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Welcome to week five

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Welcome to week 5, during which we will be discussing human resources for

health. Human resources are at the centre of health systems. Clearly, service
delivery requires interaction between a patient and a health professional, and
much discussion of human resources focuses on health professionals who are
directly involved in those interactions - doctors, nurses, midwives,
pharmacists, and others.

But equally, the other elements of health systems are dependent on human
resources. Essential medicines will only be available if people have selected,
procured, and ensured the timely and effective distribution of those medicines
to the clinicians who will prescribe and dispense them. Finances will only flow
as needed for all health system functions if people have designed the system,
collected revenues, and ensured availability of funds for salaries, medicines,
and other health system needs. The whole system can only function smoothly if
it is well-managed by people.

People with the right skills to undertake all these functions are in short supply
in many health systems. What numbers exist suggest that the availability of
staff for management, leadership, and other non-clinical functions is even
more skewed in favour of richer countries, but has received much less
attention. There are also differences in levels of unemployment among health
professionals in different countries which brings two separate problems which
we’ll discuss in the first part of the week.

Health systems differ in how they define the professional categories that make
up the health workforce. In some countries like South Africa, midwifery is a
specialisation within nursing, rather than a separate profession, for example.
Role changes for a profession may also occur informally, but there has been
some impetus to formalise that process, recognising the roles that some staff
play beyond their formal job descriptions and rewriting those job descriptions,
researching the safety and effectiveness of the distribution of tasks, improving
the training provided to promote safety and effectiveness, and standardising
how tasks are distributed. The second part of the week will address these
issues.

How and how much people are paid are clearly among the issues that matter to
health professionals, just like everyone else. Health workers don’t follow orders
blindly. And they don’t only think of the good of others. Like the rest of us, they
are human and trying to look after themselves and their families while
navigating their roles in the health sector.

Finally, we’ll discuss what we know about how management of the health
workforce is implicated in how well it performs. Managers are, themselves,
human resources in the system, are equally human, and their perspectives and
the factors influencing how they go about managing have much in parallel with
how front-line professions go about delivering care. We’ll finish the week by
addressing these issues and considering the best ways to tackle them.

© Nossal Institute for Global Health at the University of Melbourne

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The composition and distribution of the health workforcevideo
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