Analysing public sector institutional capacity for health workforce governance in the South-East Asia region of WHO.

BACKGROUND: In order to analyse the institutional capacity for health workforce policy development and implementation in countries in the South-East Asia region, the WHO facilitated a cross-sectional analysis of functions performed, structure, personnel, management and information systems of human resources for health (HRH) units in Ministries of Health. CASE PRESENTATION: A self-assessment survey on the characteristics and roles of HRH units was administered to relevant Government officials; the responses were validated through face-to-face workshops and by the WHO staff. Findings were tabulated to produce frequency distributions of the variables examined, and qualitative elements categorized according to a framework for capacity building in the health sector. Ten countries out of the 11 in the region responded to the survey. Seven out of 10 reported having an HRH unit, though their scope, roles, capacity and size displayed considerable variability. Some functions (such as planning and health workforce data management) were reportedly carried out in all countries, while others (inter-sectoral coordination, research, labour relations) were only performed in few. DISCUSSION AND CONCLUSIONS: The strengthening of the HRH governance capacity in countries should follow a logical hierarchy, identifying first and foremost the essential functions that the public sector is expected to perform to optimize HRH governance. The definition of expected roles and functions will in turn allow identifying the upstream system-wide factors and the downstream capacity requirements for the strengthening of the HRH units. The focus should ultimately be on ensuring that all the key strategic functions are performed to quality standards, irrespective of institutional arrangements.

Follow-up on commitments at the Third Global Forum on Human Resources for Health: Indonesia, Sudan, Tanzania : "A commitment is a promise, a promise is a debt".

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.