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Strategic management of the health workforce in developing countries: what have we learned?

Fritzen SA - Hum Resour Health (2007)

Bottom Line: The study of the health workforce has gained in prominence in recent years, as the dynamic interconnections between human resource issues and health system effectiveness have come into sharper focus.Since these have as a necessary (but not sufficient) condition some flexibility in personnel practices, recent trends towards the sharing of such functions with local authorities are promising.The paper identifies a number of current lines of productive research, focusing on the relationship between health policy reforms and the local institutional environments in which the workforce, both public and private, is deployed.

View Article: PubMed Central - HTML - PubMed

Affiliation: LKY School of Public Policy, National University of Singapore, 469C Bukit Timah Road, 259772, Singapore. fritzen@nus.edu.sg

ABSTRACT
The study of the health workforce has gained in prominence in recent years, as the dynamic interconnections between human resource issues and health system effectiveness have come into sharper focus. This paper reviews lessons relating to strategic management challenges emerging from the growing literature in this area. Workforce issues are strategic: they affect overall system performance as well as the feasibility and sustainability of health reforms. Viewing workforce issues strategically forces health authorities to confront the yawning gaps between policy and implementation in many developing countries. Lessons emerge in four areas. One concerns imbalances in workforce structure, whether from a functional specialization, geographical or facility lens. These imbalances pose a strategic challenge in that authorities must attempt to steer workforce distribution over time using a limited range of policy tools. A second group of lessons concerns the difficulties of central-level steering of the health workforce, often critically weak due to the lack of proper information systems and the complexities of public sector decentralization and service commercialization trends affecting the grassroots.A third cluster examines worker capacity and motivation, often shaped in developing countries as much by the informal norms and incentives as by formal attempts to support workers or to hold them accountable. Finally, a range of reforms centering on service contracting and improvements to human resource management are emerging. Since these have as a necessary (but not sufficient) condition some flexibility in personnel practices, recent trends towards the sharing of such functions with local authorities are promising. The paper identifies a number of current lines of productive research, focusing on the relationship between health policy reforms and the local institutional environments in which the workforce, both public and private, is deployed.

No MeSH data available.


Related in: MedlinePlus

Factors affecting worker motivation and behavior.
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Figure 1: Factors affecting worker motivation and behavior.

Mentions: These can be understood in terms of metaphorical 'daylight' and 'shadow-side' factors, distinguished by the degree to which they are amenable to intervention by the health authorities (and easily accessible to researchers). Both obvious "daylight" factors such as worker terms of service and managerial supervision can affect worker motivation and behaviour; but the hidden or 'shadow' side of organizational life and worker motivation must also be recognized (see figure 1). It includes the value sets of workers (which are influenced both by professional norms, social ideas about the professional roles workers are playing and by the broader organizational culture of the civil service).


Strategic management of the health workforce in developing countries: what have we learned?

Fritzen SA - Hum Resour Health (2007)

Factors affecting worker motivation and behavior.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1808474&req=5

Figure 1: Factors affecting worker motivation and behavior.
Mentions: These can be understood in terms of metaphorical 'daylight' and 'shadow-side' factors, distinguished by the degree to which they are amenable to intervention by the health authorities (and easily accessible to researchers). Both obvious "daylight" factors such as worker terms of service and managerial supervision can affect worker motivation and behaviour; but the hidden or 'shadow' side of organizational life and worker motivation must also be recognized (see figure 1). It includes the value sets of workers (which are influenced both by professional norms, social ideas about the professional roles workers are playing and by the broader organizational culture of the civil service).

Bottom Line: The study of the health workforce has gained in prominence in recent years, as the dynamic interconnections between human resource issues and health system effectiveness have come into sharper focus.Since these have as a necessary (but not sufficient) condition some flexibility in personnel practices, recent trends towards the sharing of such functions with local authorities are promising.The paper identifies a number of current lines of productive research, focusing on the relationship between health policy reforms and the local institutional environments in which the workforce, both public and private, is deployed.

View Article: PubMed Central - HTML - PubMed

Affiliation: LKY School of Public Policy, National University of Singapore, 469C Bukit Timah Road, 259772, Singapore. fritzen@nus.edu.sg

ABSTRACT
The study of the health workforce has gained in prominence in recent years, as the dynamic interconnections between human resource issues and health system effectiveness have come into sharper focus. This paper reviews lessons relating to strategic management challenges emerging from the growing literature in this area. Workforce issues are strategic: they affect overall system performance as well as the feasibility and sustainability of health reforms. Viewing workforce issues strategically forces health authorities to confront the yawning gaps between policy and implementation in many developing countries. Lessons emerge in four areas. One concerns imbalances in workforce structure, whether from a functional specialization, geographical or facility lens. These imbalances pose a strategic challenge in that authorities must attempt to steer workforce distribution over time using a limited range of policy tools. A second group of lessons concerns the difficulties of central-level steering of the health workforce, often critically weak due to the lack of proper information systems and the complexities of public sector decentralization and service commercialization trends affecting the grassroots.A third cluster examines worker capacity and motivation, often shaped in developing countries as much by the informal norms and incentives as by formal attempts to support workers or to hold them accountable. Finally, a range of reforms centering on service contracting and improvements to human resource management are emerging. Since these have as a necessary (but not sufficient) condition some flexibility in personnel practices, recent trends towards the sharing of such functions with local authorities are promising. The paper identifies a number of current lines of productive research, focusing on the relationship between health policy reforms and the local institutional environments in which the workforce, both public and private, is deployed.

No MeSH data available.


Related in: MedlinePlus