REQUIREMENTS FOR SUSTAINABLE INVESTIMENT IN HUMAN RESOURCES

Transcription

1 REQUIREMENTS FOR SUSTAINABLE INVESTIMENT IN HUMAN RESOURCES Dr. Charles M. Nzioka, MD, MPH International Workshop on improving Cooperation under Article X Council of European Union, Brussels th November 2009

2 Background Human Resources for Health(HRH) are a crucial element in delivery of public health services & the achievement of the Millenium Development Goals (MDGs) In Kenya, recent health sector studies acknowledge that HRH constraints are hampering: Health sector planning Effective health services delivery Attainment of critical health outcomes in Kenya

3 Background. Global Health Workforce levels Globally, data indicate: 13 physicians per 10,000 population with large variations bet. Countries & regions Globally, 28 nurses & midwives per 10,000 pop.(range Afr. 11/10,000 to 79/10,000 in European Region Africa, Only 2 physicians/ 10,000 compared with 32/10,000 European Region In Kenya, Only 1 physician /10,000 and 12 nurses & midwives/ 10,000 population.

4 Kenya Health Workforce Levels Kenya s Levels(doctors,nurses,midwives) 15/10,000 pop. Who recommended minimum staffing levels(doc, nurses & midwives) 23/10,000 pop. Countries with fewer than 23 health care professionals per 10,000 pop. unlikely to achieve adequate coverage rates for key primary health care interventions prioritized by Millenium Development Goals Increase required in Kenya to achieve minimum recommended level s by 53%

5 Public Health Surveillance Ongoing, systematic collection, analysis & interpretation of health related data essential to the planning, implementation and evaluation of public health practice, closely integrated with timely dissemination of these data to those responsible for prevention & control WHO definition Information for Action

6 Outbreaks reported in Kenya in 2009 Cholera: Cumulatively affected 39 districts with total of 9029 cases, 198 deaths, CFR 2.2% (Jan Oct.2009) Polio: 18 confirmed cases in three districts(feb. July 2009), No deaths Pandemic influenza A H1N1: A total 206 laboratory confirmed cases reported, No deaths Measles: Few cases reported in Dadaab refugee camp, No deaths Constant threat of biological, chemical, nuclear & other infectious dxs (unstable neighbours)

7 Resurgence of Cholera in Kenya, Trends Cases Deaths CFR * Cases Deaths CFR ** * Cases and death by 29/8/ 2008 ** Cases and deaths by 26/10/2009 reported in 39 districts

8 Percentage of Under 5 years Children with AFP and 3+ Doses of OPV by Province, Kenya, 27 th May 2008 to 26 th May 2009 Vaccination status of AFP Cases in 4 out of 8 provinces are lower than expected minimum (80%) for the country Western Nyanza Rift Valley Eastern Central North Eastern Nairobi Coast * Unknown vaccination status of AFP excluded from calculation

9 Public Health surveillance & HRH Public health surveillance is reliant on human resources for efficiency and effectiveness Key Human Resources for Health (HRH) challenges include: Staff shortages Inequitable distribution Insufficiently trained Demotivated staff High attrition especially in hard to reach areas Out migration of health staff (nurses & doctors) to West (Benefits package) Weak leadership & management capacity

10 Staff Level of Motivation in performing Surveillance tasks Staff Level of motivation at health facility level (N=135) Percent Not Motivated Fairly Motivated Highly Motivated Motivation level Results indicate that about 18% of the health facility staffs are highly motivated to do surveillance tasks, 51% are fairly motivated while 31% are not motivated at all. This data was gathered from 10 districts and 135 health facilities in Kenya 2008

11 Main Reasons for De Motivation Reasons for De-motivation Frequency (N=151) Percent 1 Lack of resources for public health surveillance (Lack of airtime etc) High workload due to staff shortage Lack IDSR Training and updates Lack of feedback reports Other reasons Total Results from 10 districts and 135 health facilities in 2008 indicate that high workload due to shortage of health facility staffs is the second main reason for de motivation in carrying out Public health surveillance in Kenya.

12 Human Resources for Surveillance Limited human resources capacity for public health surveillance with relevant skills in developing countries ( Freeze on employment, Insufficient training preservice & in service) Partners often supplement HR capacity WHO, UNICEF, Red Cross, MSF, Global Fund, Clinton found) Recruitment Offer training opportunities Laboratories with relevant infrastructure & more qualified staff have motivated staff & give more reliable diagnostic results for response

13 H1N1/AI/ZOONOSES/IHR/IDSR and Animal Disease Surveillance TODAY IHR IDSR H1N1/AI/ OTHER ZOONOSES

14 Opportunities One health approach A multisectoral approach in dealing with emerging & reemerging diseases Public/Private partnerships(ppp) Strengthening can mobilise useful human resources for public health good New technology in public health surveillance. E.g.Mobile phone technology for reporting, PDA, etc

15 Strategies for Human resource for surveillance & response Training programmes Access to career structures for development Recruitment based on need & job requirements Deployment with emphasis on equitable distribution Sharing opportunities /Interaction with professional peers in conferences Review of Pre service & in service training to include applied epidemiology & relevant dx. surveillance & outbreak response skills Motivation & compensation mechanisms Community linkages CORPS

16 Staff Cadres for capacity development for surveillance & response Health managers/ leaders Epidemiologists Surveillance officers Data managers & Data officers Laboratory officers Quality assurance/control officers Field officers for community based surveillance

17 Possible areas of cooperation Training Mentorship/Coaching Recruitment Collaboration & technology transfer Collaboration between institutions in developing & developed countries Best practice/twinning Knowledge exchange visits

18 Conclusions H Resources are a prerequisite for the success or failure of any public health surveillance system to meet its objectives Need for well trained network of highly motivated staff. Adequate strategies put in place to attract, recruit adequate and retain high caliber staff HR develoment should encompass a wider remit including training, career structures and professional development Developing and developed countries need each other and should strengthen & sustain cooperation in investiment for developing human resource capacities for effective surveillance, detection, diagnosis and containment

19 Thank you