helped by some financial and material support from community members in the form of food, help with farm work, and payment for services received [17]. These interventions can also help community health voluntary work in the pursuit of the 2030 Global Health Workforce Strategy, the 2030 Sustainable Development Goals, and universal health coverage in peri-urban areas [3][4][5].…”

“…The payment of salary top-up allowances is the main financial incentive often used in healthcare worker reform interventions. In Malawi, salary top-up allowances that were paid to healthcare workers facilitated the implementation of the 6-year Emergency Human Resources Programme that helped alleviate the healthcare worker crisis in 2005 [4]. An almost similar strategy was implemented in Kenya where the Government introduced additional "extraneous" and "non-practicing" allowances for healthcare workers deployed in under-supplied areas.…”

“…Our findings revealed that despite having been denominated in the US dollars (US$), the salaries were not adequate to meet all basic expenses each month. The payment of lower salaries by the local private sector, lack of satisfaction with the salary grading system, and failure to pay salary top-up allowances to all healthcare workers at local public clinics compounded this challenge [4]. In Mali and Sierra Leone, it was established that adequate salaries not only are a source of health personnel motivation but also helps towards their retention in resource-constrained communities [19,20].…”

“…Progress made through resolution WHA67.24 on Follow-up of the Recife Political Declaration on Human Resources for Health: renewed commitments towards universal health coverage adopted in May 2014 and the World Health Report of December 2016 on Working for Health and Growth: Investing in the health workforce has contributed towards the agenda articulated by the 2030 Global Health Workforce Strategy [3][4][5]. From this, whilst equitable distribution, availability, accessibility, competency, and motivation are priorities for health systems, this has also presented an opportunity to advance further towards more responsive human resource for health reform interventions in peri-urban areas [5].…”