Processes & Importance Of Human Resource Management In Improving Outcomes Of Health Care: As Implicated In Public Health In India

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  • Shiny, beveled text with reflection(Basic)To reproduce the text effects on this slide, do the following:On the Home tab, in theSlides group, click Layout, and then click Blank.On the Insert tab, in the Text group, click Text Box, and then on the slide, drag to draw the text box.Enter text in the text box, select the text, and then on the Home tab, in the Font group, select Gill Sans MT Condensedfrom the Font list, enter 95 in the Font Size box, and then click Bold.On the Home tab, in the Paragraph group, click Center to center the text in the text box.On the Home tab, in the Font group, click Character Spacing, and then click More Spacing. In the Font dialog box, on the Character Spacingtab, in the Spacing list, select Expanded. In the By box, enter 16.Select the space between two of the words in the text. On the Home tab, in the Font group, click Character Spacing, and then click Tight. Repeat the process for each space between words. Select the text. Under Drawing Tools, on the Format tab, in the WordArt Styles group, click the arrow next to Text Fill, click More Fill Colors, and then in the Colors dialog box, on the Custom tab, enter values for Red: 238, Green: 86, Blue: 10. Under Drawing Tools, on the Format tab, in the bottom right corner of the WordArt Styles group, click the Format Text Effects dialog box launcher. In the Format Text Effects dialog box, Click 3-D Format in the left pane, and then do the following in the right pane:Under Bevel, click the button next to Top, and then under Bevel click Circle (first row, first option from the left). Next to Top, in the Width box, enter 6.5 pt, and in the Height box,enter8 pt. Under Contour, click the button next to Color, and then click Black, Text 1 (first row, second option from the left). In the Size box, enter 0.5 pt. Under Surface, click the button next to Material, and then under Standard click Metal (fourth option from the left). Click the button next to Lighting, and then under Neutral click Three Point (first row, first option from the left). In the Angle box, enter 30°. Under Drawing Tools, on the Format tab, in the WordArt Styles group, click Text Effects, point to Reflection, and then under Reflection Variations click Tight Reflection, touching (first row, first option from the left). To reproduce the background on this slide, do the following:Right-click the slide background area, and then clickFormat Background.In the Format Background dialog box, click Fill in the left pane, select Gradient fill in the right pane, and then do the following:In the Type list, select Linear.Click the button next to Direction, and then clickLinear Down (first row, second option from the left).Under Gradient stops, click Add gradient stop or Remove gradient stop until three stops appear in the slider.Also under Gradient stops, customize the gradient stops that you added as follows:Select the first stop in the slider, and then do the following:In the Position box, enter78%.Click the button next to Color, and then under Theme Colorsclick Black, Text 1(first row, second option from the left).Select the next stop in the slider, and then do the following:In the Position box, enter92%.Click the button next to Color, click More Colors, and then in the Colors dialog box, on the Custom tab, enter values for Red: 49, Green: 18, Blue: 17.Select the last stop in the slider, and then do the following:In the Position box, enter100%.Click the button next to Color, and then under Theme Colorsclick Red, Accent 2, Darker 50%(sixth row, sixth option from the left).
  • Animated text flying in by letter(Basic)To reproduce the text effects on this slide, do the following:On the Home tab, in theSlides group, click Layout, and then click Blank.On the Insert tab, in the Text group, click Text Box, and then on the slide, drag to draw the text box. Enter text in the text box, select the text, and then on the Home tab, in the Font group, select Corbel from the Font list, enter 50 in the Font Size list, and click Bold.On the Home tab, in the Paragraph group, click Center to center the text.Select the text box. Under Drawing Tools, on the Format tab, in the WordArt Styles, click on the Format Text Effects: Text Box dialog box launcher. In the Format Text Effects dialog box, in the left pane, click Text Fill. In the Text Fill pane, select Solid Fill, and in the Color list, select Olive Green, Accent 3 (first row, seventh option from the left).Also in the Format Text Effects dialog box, in the left pane, click 3-D Format. In the 3-D Format pane, do the following:Under Bevel, do the following:In the Top list, under Bevel, select Angle (second row, first option from the left). In Top, under Width, enter 1.5 pt. In Top, under Height, enter1.5 pt.Under Depth, in the Color list, select Automatic, and in the Depth text box, enter 2.5ptUnder Contour, in the Color list, select Olive Green, Accent 3 (first row, seventh option from the left).Under Surface, do the following:In the Material list, under Translucent, select Powder (first option from the left).In the Lighting list, under Special, select Flat (first option from the left).In the Angle box, enter 315°.On the slide, select the text box, and then on the Home tab, in the Drawing group, click Arrange, and then under Position Objects, point to Align, and do the following:Click Align to Slide.Click Align Middle.Click Align Center.To reproduce the animation effects on this slide, do the following:On the slide, select the text box and then on the Animations tab, in the Animation group, click the More arrow on the Animation Effects Gallery, and under Entrance, click Fly In. To modify the effect, on the Animations tab, do the following: In the Timing group, do the following:In the Start list, select WithPrevious.In the Durations list, select 00.50.In the Animation group, click Effect Options and under Direction, click From Left.In the Advanced Animation group, click Animation Pane. Then in the Animation Pane, do the following:Click the arrow next to the fly-in effect and click Effect Options.In the Fly In dialog box, on the Effects tab, under Enhancements, in the AnimateText box, select ByLetters.Under Enhancements, in the % delay between letters box, enter 6.In the Advanced Animation group, click AddAnimation, then under Exit, select FlyOut. To modify the effect, on the Animations tab, do the following: In the Timing group, do the following:In the Start list, select AfterPrevious.In the Durations list, select 00.50.In the Delay list, select 01.50.In the Animation group, click Effect Options and under Direction, click To Right.In the Advanced Animation group, click Animation Pane. Then in the Animation Pane, do the following:Click the arrow next to the fly-in effect and click Effect Options.In the Fly Out dialog box, on the Effects tab, under Enhancements, in the AnimateText box, select ByLetters.Under Enhancements, in the % delay between letters box, enter 6.Select the fly out exit effect, and under Modify: Fly Out, do the following:In the Start list, select AfterPrevious. In the Direction list, select ToRight. In the Speed list, select Fast. Click the arrow next to the fly out exit effect, and select Effect Options. In the FlyOut dialog box, do the following:On the Effect tab, in the Animate Text list, select By Letters. Also on the Effect tab, in the % delay between letters box, enter 6.On the Timing tab, in the Delay box, enter 1.5.To reproduce the background on this slide, do the following: Right-click the slide background area, and then click Format Background. In the Format Background dialog box, click Fill in the left pane, select Gradient fill in the Fill pane, and then do the following:In the Type list, select Radial.Click the button next to Direction, and then click From Center (third option from the left).Under Gradient stops, click Add or Remove until two stops appear on the slider, then customize the gradient stops as follows:Select Stop 1 from the slider, and then do the following:In the Position box, enter 0%.Click the button next to Color, and then click Black, Text 1, Lighter 50% (second row, second option from the left).Select Stop 2 from the slider, and then do the following: In the Position box, enter 100%.Click the button next to Color, and then click Black, Text 1 (first row, second option from the left).

Transcript

  • 1. Processes & Importance Of Human Resource Management In ImprovingOutcomes Of Health Care: As Implicated In Public Health In India Presented by : Dr. Rajib Saha 2nd year post graduate trainee MD Community Medicine Burdwan Medical College & Hospital
  • 2. Introduction:Management: The purposeful and effective use of resources-manpower, material and finances- for fulfilling a pre-determined objective.Human Resource: Both professional and technical workerswho are needed to provide the service.Definition Of Human Resource Management : Humanresource management is the integrated use of systems, policiesand management practices to support the organization inmeeting its desired goal through recruitment, maintaining anddevelopment of employees. (According to ManagementSciences for Health)1.
  • 3. Importance of Human resource management:• Human resource management is the critical management area that is the most important asset for any organization as well as health care system also and it accounts about 70 to 80% of its budget.
  • 4. Relationship between health system inputs, budget elements and expenditure categories 2EXPENDITURE CATAGORIES BUDGETS ELEMENTS HEALTH SYSTEM INPUTS OUTPUT HUMAN RESOURCES RETIREMENT PHYSICALTOTAL CAPITALFINANCIALRESOURCES PRODUCTION ON HEALTH INTERVENTIONS LABOUR COSTS DEPREDATION MAINTAINANCE OTHER CONSUMABLES RECURRENT
  • 5. Organization invest on work force Satisfied and motivated workforce Deliveredquality health servicesFulfilled Its Mission Meet Its Enhance Health Objectives Its Competitive Advantage
  • 6. Benefits of a strong HRM system• FOR THE ORGANIZATION: I) Increases the organization’s capacity to retain staffs and achieve its goals. II) Increases the level of employee’s performance. III) Uses employee’s skills and knowledge efficiently. IV) Saves costs through the improved efficiency and productivity of workers. V) Improves the organization’s ability to manage change.• FOR THE EMPLOYEE: I) Improves equity between compensation of employee and level of responsibility. II) Helps employees to understand how their work relates to the mission and values of the organization. III) Helps to motivate employees. IV) Increases employee’s job satisfaction. V) Encourages employees to work as a team.
  • 7. Current Situation Of Human Resources in India Some data sources regarding human resources of health care system of India are:• i) Census of India.• ii) Revised Indian National Classification of Occupations: Directorate General of Employment and Training, Ministry of Labour, Government of India.• iii) Survey on Employment and Unemployment done by the National Sample Survey Organisation.• iv) Recognised medical colleges from the Medical Council of India.
  • 8. According to 2001 Census, India3• Health Workers: 2.2 million• Allopathic Doctors: 6,77000 practitioners• Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy: 2,00000 practitioners• 27 health workers per 10000 populations• Allopathic Doctors 31%• Nurses And Midwives 30%• Pharmacists 11%• Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy 9%• Others 9%
  • 9. IN CROSS-COUNTRY COMPARISONS INDIA WHO BenchmarkTotal no. OfAllopathic doctors, 11.9 per 10,000 people 25.4 workers per 10,000Nurses, and (about half the WHO benchmark ) population.Midwifes.• When adjusted for qualification, the number falls to about a quarter of the WHO benchmark.• India has roughly one nurse and nurse-midwife per allopathic doctor and the qualification adjusted ratio falls further to 0.6 nurses per doctor.
  • 10. HUMAN RESOURCE RELATED PROBLEMS OF HEALTH CARE SYSTEM IN INDIA
  • 11. . Medical education system: Medical colleges are not evenly distributed across India. The south-western states of Andhra Pradesh Maharashtra, karnataka, Kerala and Tamil Nadu which together account for 31% of the country’s population account for 58% of all medical colleges (public and private) in India. The high number of medical schools in these states is because of the growth of private institutions and specific political and caste groups that have invested in the lucrative business of medical education10. Nursing Education System: The condition of the teaching infrastructure is generally poor withinadequately equipped libraries and demonstration rooms, overworked teaching staff, littlepractical experience for students, and few opportunities for in-service training for teaching staff11.
  • 12. PROCESSES OF HUMAN RESOURCE MANAGEMENT Good employment Policy Leadership and advocacy Adequate Financial HRM resource Partnership SYSTEM with local community, p rivate sector, donors Pre-service , other key education/ stake holders training Better health outcome
  • 13. Importance Of Human Resource Management Components IMPORTANCES• HRM capacity HRM budget Allows for consistent HR planning and for relating costs. HRM staff Staff are essential in HRM for policy development and implementation .• HRM planning Organizational mission and goals Mission provides direction to HRM activity and to the work of the staff. HR Planning Allows HRM resources to be used efficiently in support of organization goals.
  • 14. • Personnel policy & practice Job classification system Allows organization to standardize the jobs and types of skills it requires. Compensation and benefits system Allows for equity in employee’s salary and benefits tied to local economy. Recruitment, hiring, transfer, and promotion Assures fair and open process based on candidate’s job qualifications . Orientation program Helps new employees to identify the goals/values of the organization. Policy manual Provides rules and regulations that govern how employees work and what to expect. Discipline, termination, and grievance procedures Provides fair and consistent guideline for addressing performance problems. Other incentive systems- Financial Incentives, Non-financial Incentives.
  • 15. Union relationships Promotes understanding of common goals and decreases adversarial behaviours. Labour law compliance Allows organization to function legally and avoid litigation.• HRM data Employee data Allows for appropriate allocation and training of staff, tracking of personnel costs. Computerization of data Accessible, accurate, and timely data is essential for good planning. Personnel files Provide essential data on employee’s work history in organization.• Performance management Job descriptions Defines what should be done by people and how they would work together. Staff supervision Provides a system to develop work plans and monitor performance. Work planning and performance review Provides information to staff about job duties and level of performance.
  • 16. • Training Staff training A cost-effective way to develop staff and organizational capacity. Management/leadership development Leadership and good management are keys to sustainability. Links to external pre-service education Pre-service training based on skills needed in the workplace is cost effective.
  • 17. Recent Initiatives In The Field Of Human Resource Management In India1211. Creating the norms: The IPHS( Indian Public Health Standards)• Two ANMs per sub-center and one male MPW.• Three nurses/ANMs per PHC plus two medical officers.• Adding ayush staff into available pool.• Nine nurses per CHC plus 5 specialists and 3 to 4 medical officers .2. Expanding available skilled human resource• More medical colleges- government and private and through public private partnerships.• More government seats in private medical colleges.• More nursing schools & nursing colleges.• More technical and paramedical courses.• Reviving ANM and MPW training centers.3. Increasing availability in priority areas Compulsory rural postings- pre- post graduation – eg Orissa, Chhattisgarh and Tamilnadu. Contractual appointments made to the facility. 1. Eg Additional ANMs nurses in Bihar, West Bengal, Tamil nadu etc. 2. Eg specialists in Madhya pradesh. Fair transfer policy- rotational postings e.g. Tamil nadu. Incentives for difficult areas: eg Himachal and Orissa. ‘Pooling’ of medical officers: West Bengal, Bihar, Jharkhand.
  • 18. Public Private Partnership options as HR solutions Contract in options. 1. Madhya Pradesh for specialists. Contract out options. 1. Arunachal Pradesh: PHCs to Karuna trust. 2. Bihar: PHCs, diagnostics, district planning. 3. Gujarat: PHCs, CHCs and a district hospital & CHIRANJEEVI. 4. Punjab: Village level dispensaries. 5. Sewa Mandir Rajasthan / Haryana maternity hut . Increasing availability of skilled in priority areas  Multi-skilling existing staff to play more tasks. 1. Medical officers to play specialist roles: emergency. 2. Ayush doctors for medical officer roles. 3. Nurse practitioners to fill in for doctors. 4. Pharmacists providing curative care. 5. Male multi purpose workers work as male multi-skilled workers to provide a set of support services of the PHC. ANM schools in under-served areas.
  • 19. 4. Community level service providers ASHA: 4 lakh ASHAs- major and one of most visible components of NRHM. Anganwadi worker- increasing her effectiveness as health care provider. The RMP: Training them. The traditional birth attendant: continuing role for the TBA where institutional delivery levels are low. Community midwifes and maternity huts.5. Strengthening Capacity building activity• Strengthening SIHFWs.• Developing an integrated training approach.• IMNCI plus skilled birth attendance as focus of increasing skills for the ANM and PHC- poorly integrated with family planning.• Reviving ANMTCs and MPWTCs.• Moving towards DTCs.• Need to redefine the role of SIHFWs/NIHFWs as apex of a pyramid of institutions that ensure that all the necessary skills required for quality service delivery are in place.
  • 20. 6. Improving workforce performance• Putting an accountability framework in place: – Hospital development committees. – Community monitoring programme. – Involvement of PRIs.• Linking funds for new contractual appointment to filling up of regular vacancies.• Untied funds to enable local health care providers.• Bringing in a cadre of health managers and data managers and financial managers.• Introducing health management courses and promoting health management certification for key posts.• Insisting on public health qualifications for key public health posts.
  • 21. References1. http://www.msh.org/Documents/emanager/upload/eManager2009No1_HRM English.pdf (Last retrieved on 09/11/2011 at 7.00 p.m.)2. World Health Report 2000 Figure 4.1 g.753. Rao K, Bhatnagar A, Berman P. India’s Health workforce: size composition and distribution. La Forgia J, Rao K eds. India Health Beat, New Delhi. World Bank, New Delhi and Public Health Foundation of India, 2009.4. Government of India. Bulletin on rural health statistics 2008 (2009). http://mohfw.nic.in/Bulletin%20on%20RHS%20-%20March,%202008%20- %20PDF%20Version/Title%20Page.htm (Last retrieved on 09/11/2011 at 7.00 p.m.).5. Banerjee A, Deaton A, Duflo E. Wealth, Health, and Health Services in Rural Rajasthan. Am Econ Rev 2004; 94: 326-30.6. Kaushik M, Jaiswal A, Shah N, Mahal A. High-end physician migration from India. Bull World Health Organ 2008; 86: 40-45.7. Mullan F. Doctors For the world.Indian physician emigration Health Aff 2006; 25: 380.8. Mullan F. The Metrics of the Physician Brain Drain.N Engl J Med 2005; 353:1810-18.9. Government of India. Task force for planning on human resources in health sector. Planning Commission, Government of India, 2006.10. Kaul R. Whither equity? Seminar 2000; 494.11. Academy for Nursing Studies. Situational analysis of public health nursing personnel in India. Hyderabad: Academy of Nursing Studies, 2005.12. Global Health Workforce Alliance/WHO. 2008. Guidelines: Incentives for Health Professionals.Geneva;WHO.13. Health Sector Reforms In India Initiatives From States (Volume II). Ministry of Health and Family Welfare March 2007.
  • 22. Types of Incentives• Financial IncentivesTerms and conditions of employment• Salary/wage• Pension• Insurance (e.g., health)• Allowances (e.g., housing, clothing, transport parking, child care)• Paid leavePerformance payments• Achievement of performance t• Length of service• Location or type of work (e.g., remote locations Other financial support• Fellowships• Loans
  • 23. Nonfinancial Incentives Positive work environment• Work autonomy and clarity of roles and responsibilities.• Recognition of work and achievement.• Supportive management and peer structures.• Manageable workload and effective workload.• Management.• Effective management of occupational health and safety risks, including a safe and clean workplace.• Effective employee representation and communication.• Enforced equal opportunity policy.• Maternity/paternity leave.• Flexibility in employment arrangements• Flexible work hours.• Planned career breaks.• n• n
  • 24. Access to services, such as1. Health2. Child Care Schools3. Recreational Facility4. Housing5. TransportationSupport for development• Effective supervision• Coaching and mentoring structures• Access to and support for training and education• Sabbatical and study leaveIntrinsic Reward 1. Job Satisfaction2. Personal Achievement3.Commitment To Shared Values4.Respect Of Colleagues