Edward Denys Van Eer - Strategies to Retain Health Workers in Remote, Underserved Areas/Suriname

300 views

Published on

Presentación de Edward Denys Van Eer/Surinam hecha por ocasión del Taller “Abordajes de Atención Primaria a la Salud y estrategias para permanencia de profesionales en zonas alejadas y desfavorecidas en los países de Suramérica”, que se realizó en el ISAGS los días 13, 14 y 15 de mayo de 2014.

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
300
On SlideShare
0
From Embeds
0
Number of Embeds
4
Actions
Shares
0
Downloads
1
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Edward Denys Van Eer - Strategies to Retain Health Workers in Remote, Underserved Areas/Suriname

  1. 1. SURINAME STRATEGIES TO RETAIN HEALTH WORKERS IN REMOTE, UNDERSERVED AREAS
  2. 2. Suriname can be divided in  Rural Interior  Rural coastal  Urban (coastal)
  3. 3. PROVISION OF PRIMARY HEALTH CARE IN SURINAME In Suriname, we can distinguish three geographic areas in the provision of Primary Health Care:  Urban (coastal) provided by either the Regional Health Services or Private General Practitioners  Rural coastal provided by the Regional Health Services  Rural Interior provided by the Medical Mission PHCS Our presentation is focusing on both rural areas.
  4. 4. Remote areas National (population of 500.000) Rural coastal area, RGD (population of 200.000) Rural interior area, MZPHCS (population of 48.179)¹ Number of physicians/1000 inhabitants 0.3 0.15 0.45 number of nurses/1000 inhabitants 1.0 2.16² 1.62 number of dentists/1000 inhabitants 0 0 0.01 number of health promoters/health agents/1000 inhabitants 0.02 0.04 < 1 [1] Data of 2012 [2] Health assistants Distribution of health workers
  5. 5. PROBLEMS IN THE PLACEMENT OF HEALTH WORKERS Factors for non‐placement of workers in areas with fewer workers  Sparely populated areas and isolation from lager society  Poor infrastructure (houses, etc.)  The lack of:  utilities such as permanent electricity, running water, sanitation and modern communication;  employment and other opportunities for spouses and secondary and tertiary schools for children;  diverse social contacts;  opportunities to continued study.
  6. 6. TYPE OF HEALTHWORKERS Difficult to place in remote and underserved areas are:  Nurses, specialist nurses (HIV-, DM-, schoolnurses, etc.), midwifes;  Physicians;  Dentists and dental care providers;  Pharmacists and assistant pharmacists;  Paramedical personnel such as physiotherapists, etc.;  Health educators.
  7. 7. FORMS OF CONTRACTING AND REMUNERATION FOR THE HEALTH WORKFORCE IN THE PUBLIC SECTOR  contracting workers  Monthly salary paid workers  Employers are employed by a:  Faith based foundation subsidized by the national government (Medical Mission).  State owned foundation subsidized by the national government (Regional Health Service).  professionals’ remuneration types  Monthly salaries with performance bonuses once a year.
  8. 8. Rural coastal provided by the Regional Health Services Rural Interior provided by the Medical Mission PHCS Students (nursing, pharmacy-assistants, midwife- students, etc.) are hired out of the rural districts for the specific studies under a contract. The contract include the fact that the organization gives a scholarship, but students has the compulsory internships and after finishing they have to work in the remote area for at least 3 years Minimum of 4 years compulsory work period in the hinterland for all health assistants who are trained by the Medical Mission and are viewed as the central health care worker for the hinterland population. Note: For the rural interior we try to overcome the global and national crisis of shortage on healthworkers partly by making use of Health assistants. Health assistants are not Community Health Workers. They can be comparing with a physician assistant (USA) who is a healthcare professional licensed to practice medicine as part of a team with physicians. They are concerned with preventing and treating human illness and injury by providing a broad range of health care services under the direction of a physician. They conduct physical exams, diagnose and treat illnesses, order and interpret tests, prescribe medications, conduct childbirth and counsel on preventive health care. Placement strategies for workers in remote and underserved areas Compulsory working period
  9. 9. Rural coastal provided by the Regional Health Services Rural Interior provided by the Medical Mission PHCS Conditions in a collective contract of employment makes relocation to other remote areas possible for all health workers working with the Regional Health Services or the Medical Mission PHCS. Workers in Rural coastal areas has special remuneration such as “residence -allowance”, transportation payment, etc. Health assistants receive a residence - allowance upon their salary depending on the degree of isolation of the place they have to work. The institute’s HR department is responsible for the elaboration and execution, and the government is responsible for the financing by subsidizing the institution. Placement strategies for workers in remote and underserved areas Collective employment contract
  10. 10. Rural coastal provided by the Regional Health Services Rural Interior provided by the Medical Mission PHCS The strategies includes enhancement of the work environment Some of the interventions are:  renovation of facilities  introduce ICT in health work  improved medicine supply  multidisciplinary approach of health work by integrating social workers , spiritual guides etc As much as possible facilities are put in place for pleasant residency in the interior.  Free housing near the health facilities  Make solar energy systems and running water available  cellular phones and tablets with internet connection are available on many remote health centers and clinics. Placement strategies for workers in remote and underserved areas Improvement of infrastructure
  11. 11. REGULATING THE AVAILABILITY OF HEALTH WORKERS The main training institutions producing PHC workers are:  The Central School for nursing and auxiliary healthcare workers in the capital (trains mostly for hospitals)  The training program of the Medical Mission for Health Assistants for the Hinterland  The Medical Faculty  Uptake of medical students have been increased  Students who receive scholarships are required to work a number of years in remote areas. However this requirement is not any longer followed strictly
  12. 12. STRATEGIES OF SOCIAL ACKNOWLEDGEMENT AND RECOGNITION OF HEALTH WORKERS IN THE PHC  Social acknowledgement and recognition is not well developed. A few general acknowledgements such as:  “nurse of the year” award.  “best health worker for the interior”.  There are no incentives for research and knowledge exchange for these professionals.  The national strategic plan for the renewal of PHC has identified the development of an incentives system for working in PHC as a priority.

×