Human Resource Management in

the Health Sector

By:- Yemane G/mariam (MPH in HSM)

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 Learning objectives

At the end of this session, students will

be able to:
 Describe the role of human resource
Management
 Identify basic steps in human resource
planning
 Understand the advantages and limitations
of performance appraisal

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 HRM function

 It is a process of estimating the number of persons

and the kind of knowledge, skills and attitudes they
need to achieve predetermined health targets.
 Involves specifying who is going to do what , when
, where , how and with what resources for what
population group or individuals.
 The planning must be a continuing and not a
sporadic process. And it requires continuous M&E.
 Hall describes the health human resource process
as involving three major and interrelated steps:
planning, production, and management
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 Staffing activities
A time flow of distinct phases
Acquisition :- Separation :
 human resource planning , Retirement,

 Recruitment Resignation,
 Selection and orientation Discharge and
Retention and maintenance:- Death
 Performance appraisal ,

 Placement training and development ,

 Discipline( corrective actions),

 Compensation and benefit administration ,

 Employees assistance and career development

 Safety and health

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HRP
 Human resource planning ensures that the
organization have the right number of people ,
appropriate qualification and skills and delivers
appropriate levels of quality of services.
It involves five steps
 Profiling

 Estimating

 Inventorying

 Forecasting

 Planning

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 Step 1 :-profiling
 Initial step is to profile the HSO/HS at some future
point
 Estimating the number and type of job (skills)

 Subjective but anticipated demand for service

change in profession profile or labor supply
 Staffing for new technology can be taken into
account.
Step 2 :- estimating
Consider expected change, new services, reengineering
initiatives, or strategic organizational change

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 Estimating Cont’d…
 There is no perfect way to model/project HR
 The conceptual basis for planning depends on:

a) Do we want to know how many health workers are

required to continue serving the population in the
way it is currently being served (utilization based
approach)?
b) How many are needed to support the services
required to meet all or a proportion of the expected
needs of the population(needs-based approach)?
c) How many health workers are required to satisfy the
expected demand for the future provision of the
health care services (`effective demand’-based
approach)?
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Step 3 :- inventorying
 In many African countries, the current
status of health workers in terms of their
numbers and categories, patterns of
distribution, patterns of practice and
attrition rates is not well-documented.
 Present employees and their skills
 Talent inventorying, conducting HR audit
 Skills , abilities and potential and how are
they being used, training need, career path

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 Step 4: Forecasting
 An assessment of changes in the present
work force
 Entries Vs Exit or transfers
 Consider promotion

Step 5 Planning
 Assumption + information are bases for
planning
 Step 1 through step 4 are the bases for
planning
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Human resources sources
From external and internal
 Internal (feeling HSOs vacancy by transferring or
promoting)
Advantages
 Cost effective, quicker and reduces recruiting and
relocation costs and enhances employee’s morale
Disadvantages discuss
 External (labor market supply : outside of the
organization
 Advertising . pass the work to potential employees,

What are the major recruitment problems in the

health sector?
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 JOB analysis and description
 Job analysis : observing and studying a
job to determine its contents (duties &
responsibilities)
 Conditions under which it is performed
 Its relationships to other jobs
 Analysis results
 Identifying skills, training, and abilities
 Is the source for developing job
description
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 JOB description
Varies from organization to organization. It
includes
 Job title
 Locations
 Job summary
 5-9 general duties and responsibilities
 supervision given/received
 special work conditions >
hazards/classifications
 qualification : minimum education, training ,
experiences , demonstrated skills is required
 should be continuously updated
 fundamental document in legal disputes
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 Recruitment
Recruitment :
 Searching for and attracting prospective
employees
Selection
 Select from among using job description or
qualification as a guide
 Basic source of information
 Application form
 Pre employment interview & Testing
 Application form and pre employment
interviews
 Education , Training
 Previous employment

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Orientation
Induction and orientation
Follows selection
 Induction: ensuring that employee can
perform the job with out danger to them selves
and clients
 Orientation: Physical Information about the
physical facility organizational structure
Advantages :gives a clear understanding of what
they need to know

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 Retaining employees
 HRM maintenance and retention activities
occur throughout the term of employment.
These activities include
 Appraising each employees job performance
 Moving employees within the organization
through promotion, demotion and transfer
 Disciplinary counseling and separation when
necessary (hire and fire)
 Administering compensation and benefits
 Providing employee assistance and career
counseling
 Ensuring healthful workplace and personal
safety
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 Retaining employees cont…
Performance appraisal
 The results of performance appraisal has many
uses
 Determining whether individual work results
are consistent with expectations
 Provide feedback for both the employee and
supervisor
 Identify high, marginal and unsatisfactory
performers
 Less than satisfactory performance :

 Lack of technical job skills

 Poor process or job design
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Performance appraisal cont…
 Identify potential and desirable
employee movement within the
organization
 Providing information for
compensation
 Provide information for employee
assistance and counseling
 Virtually the HRM retention
activities are linked to performance
appraisal
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Performance appraisal cont…
Appraisal Methods
There are many approaches
 Rating scales
 Person to person comparison

 Check list

 Critical incidence methods

Most common method is rating scale method

which filled by the manager

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Performance appraisal cont…
The scale typically specifies
1. Personal traits and behaviors such as
cooperativeness , dependability ,
initiatives , judgments, and attitude.
2. Job dimension attributes , such as the
quantity of work, quality of work, and job
knowledge.
 For each scale there are usually a scoring
mechanisms using descriptive adjectives

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 Performance appraisal cont…
Other approaches
 Inputs from peers and subordinates
 Self appraisal and customers

Benefits of Systematic appraisal

 It provides a standard format by which managers
through out the organization assess the employee’s
performance.
 It also forces the managers to observe how well
employees are performing and to consider what can
be done to improve performance
 Employees have the right to know how well they are
performing
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 Appraisal problems
 Managers don’t agree on the definitions of terms
 One managers appraisal of employees may be
more critical than another's
 Some don’t give low ratings because they are
afraid of antagonizing subordinates
 Low ratings may be reflecting negatively on
managers performance
 Rate perceptual biases--no one is “excellent”

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 Training and Development
Training program
 A design to maintain or improve current job
performance
 Development program
 Develop skill necessary for future work activities
Procedures to determine training needs
1. Performance appraisal
2. Analysis of job requirement
1. Skills and knowledge specified are examined
3. Organizational analysis
1. Effectiveness of the organization in meeting its
goals are analyzed to determine where differences
exist
4. Employee survey
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 Training and Development cont…
On the Job Training
 Job rotations

 Employee works on a series of job ->period of time

 Internship: combined with classroom instruction

 Apprenticeships: trained under highly skilled

coworker
 Off the job training :Takes place outside the
workplace but attempts to simulate activities in
working condition

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 Compensation administration
 Is one of the most important aspect of maintaining
and retaining
 Wages, salaries, and fringe benefits

 It affects the organization ability to attract and retain

qualified employees.
Work place health and safety
 Major contributing factor for retaining a work force

 Responsibility of the employers to provide a secure

and safe work place for their employees and
customers

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 Discipline (Corrective counseling )
 Used to be associated with punishment
 Means corrective counseling
 Procedures
 Should be based on facts with clear and demonstrable
justifications
 Treated consistently

 Progressive and related to behavior

 Unrecorded oral warning

 Oral warning noted in the employment record

 Written warning noted in the employment record

 Suspension from the job

 Discharge . FOLLOW the 1994 /2002 CPA Regulations

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Separation from employment
 Why employees leave HSOs/HO?
For various reasons
 Better salary
 Discharge
 Retirement or death etc
 Pre retirement planning :is to prepare employees
for changes at retirement

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Group exercise
The key challenges I Ethiopian Situation

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 References
 Dovlo D. The Health Workforce in Africa: Challenges and
Prospects. A report of the Africa Working Group of the
Joint Learning Initiative on Human Resources. WHO,
World Bank & Rockefeller Foundation. Global Health
Trust. March 2004b.
 FMOH (2003) HSDP I Review
 Beaufort L etal managing health service organizations and
systems 4th edition,2000
 Joint learning initiatives(2004) human resource for health
overcoming the crisis,Harvard USA.
 Green, A. (1999). An Introduction to Health Planning in
Developing Countries, 2nd ed. Oxford University Press
 Hornby, P., Ray, D.K., Shipp, P. & Hall, T.L. (1998).
Workload Indicators of Staffing Needs (WISN): a Manual
for Implementation. Geneva:
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WHO. 30
 Thank u
I can not spell S CCESS with out U

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