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Human Resources for Health (HRH): the Belgian Charter
Human Resources for Health (HRH): the Belgian Charter
Human Resources for Health (HRH): the Belgian Charter
Human Resources for Health (HRH): the Belgian Charter
Human Resources for Health (HRH): the Belgian Charter
Human Resources for Health (HRH): the Belgian Charter
Human Resources for Health (HRH): the Belgian Charter
Human Resources for Health (HRH): the Belgian Charter
Human Resources for Health (HRH): the Belgian Charter
Human Resources for Health (HRH): the Belgian Charter
Human Resources for Health (HRH): the Belgian Charter
Human Resources for Health (HRH): the Belgian Charter
Human Resources for Health (HRH): the Belgian Charter
Human Resources for Health (HRH): the Belgian Charter
Human Resources for Health (HRH): the Belgian Charter
Human Resources for Health (HRH): the Belgian Charter
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Human Resources for Health (HRH): the Belgian Charter

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Dr Stefaan Van Bastelaere (Senior Health Expert at the Belgian Development Agency) presents the Belgian Charter on Human Resources for Health at the European Congress on Tropical Medicine and …

Dr Stefaan Van Bastelaere (Senior Health Expert at the Belgian Development Agency) presents the Belgian Charter on Human Resources for Health at the European Congress on Tropical Medicine and International Health, held in Copenhaguen in September 2013.

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  • 1. Human Resources for Health (HRH): from theory to practice Dr Stefaan Van Bastelaere Senior Health Expert
  • 2. The global context of HRH Components of a crisis : • World Health Organisation 2006 • African countries = 24% of disease burden | 3% of health professionals | 1% means • Kampala declaration 2008 - First world forum on HRH • Global shortage estimate 4 million • US estimate for 2020 : gap of 100,000 physicians | 1,000,000 nurses | 250,000 other health professionals • Systematic underproduction in some countries • Systematic overproduction in other countries • Poor or absent HR planning • Poor or absent HR Monitoring & Evaluation • Resistance to change (task-shifting, task-sharing) • Little attention paid to clinical activities September 2013 European Congress on Tropical Medicine and International Health 2
  • 3. Migration • as old as mankind • not the cause, but the solution Drivers for migration • stick • stay • push • pull September 2013 European Congress on Tropical Medicine and International Health 3 The global context of HRH
  • 4. Components of a solution : • Comprehensive HRH policies and management Source: WHO 2006 September 2013 European Congress on Tropical Medicine and International Health 4 The global context of HRH
  • 5. Components of a solution : • 2010 : Code of practice on international recruitment, World Health Assembly • 2012 : Belgian HRH Charter • Reducing push forces – strengthen stick factors : Self esteem! Better connectivity : telemedicine Results-Based Finance – Performance-Based Finance: motivation strategy Improving housing and working conditions… September 2013 European Congress on Tropical Medicine and International Health 5 The global context of HRH
  • 6. The Belgian HRH Charter 5 strategic result areas  RA 1 : Partnership and harmonization  RA 2 : HRH policies and development plan  RA 3 : Training  RA 4 : Recruitment policies  RA 5 : In Belgium September 2013 European Congress on Tropical Medicine and International Health 6
  • 7. RA 1 : Partnership and harmonisation • Federal Public Service Foreign Affairs  Embassies do political and policy dialogue  Long-term vision : predictability of programs 4-5 years • BTC interventions fully embedded in local institutions  Ministries of Health, Ministries of Education, Hospitals, Districts or local health systems  Universities or local schools  Local steering bodies • BTC actively participating in Sector-Wide Approach  Development of “Compact”  Health sector cluster groups, HRH Working Group  Joint sector reviews September 2013 European Congress on Tropical Medicine and International Health 7 From theory to practice : implementing the charter
  • 8. RA 2 : HRH policies and development plans • Support HR department of Health Ministries • Support development and implementation of HRH plans (Rwanda, Burundi, Niger, DR Congo, Mozambique, Senegal) respecting values :  Equity  Gender  Sound geographic distribution September 2013 European Congress on Tropical Medicine and International Health 8 From theory to practice : implementing the charter
  • 9. Improve professional motivation • Performance-Based Financing (Rwanda, Burundi) • Better professional environment :  Investing in communication ICT  Better equipment  Housing September 2013 European Congress on Tropical Medicine and International Health 9 RA 2 : HRH policies and development plans From theory to practice : implementing the charter
  • 10. Performance-Based Financing as motivational factor • 85-95 % of delivered services compliant to quality standards • Substantial topping up of the salaries Figure 7: Quality of services achievement in group 1 September 2013 European Congress on Tropical Medicine and International Health 10 RA 2 : HRH policies and development plans From theory to practice : implementing the charter
  • 11. RA 3 : Training Support development of capacities by strengthening professional education in partner countries • Nursing schools : paramedical public schools in Burundi and Rwanda being upgraded, new curriculum developed, motivation of teaching staff • Undergraduate and postgraduate trainings  National University of Rwanda • Internship, training of District Medical Officers • Capacity-building program for hospital management teams in South Africa September 2013 European Congress on Tropical Medicine and International Health 11 From theory to practice : implementing the charter
  • 12. • Scholarship programs in all our partner countries • Shift from „individual scholarships‟ to an integrated „institutional capacity development program‟ • Individual scholarships (before 2012) o Beneficiaries: individuals o Sectors: all o Based on individual training needs o No follow-up o Nationwide o Yearly agreement between partner states September 2013 European Congress on Tropical Medicine and International Health 12 RA 3 : Training From theory to practice : implementing the charter
  • 13. Institutional capacity development plans (as from 2012) • Beneficiaries: geographical consistency • In line with HRH planning of partner countries and institutional capacity development plans • Sector-specific: in „concentration‟ sector (health, education, agriculture, infrastructure) • Priority to local and regional training institutes • Minimum 4 years‟ duration • Special focus on: Partnership with international partners (Institute for Tropical Medicine…) | Sandwiched approaches | Distance learning | Gender balanced September 2013 European Congress on Tropical Medicine and International Health 13 RA 3 : Training From theory to practice : implementing the charter
  • 14. RA 4 : Recruitment • Respect the WHO “Code of Practice”  Right to migrate, circulation of competences ? o BTC employed international experts without restrictions on nationality (Niger, Burundi, Senegal, Peru, Cameroun, DR Congo…) • Compensate for negative consequences  Only possible in partner countries September 2013 European Congress on Tropical Medicine and International Health 14 From theory to practice : implementing the charter
  • 15. RA 5 : In Belgium • Inform and raise awareness  Charter signed and available on intranet  Information on partner country HRH plans on healthpl@form  Participation in HRH WG of Because-Health,  Collaboration on HRH issues with different NGO‟s • Collaboration with diaspora and universities  IOM  Contracts with almost all Belgian universities • Capitalise and share knowledge  https://intranet.btcctb.org/claroline/  www.be-causehealth.be/en/themes-and-working-groups/human- resources-for-health September 2013 European Congress on Tropical Medicine and International Health 15 From theory to practice : implementing the charter
  • 16. Conclusions Development agencies can make a difference  Work on planning, production and monitoring  Influence on push and stick factors Harmonisation and coordination under a national consensus is key September 2013 European Congress on Tropical Medicine and International Health 16

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