Improving health workforce governance: the role of multi-stakeholder coordination mechanisms and human resources for health units in ministries of health

Martineau, Tim ORCID: https://orcid.org/0000-0003-4833-3149, Ozano, Kim, Raven, Joanna ORCID: https://orcid.org/0000-0002-4112-6959, Mansour, Wesam, Bay, Fiona, Nkhoma, Dominic, Badr, Elsheikh, Baral, Sushil, Regmi, Shophika and Caffrey, Margaret (2022) 'Improving health workforce governance: the role of multi-stakeholder coordination mechanisms and human resources for health units in ministries of health'. Human Resources for Health, Vol 20, e47.

Preview

Text s12960-022-00742-z.pdf - Published Version Available under License Creative Commons Attribution. Download (1MB) | Preview

Abstract

Background
A cohesive and strategic governance approach is needed to improve the health workforce (HW). To achieve this, the WHO Global Strategy on Human Resources for Health (HRH) promotes mechanisms to coordinate HRH stakeholders, HRH structures and capacity within the health sector to support the development and implementation of a comprehensive HW agenda and regular reporting through WHO’s National Health Workforce Accounts (NHWA).

Methods
Using an adapted HRH governance framework for guidance and analysis, we explored the existence and operation of HRH coordination mechanisms and HRH structures in Malawi, Nepal, Sudan and additionally from a global perspective through 28 key informant interviews and a review of 165 documents.

Results
A unified approach is needed for the coordination of stakeholders who support the timely development and oversight of an appropriate costed HRH strategy subsequently implemented and monitored by an HRH unit. Multiple HRH stakeholder coordination mechanisms co-exist, but the broader, embedded mechanisms seemed more likely to support and sustain a comprehensive intersectoral HW agenda. Including all stakeholders is challenging and the private sector and civil society were noted for their absence. The credibility of coordination mechanisms increases participation. Factors contributing to credibility included: high-level leadership, organisational support and the generation and availability of timely HRH data and clear ownership by the ministry of health.

HRH units were identified in two study countries and were reported to exist in many countries, but were not necessarily functional. There is a lack of specialist knowledge needed for the planning and management of the HW amongst staff in HRH units or equivalent structures, coupled with high turnover in many countries. Donor support has helped with provision of technical expertise and HRH data systems, though the benefits may not be sustained.

Conclusion
While is it important to monitor the existence of HRH coordination mechanisms and HRH structure through the NHWA, improved ‘health workforce literacy’ for both stakeholders and operational HRH staff and a deeper understanding of the operation of these functions is needed to strengthen their contribution to HW governance and ultimately, wider health goals.

Item Type:	Article
Subjects:	W General Medicine. Health Professions > W 21.5 Allied health personnel. Allied health professions W General Medicine. Health Professions > W 21 Medicine as a profession. WA Public Health > WA 20.5 Research (General) WA Public Health > Health Administration and Organization > WA 540 National and state health administration WA Public Health > Health Administration and Organization > WA 546 Local Health Administration. Community Health Services
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1186/s12960-022-00742-z
Depositing User:	Jan Randles
Date Deposited:	09 Jun 2022 13:41
Last Modified:	09 Jun 2022 13:41
URI:	https://archive.lstmed.ac.uk/id/eprint/20476

Statistics

View details

Actions (login required)

Edit Item