Overview presentation by Tim Martineau for seminar on human resources in health and education in fragile and conflict affected settings, organised by HEART in June 2016.

1. Cross-sectoral issues between Health
and Education in Human Resources in
fragile and conflict-affected states
HEART seminar on Human
Resources in Fragile and
Conflict-affected States
Royal Society, London 9th June 2016

2. Introductions
 Name
 Organisation
 Role/specialism
HEART 2
NAME INSTITUTION
Alvaro Alonso-Garbayo ReBUILD team at LSTM
Chris Berry DFID
Chris Joynes EDT
Elisabeth Resch OPM
Helen Mobey EDT
Jo Keatinge DFID
Katharine Holmes EDT
Lizzie Smith DFID
Nick Hooton ReBUILD team at LSTM
Nicola Watt DFID
Nigel Pearson Independent Consultant
Patrick Douglas EDT
Peter-Sam Hill OPM
Rashid Zaman OPM
Sam Franzen OPM
Sophie Witter ReBUILD team at QMU
Susy Ndaruhutse EDT
Tim Martineau ReBUILD team at LSTM
Willy McCourt Independent Consultant

3. HEART Consortium Members
www.heart-resources.org
3

4. 4

5. Programme
 Introduction, Tim Martineau (Liverpool School of
Tropical Medicine) and Joanna Buckley (OPM)
HEART 5

6. Recruitment to retention ‘pipeline’
Adapted from: Vujicic et al, 2006
• Initial posting
• Induction
• Bonding
• Career choice
• Science grades
• Capacity
• Need (quality
& quantity)
• Registration
• On payroll
• ROI
Selection
• criteria
• process

7. Recruitment to retention ‘pipeline’
Adapted from: Vujicic et al, 2006
• Shortage of
health workers
in Africa in
2013 = 4.2M
• Shortage of
18M health
workers to
meet SDGs
• 100M children no 1o
Education
• 18 countries with
Lower 2o pupil :
teacher ratio >30:1

8. Comparing HR in health and educations sectors in MLICs
Similarities
 largest public sector workforce
 difficult to staff in remotest areas
 traditionally high proportion of
females
 historically high engagement of
FBOs
 increasing privatisation of
professional training and service
delivery
 both sectors have dedicated HR
targets in their respective SDGs
 ?powerful unions
 ?use of performance-based
incentives
Differences
 complexity of cadres in health vs
simpler structure in education
 high level of international migration
of health professionals vs lower for
education sector
 less predictable workloads in health
(Hanson 2015)
 ?greater use of task-shifting in
health
HEART 8

9. Few examples of work across health and education

10. Context of fragile and conflict-affected states
 Since 2010, all major donors have published frameworks for programming in
FCAS development projects need to be sensitive to how interventions shape
the broader state-building and conflict dynamics within which they operate.
 DFID increased spending in FCAS to 30% of UK ODA by 2014-15, representing
an 86% increase since 2010. In November 2015 HMG made a commitment to
allocate 50% of all DFID’S spending to fragile states and regions.
 This commitment, combined with the reduction in number of DFID priority
countries from 43 to 28 following the 2011 Bilateral Aid Review, and
commitment to spend 0.7% GNI on ODA have led to a significant absolute
increase in DFID’s expenditure on FCAS.
 Range of scenarios of FCAS:
– Humanitarian assistance (less in education)
– Reconstruction phase
– Development phase
– Transition from one to another

11. Challenges of working in fragile and conflict-affected states
 Being conflict sensitive – who you engage with, how and where. Adverse
impacts of certain health interventions e.g. Taliban's offensive against the polio
vaccinations in Pakistan.
 Access – e.g attacks on hospitals in Syria and Afghanistan.
 Lack of strong institutions – gaps in regulatory, legislative and policy framework
e.g. Somalia.
 Questions of equity of access
 Limited infrastructure e.g. roads, electricity, water

12. Objective of the session
 explore the potential for cross-sectoral learning,
and attempt to draw out some initial lessons
about challenges and effective strategies that
could further strengthen human resources in the
fields of education and health in complex
contexts and redress the current sectoral silos

13. Programme
 Introduction, Tim Martineau (Liverpool School of
Tropical Medicine) and Joanna Buckley (OPM)
 The health perspective, Sophie Witter (Queen
Margaret University)
 The education perspective, Chris Joynes (Education
Development Trust)
 Tea and coffee break
 Lessons learnt (Chris Berry and Lizzie Smith, DFID)
 Floor discussion
 Wrap-up and conclusions
HEART 13

14. Floor discussion in HR in health and education in FCAS
 What are the most important common challenges?
 What are the differences?
 Where could there be greater collaboration
between the two sectors? (programme design,
research, etc)
 What specific help do donors and governments
want?

15. Thank you