HR and Health

1. HR Innovations
Strengthening HR
BBSR WS on 3rd-4th Feb’12
Dr D. N.Nayak
JD-Team Leader
State Human Resource Management Unit,
Department of Health and Family Welfare,
Government of Odisha

2. Out Lines….
 HRH are the Key to success..
 Disease burden and HRH in Odisha
 Requirement, Availability of Human Resources &
Gap analysis
 Initiatives……for Augmentation of Human
Resources
 Filling of Vacancies………..Recruitment
 Way Ahead……..

3. BACKGROUND
Developing countries
WHO-norm:2.5/1000 popl
Current:25% less
2

4. Gap Analysis

5. Gap Analysis
Requirement of Paramedics as per norms
Category IPHS Sanc Pos vac Odisha
Staff Nurses 26574 2046 1798 248 14410
Pharmacist 4529 1945 1844 101 731
Lab. Technicians 4433 876 657 219 1172
Radiographer 1524 235 123 132 344
HW(F)/ANM 15211 7607 7246 361 8527
HW (Male) 8349 4729 3145 1584 8349

6. Status of Key Specialists
Sl.No Category Sanc Pos vac
1 Spl.O&G 514 360 154
2 Spl. Paediatrics 374 228 146
3 Spl. Medicine 248 142 106
4 Spl. Surgery 243 137 106
5 Spl. Anaesthesiology 87 51 36

7. Gap analysis PH nursing – existing and
proposed
Sl.N Positions Proposed Existing Difference
o Strength sanction
1. ANM 8527 7607 920
(+1630 cont)
2. LHV 1599 1128 471
3. BPHN 314 0 314
4. Dy.DPHNO 60 0 60
5. DPHNO 30 6 14
Total 10530 8751 1779

8. Gap analysis-Clinical nursing – existing and
proposed
Sl.N Positions Proposed Existing Difference
o
1. Staff nurse 14410 4100 10310
2. Nursing Sister 997 242 242 755
(Head Nurse )
3. Asst.Matron 200 40 160
4. Matron 86 11 75
5. Chief Matron 18 3 15
Total 15711 4396 11315
Note : We have already proposed for 6963 posts of Staff Nurses

9. Gaps as per proposed norm for Odisha
(Tutors)
Designation Required as Govt. Sanction Gap
for Odisha Strength
Nursing Tutor / 131 131 0
PHN Tutor (
ANM+
GNM+LHVTC)
Nursing 997 242 755
Sister/Superviso
r
DPHNO 30 16 14
Dy. PHNO 60 0 60
BPHN 314 0 314

10. College of Nursing
Sl.n Positions Existing Proposed Difference
o sanctioned strength
strength
1. Clinical Instructor 8 8 Nil
2. Assoc. Prof (lecturer) 4 4 Nil
3. Assoc. Prof (Reader) 1 1 Nil
4. Vice Principal 0 1 1
5. Principal 1 1 Nil
Total 14 15 1

11. Filling of Vacancies

12. Filling of Vacancies……factors….
 Recruitment
 Placement
 Remuneration
 Recognisation
 Job Satisfaction
 Retention
 Output-…….Achievements……Goals

13. Challenges
 Recruitment
 Availability Gap…. demand and supply- No. of training Institution do
not cope with requirement for the state
 OPSC
 Adhoc- Reluctant to join
 Contractual- mostly retired and over aged
 Placement
 Filling of Vacancy specially in difficult areas
 Skewed distribution
 Reluctance to work in difficult areas-demotivation
 Transfer- un-certainty

14. Challenges
 Non Joining
 Retention
 Salary package
 Compensation
 Attractive Career Path
 Recognisation
 Job Satisfaction
 Absenteeism- Rotation
 Private Practice

15. Recruitment…. Process and modes
 Process
 Public Service Commission
 Ad hoc
 Contractual
 Contract-in
 Counseling
 Referral

16. Recruitment…. Process and modes
 Modes
 Centralised
 Decentralised
 Mixed

17. Recruitment of doctors
 Recruitment through O.P.S.C
 1st Batch-481
 2nd Batch-311
 3rd Batch-under process
 Ad-hoc appointments
 1st Batch-287
 2nd Batch-96
 3rd Batch -350
 Contractual engagement (up to 68 Years)
 309 doctors engaged
 Decentralized recruitment at District level

18. Recruitment of paramedics
 Paramedics made into district cadres
 CDMOs authorised to fill vacant posts on priority
basis.
 Policy decisions to engage pharmacists as HW(M)
 Policy shift from Contractual to regular appointment
 Regularisation of service as permanent government
servant after 6 years of uninterrupted service-
 Multi-skilling – Doctors/Lab Technicians
 Task Shifting- Public Health & Management functions
may be entrusted with others.

19. Initiatives for Strengthening HR
management
 Institutional Arrangement
 State Human Resource Management Unit
(SHRMU)
 Nursing Management Support Unit (NMSU) with
focus on realignment of structure
 Database, HRMIS
 Capacity building
 Operational research to generate evidence

20. Steps to make government service more
attractive / Retention
 Entry level posts upgraded to Jr. Class – I.
 Specialist allowance introduced @ Rs.3,000
 More promotional avenues created: About 1200
medical officers have already been promoted
 Post Mortem allowance @ Rs.500 to each Medical
Officer
 Legislation for doctors’ safety
 Later retirement age from 58 to 60
 Development of rational and transparent transfer
policy in process

21. Incentives for difficult areas….
 Financial
 Additional financial incentives for doctors working in
KBK regions (periphery Rs.8,000 and District HQ
Rs.4,000)
 Contractual doctors (PG qualified) receive Rs.25,000
for District HQ, Rs.30,000 for periphery institution.
 Non Financial
 Promotion
 PG study
 Other Facilities- Cluster housing facilities at block
level (in process)

22. We are working on -Public Health Cadre
 HR Policy Frame working….
 Nursing Restructuring in progress
 Creation of dedicated….Public Health Cadre is in
progress and is a priority for the state
 Functions defined
 Functionaries identified
 Institutions identified, renamed and finalised
 Structural Reform in progress

23. HR Policy .. Future …..
 Focus on
 Primary Care-
 Grass Root Level
 Ensure availability of motivated and dedicated !! health
work force at delivery points
Let us join hands to work on it together.

24. Enhancing Production Capacity
 Doctors
 Promoting establishment of more medical colleges
 Enhancing UG seats in medical colleges (+43 X 3 MCH)
 Enhancing PG seats in key disciplines in medical Colleges
 Planning for Diploma courses in key disciplines
 Paramedics
 Establishment of more institutions for nurses, especially in under served
areas.
 Engaging SN/ ANMs passing out from private government recognised
institutions
 Increasing the intake capacity of Nurses and planning for more
autonomy for Nurses
 Promoting Private Nursing Institutions
 Increasing seats -LTs and radiographers in government colleges

25. Can we consider out of box….?
 Non-Financial-(Green Channel)
 Weigtage for PG selection, Post-graduate other
PG or Diploma courses @ 5%-10% per annum
per year of service
 Out of the way promotion- Accelerated assured
carrier progression (years-10,15,20,25)
 Post dated Transfer and relieve Order
 Choice of posting after completion of tenure in
hard and difficult area
 Housing Facilities
 Recognisation…..Letter of appreciation.

26. Can we consider….?
 Financial
 Conveyance Allowance to and fro twice in a
year
 Differential package
 Non-Practicing/Rural Allowance(25%-50%)

27. THANK YOU

28. Proposed structure of PH nursing
DPHNO
30(0.28%)
Dy.DPHNO
(60-0.57%)
BPHN
314 (2.98%)
LHV-1599 (15.18%)
HW(F) (8527-81%)

29. Proposed structure of clinical nursing
Chief Matron
18(0.11%)
Dy.Nsg Supt
(Matron)
(86-0.55%)
Asst.Nsg.Supt(
A.Matron)
200 (1.27%)
Nursing Sister
(Supervisor)-997(6.34%)
Staff Nurse (14410-92%)

30. Existing numbers and intake capacity of ANM Schools
New Present Intake
Category Of Number of
Sl. No Institution Intake capacity
Institutions Institution
Sanctioned Capacity (Proposed)
1 ANM (Govt.) 16 2 640 720
30 NOC to
2 ANM (Pvt) 50 1490
be Given
TOTAL 66 32 2130 720

31. Existing numbers and intake capacity of GNM Schools
Number of Institutions Intake Capacity
Sl
Category
No
Existing
New Sanction Existing Proposed
Institutions
1 GNM trg schools 3 1+4 200 200 + 300
2 GNM (Pvt) 36 8 1355 1430
GNM (pub sector)
3 2 0 70 60
Rourkela & Talcher
TOTAL 41 13 1625 1990

32. Existing numbers and intake capacity of B.Sc Nursing
Category of No. Intake
Sl. No. Remark
Institution Institutions capacity
Nursing College SCB Nursing
1 1+1 20+60
(B.SC) – Govt. College
Nursing College
2 12 600
(Pvt.)
TOTAL 13+1 620+60

33. Existing numbers and intake capacity of
M.Sc Nursing
Category of No. Intake
Sl. No. Remark
Institution Institutions capacity
1+1 10+25 SCB Nursing
Nursing College College
1
(M.SC) - Govt
3 50
Nursing College
2
(Pvt)
4+1 60+25
TOTAL

34. Capacity building / Skill Development
 Institutionalisation of Training Programmes
 State level training selection committee constituted
 Focus on Public Health
 28 MBBS doctors already trained in post graduate
diploma in public health management .
 Training of total 60 BEE, BPO and Ayush doctors in
health promotion medicine in progress
 Training of 20 MBBS doctors in family medicine in
progress
 Multi-skilling
 Personnel trained in additional skills, eg SBA, EMoC

35. Capacity building Ctd.
 Training
 Training of senior and middle level managers in disaster
management at IIPH Hyderabad
 Training of mid-level managers on economic evaluation
and cost effective analysis at IIPH, New Delhi
 Training on research methodology in health science
 Exposure visits
 Hospitalmanagers for bio-medical waste management
 Nursing personnel to Andhra Pradesh
 Nursing personnel to University of Nottingham, UK

36. Innovations & Initiatives
 Databases for doctors, health institutions
established and for paramedics in process
 SHRMU encourages professionals to submit
research proposals
 Research and Ethical Committee constituted
 Study under way on retention of health personnel
in remote and rural parts of Orissa.

37. More Steps to reduce vacancies
• Centralised web-based application and
recruitment using pre-designed software
• Short-listing of candidates at central level, with
final verification and appointment at district level
• Recruiting on campus
• Existing and retiring staff nurses, tutors etc
considered for recruitment to faculty positions
• B.Sc and M.Sc qualified nurses may be posted at
the ANM / GNM trg schools / nursing colleges
• Possible additional allowances for difficult areas
• Increase in sanctioned staff nurse posts by 6,963
• Establishment of tribal ANM schools with free
education and bonding in disadvantaged areas

38. Status-Human Resources on Health
Category Requir Requir Sanction Position
ement ement
as per as per Regular Contractual
IPHS’0 IPHS’11
Mar’0 Sept. Mar’ Sept. 11 NRHM Others
5
5 11 05
Doctors 6422 4259 4394 3459 3575 278
(Allopathy)
Specialist 4233 824 1819 673 1123 - -
Staff Nurse 11088 2244 3522 2122 1775 884 6
MPHW(M) 6695 4911 5727 4659 3083 - 602
MPHW(F) 14724 7121 9237 6871 7072 1186 -
Lab. Tech 2667 801 1639 728 653 110 271
Pharmacist 2704 2039 2114 1957 1812 134 5
Radiographe 941 162 235 123 115 - -
r

39. Doctors in KBK & KBK+ Districts
Sl. Vacancy
No District Sanction Position
1 Bolangir
162 150 12
2 Boudh
56 38 18
3 Gajapati
83 71 12
4 Kalahandi
176 130 46
5 Kandhamal
146 87 59
6 Koraput
168 116 52
7 Malkangiri
88 54 34
8 Nawarang Pur
116 56 60
9 Nuapada
70 45 25
10 Rayagada
121 85 36
11 Sonepur
76 64 12
Total (KBK &KBK+) 1262 896 366 (29%)
Total (Non-KBK) 3089 2475 614(19.9%)

40. Specialists in KBK & KBK+ Districts
Sl. Vac.
No District Sanc. Pos.
1 Bolangir 69 45 24
2 Boudh 25 16 9
3 Gajapati 36 26 10
4 Kalahandi 83 48 35
5 Kandhamal 65 40 25
6 Koraput 71 40 31
7 Malkangiri 35 15 20
8 Nawarang Pur 47 12 35
9 Nuapada 33 18 15
10 Rayagada 48 24 24
11 Sonepur 34 24 10
238
Total 546 308 (56.4%)
Total (non KBK) 1273 815 458(35.9%)

41. Status of Staff Nurse in KBK & KBK+
Districts
Staff Nurse
Sl. No District San Pos Vac
1 Bolangir 130 88 42
2 Boudh 36 15 21
3 Gajapati 49 35 14
4 Kalahandi 145 81 64
5 Kandhamal 112 68 44
6 Koraput 136 102 34
7 Malkangiri 76 39 37
8 NawaraPur 90 18 72
9 Nuapada 37 41 -4
10 Rayagada 78 40 38
11 Sonepur 46 29 17
Total 935 556 379(40.5%)
Total (non KBK) 3522 2665 857 (24.3%)

42. Status of Pharmacists in KBK &
KBK+ Districts
Pharmacist
Sl. No District San Pos Vac
1 Bolangir 83 72 11
2 Boudh 19 18 1
3 Gajapati 34 34 0
4 Kalahandi 94 94 0
5 Kandhamal 81 75 6
6 Koraput 84 83 1
7 Malkangiri 68 52 16
8 NawaraPur 63 64 -1
9 Nuapada 30 31 -1
10 Rayagada 57 54 3
11 Sonepur 37 28 9
Total 650 605 45(6.9%)
Total (State) 2114 1951 163(7.7%)

43. Status of Radiographer in KBK &
KBK+ Districts
Radiographer
Sl. No District San Pos Vac
1 Bolangir 6 3 3
2 Boudh 5 1 4
3 Gajapati 4 2 2
4 Kalahandi 6 5 1
5 Kandhamal 9 8 1
6 Koraput 7 3 4
7 Malkangiri 7 4 3
8 NawaraPur 2 2 0
9 Nuapada 4 4 0
10 Rayagada 3 2 1
11 Sonepur 4 2 2
Total 57 36 21( 36.8% )
Total (State) 235 115 120(51%)

44. Status of Health Worker (M) in KBK
& KBK+ Districts
HW (Male)
Sl. No District San Pos Vac
1 Bolangir 199 147 52
2 Boudh 64 44 20
3 Gajapati 160 102 58
4 Kalahandi 235 192 43
5 Kandhamal 190 150 40
6 Koraput 244 177 67
7 Malkangiri 116 65 51
8 NawaraPur 184 66 118
9 Nuapada 134 117 17
10 Rayagada 201 110 91
11 Sonepur 167 134 33
Total 1894 1304 590( 31.2%)
Total (State) 5727 3685 2042(35.7%)

45. Status of Health Worker (F) in KBK
& KBK+ Districts
HW (Female)
Sl. No District San Pos Vac
1 Bolangir 316 299 17
2 Boudh 92 91 1
3 Gajapati 231 173 58
4 Kalahandi 350 345 5
5 Kandhamal 247 226 21
6 Koraput 409 349 60
7 Malkangiri 218 192 26
8 Nawarang Pur 378 388 -10
9 Nuapada 147 143 4
10 Rayagada 310 315 -5
11 Sonepur 121 124 -3
Total 2819 2645 174 ( 6.17 %)
Total (State) 9237 8258 979 ( 10.6%)

46. Status of Lab. Technicians in KBK &
KBK+ Districts
Lab. Technicians
Sl. No District San Pos Vac
1 Bolangir 65 55 10
2 Boudh 21 13 8
3 Gajapati 31 25 6
4 Kalahandi 54 35 19
5 Kandhamal 62 37 25
6 Koraput 79 45 34
7 Malkangiri 54 18 36
8 NawaraPur 54 25 29
9 Nuapada 46 17 29
10 Rayagada 54 43 11
11 Sonepur 25 15 10
Total 545 328 217(40.56%)
Total (State) 1639 1034 605 ( 37%)

47. Requirement of Paramedics as per norms
Requirement GAP
Category of Health Existing
Personnel Sanction RHS (Minimum
Minimum
IPHS Vacancy Posts to be
(RHS-2009)
created)
Staff Nurses 14410 10132 2046 271 8086
Pharmacist 2676 1914 1945 133 731
Lab. Technicians 2823 2069 897 244 1172
Radiographer 918 511 235 120 344
HW(F)/ANM 14985 14608 7607 535 7001
HW (Male) 6718 6688 4667 1584 2021

48. Vacancies filled during last year
Category Periphery NRHM Total
Staff Nurse 251 884 1135
Pharmacist 71 32 103
MPHW (F)/ NA 1186 1186
Addl.ANM
MPHW (M) 421 NA 421
L.T 215 109 324

49. HR Status as on October'2011
Sl. No Category of Post Sanction Position Vacancy
1 Doctor 4394 3853 541(12.3%)
2 Pharmacist 2114 1951 163 (7.7%)
3 Staff Nurse 3522 2665 857(24.3%)
4 L.T 1639 1034 605 (37%)
5 MPHW (M) 5727 3685 2042(35.7%)
6 MPHW (F) 9237 8258 979(10.6%)
7 LHV 1128 1013 1159(10.2%)
7 Radiographer 235 115 120(51%)

50. A Framework for Managing Human Resources
50
Source: Joint Learning Initiative, Harvard University