Steps of planning for education and training of human resources

3.3 STEPS OF PLANNING FOR EDUCATION
AND TRAINING OF HUMAN RESOURCES
PRESENTED BY : AAKRITI CHAPAGAIN
AMRITA MALLA
AKSHETHA UPADHYAY

Learning objectives:
1. Analysis for human resources development need.
2. Estimation of human resources requirement.
3. Preparation of production plan.
4. Overview of main features of current human resources for health
plan of Nepal.
4/10/2024 PRESENTED BY BPH 8TH SEM ROLLNO (3.4.5) 2

A. Analysis for human resources development need.
Analyzing human resources development needs involves assessing the current
skills, knowledge, and abilities of employees and identifying areas where
improvement or development is necessary to meet organizational goals.
Analysis of human resources development need on the basis of:
•Demographic trend
•Epidemiological trends
•Socio-economic trends
•Development of public health and medical care technologies.

a. Demographic Trend :
•Present and projected population by age and sex , population density
and distribution, migration, life expectancy present and projected
birth and death rate etc. are the principle factors to be considered for
HR planning.
b. Socioeconomic trends:
Different socioeconomic indicators such as education, gender
disparity, poverty, and culture changes can be assessed.

c. Epidemiological trends:
•The next factors which determines the human resources for health is
the Existing distribution, determinants and disease burden/ problems
of the country.
•These are: incidence rate, the prevalence rate of the top ten disease,
Diseases targeted for elimination e.g. Leprosy, Disease targeted for
eradication e.g. poliomyelitis, possibility of the pandemic, social
problems of the country e.g. HIV/AID, high mortality rate e.g. MMR
Remerging and emerging public health problems, Morbidity
indicator.

d. Development of Public and Medical Care
Technologies:
•Availability, accessibility, affordability and acceptability of modern
scientific technology in the country play a significant role in the
requirement of different categories and competency of HR.
•These factors should be taken into consideration during short-term
and long-term health and HR planning.
•Planned technology implementation in the health service delivery
system should be integrated and co-coordinated with concerned
universities of the country.

B. Estimation of human resources requirement.
Estimating Human Resource (HR) requirements refers to predicting
the number and types of employees an organization will need in the
future. It's essentially forecasting the organization's future workforce
needs based on various factors.

Methods of estimation of HR requirement
1. Public health and medical service needs focused method
2. Service oriented/ target panel method
3. Market oriented- economic demand method
4. Projection method
5. Population provider- ratio method

1.Public health and medical service needs focused method:
•This methods seeks to determine what health services people required
to keep them healthy.
•The determination is made by health professionals, with or without
the involvement of the consuming public, and are based primarily on
medical and technological consideration.
•Other issues, such as cost, the capacity to deliver the services needed,
and the degree to which people are seeking health services may be
important but are a secondary concern.

2. Service target/panel expert method:
•In this method, the primary focus is on setting targets for the production and
delivery of health services.
•The targets are establishes by the health authorities and may be based on a wide
variety of inputs including health needs, economic demand, consumer wants and
manpower ratios.
•This method usually presupposes a health system that takes an active role in
shaping sectoral development.

3. Market oriented-economic demand method:
•Human resources production in the market.
•Qualitative expect of the training education.
•Human resource productivity and its use.
•Financial resources available and their use.
•Intra-sectoral and extra-sectoral relationship.
•Government and private universities training institutes are the prime
source of human resources production in the country.

4. Population provider ratio method:
•This method uses an observed or desired population ratio as the basis
for deriving manpower requirements.
•This method has been a favorite method in many countries, primarily
because of its simplicity and easy to carry out.
•Yet it is usually difficult to determine the appropriate population-to-
health worker ratio for each country’s situation,
• The appropriate population ratio usually depends on the level of
economic development and the type of healthcare system
management in each country.

5. Projection method:
•Projection of manpower is another important aspect of manpower
production there are different methods used to project the manpower
requirement.
•The selection of an appropriate method or methods for requirement
projection should take into action:
The degree of government involvement in planning and health care
delivery.
The quality of the available database and planning expertise.

C . Preparation of production plan
Pre-preparation of production plan" in HR estimation refers to
incorporating HR needs into the initial stages of production planning.
This proactive approach ensures you have the right workforce in
place to achieve your production goals.

The steps of HRDH planning are:
1. Preparing Health Manpower planning (HMP)
2. Health Manpower Situation Existing Report and Existing Manpower and Services:
3. Future Supply of Manpower:
4. Manpower requirements - quantity, que and distribution:
5. Mismatches between supply and requirements for human resources supply
6. Solving Mismatches
7. Organizational Management problems
8. Human Resource Development Strategy and Outline Plan
9. Detailed Human Resource Development plan
10. Implementation and Monitoring

1.Preparing Health Manpower (HMP)
•health manpower planning begins when a government or organization decide to
undertake it in conjunction with additional health planning or country health
programming.
• When such decision is made, government polices about areas of concern and the
expected outcome must be developed for manpower planning group.
•The timetable of health manpower planner and the sequence of reporting should
also be established at the outset.
The group of health manpower planners should include representatives of health
service organizations, health manpower development institutions, professional
bodies and other interests,At the same time, a steering committee to which the
health manpower planning group would report should be convened.

1.Preparing Health Manpower (HMP) con…
•The steering committee should consist of high-level decision-makers who have
sufficient authority to implement the plans. The HMP working group should be
made fully aware of all social and health policies and issues.

Step 2: Health Manpower Situation Report on Existing Manpower
and Services:
• The working group is responsible to gather data on health situations
in advance but within a reasonable time. Therefore, it is not worth
launching a special survey, which unnecessarily increases the cost
and data collection time.
•The HMP groups should be selective in information collection; seek
only what is relevant to the questions at hand. The most advantageous
way of collecting HMP data is to do it along with health planning
data.

and Services Con..
The information that should be collected during the data collection
phase includes;
 Background information of the country
 The fiscal situation and trends in national, provincial and local
budgets
 National health plan: Long-term and short term
 Present health services and trends: number and types of services
provided and relevance of services to major health problems.

and Services Con..
Production information:
•The number and types of training institutions and curriculum used the enrolling
capacity, the destination of graduates, and the teacher capabilities.
•The courses available for continuing education.
• Present staff situation and recruitment; staffing pattern-grades, full-time or
trends: part-time; reasons-career turnover rates economic reasons, etc. change or
and
•Utilization of health other socio- distributions and personnel: workload structure;
productivity; career supervision; appraisal; etc. performance

and Services Con..
• Personnel policies: staff development; hiring and firing; retirement and pensions
etc. The data collection is consolidated presented in the situation and report. It is
recommended that expertise from the field of health, statistics, demography, and
education should have representation in a team that is responsible for the
collection and presentation of data.
•The data collection is consolidated presented in the situation and report. It is
recommended that expertise from the field of health, statistics, demography, and
education should have representation in a team that is responsible for the
collection and presentation of data.

Step 3: Future Supply of Manpower:
• The baseline projection of the future supply of human resources is done based on an
analysis of the current staffing situation: loss and gain that would occur in the
present number.
•There should be specified controllable and uncontrollable situations that would
affect the loss and increment in human resources during the baseline human resource
projection.
•The expected new trainees and their recruitment, people returning to work after a
long break, and transferring from other organizations and / or countries are the basis
for future additions to the staff.
•The rate of attrition, movement through promotion from one category to another
category, transfers, deaths and retirement are the major reasons for the loss of staff.

Step 4: Manpower requirements - quantity, quality and
distribution:
Four approaches are being used in estimating the future requirements of human
resources in terms of quantity, quality, productivity and distribution.
a. The health Needs Approach: It is based on expert opinion about the amount
and nature of health services needed to attain and preserve the health of the
people. The approach uses assessment by health professionals based on
demographic and epidemiological forecasts of the future health needs of a
population.
b. The service target approach: This approach identifies targets for the
provision of various kinds health services based on diverse criteria of needs and
feasibility; these services are then converted into the manpower needed to meet
them.

Step 4: Manpower requirements - quantity, quality and
distribution: Con..
The approach involves the setting of specific health service targets and then
assessing the personnel requirements to accomplish each of these.
c. The health demand approach: This approach estimates the demand for
services effective as a function of income, price, accessibility etc.
d. Manpower population ratio: Using desirable or empirical ratios normative is
based on diverse criteria. At the same time numerical estimates of manpower
needs are being made, the skills needed by different categories of health workers
must be identified. How health personnel will be distributed throughout the
country and among different services should also be estimated.

Step 5: Mismatches between supply and requirements for human
resources
•Having projected the future supply of manpower and manpower needs, the
working group can compare the future supply and need for human resources to
help in revealing the discrepancy or mismatches between supply and
requirement.
•Mismatch problems can be of several different types: distribution, number of
skills staff, and/or productivity. Manpower problems are often country-specific
and their solutions should also be adapted to suit specific national circumstances.
•Some manpower problems fall outside of the term of reference of the HMP
working group and should be excluded from further consideration.

Step 6: Solving Mismatches
•Once the problems have been identified and broadly classified, the working
group will propose solutions to them. As a first step to proposing solutions, the
working group should list all major alternative solutions to a particular set of
problems without considering their feasibility.
•The brainstorming sessions can be employed to prepare the initiative of all
possible alternative solution for each problem.
•Arrange the possible solutions in priority order by analyzing the constraints and
their consequences. The next step is to propose the best solutions by scrutinizing
the list of all possible solutions.
•The solution that appears feasible with the given resources and that has long
term effect is chosen along with at least one to two alternative solution.

Steps 7:Organizational and Management problems
•The different manpower development solutions proposed by the working group
will have certain organizational and management implications. Coordination
between services development health development.
• Each should not follow its independent path. Educational planning for the
training of health staff. Curricula and training methods should be relevant to the
needs of services. Effective management of health staff.
•Career development prospects for the heath staff. Continuing education supports
career development and maintains and supplements the skills of the health staff.
It is often found. for example, that certain personnel policies block paths of
advancement. After several years, these policies cause great dissatisfaction
among staff. Some modifications of personnel policies can easily prevent the
problem.

Steps 7:Organizational and Management problems Con..
•By examining such long-term implications of the proposed solutions
the working group will help to avoid such situations. This will help
the harmonious and coordinated growth of health service and
manpower development.

Step 8: Human Resource Development Strategy and Outline Plan
•The next step is to consolidate the human resources development strategy,
considering both long-term and short-term solutions. The strategies, the
sequencing of the actions to be taken and the resources needed (approximately),
are outlined to resolve the mismatch between the supply and requirements of the
health human resources The working group presents it to the steering committee
for the policy guide.
•The actions are modified according to the availability of resources, if needed and
put into priority order.

Step 9: Detailed Human Resource Development Plan
•When the steering committee approves the human resource
development strategy the working group and outline plan can
develop, the detailed plan.
•The working group should be expanded during detailed plan
development to include program managers and financial staff.
Continuation communication must be maintained between the groups
and with staff from the personnel, finance and budget other
concerned bodies. frequent coordination meetings should be held.
Adequate secretarial support will be essential at this step.

Step 9: Detailed Human Resource Development Plan Con..
The solutions developed earlier will be break down into two types of
program activities: Developmental and ongoing.
The developmental activities are aimed to improve the potential of human
expanding training institutions resources e.g. Expanding training institution and
working procedures.
Ongoing activities are those that are usually performed routinely to maintain the
potential human resource development system. A schedule of activities should
also be incorporated into the plan. The human resource plan document will vary in
format from country to country but should contain a set of basic components as
follows;
 The policy basis of the plan
 The health service goals and targets
 The problems human resource development in health

Step 10: Implementation and Monitoring
The last step in human resources development is to put the plan into action or
carry out the activities identified in the detailed plan earlier. The plan should be
monitored during its implementation by using the specific method as per the
guideline. The monitoring helps to assess the situation and outline unforeseen
constraints that are coming in the way of effective implementation of the plan.
The need and frequency for re-planning very much depend on the following
factors;
 The degree of uncertainty of the results of implementation
 The capability of the staff to undertake re-planning
 The general reviewing trend of the ministry
 The timeframe within which the activities have to be completed

D. Overview of main features of current human
resources for health plan of Nepal.
The HR strategic plan is intended to accomplish three things. These
are:
a. to specify the direction of growth of development of HR
b. to specify outline HR objectives for the medium term which
provide a framework for short-term plan development; and
c. to identify short-term actions and, in particular, policy actions
which are needed for the MOH to proceed towards the medium-term
future.

1.Overview of the Human Resources Available
Qualified Staff
Professionals with diverse medical expertise.
Distribution
Human resources availability across various regions.
Skills Inventory
Assessment of the unique skills of available medical staff.

2.Recruitment and Training Process for Healthcare Professionals
Identifying Talent
Locating prospective healthcare professionals based on skill criteria.
Educational Programs
Developing tailored training programs for specific medical niches.
Continuous Learning
Implementing ongoing medical education and skill enhancement.

3.Roles and Responsibilities of the Human Resources Team
Staff Management
Overseeing schedules, leave, and performance evaluations.
Recruitment Planning
Conducting strategic workforce planning and talent acquisition.
Training Coordination
Coordinating professional development and training programs.
Policy Compliance
Ensuring adherence to legal and regulatory requirements.

4.Challenges Faced by the Human Resources Team
Efficiency
Streamlining processes to optimize staff performance.
Employee Engagement
Promoting staff involvement and job satisfaction.
Professional Growth
Encouraging ongoing career development and skill enhancement.

5.Collaboration with Other Healthcare
Organizations
Shared Expertise
Exchanging knowledge and best practices with partner organizations.
Resource Sharing
Pooling resources for joint initiatives and capacity building.
Research Collaboration
Engaging in joint medical research and clinical trials.

6. Future Plans for Enhancing Human Resources in the Health
Plan
Technology Integration
Implementing digital systems for efficient HR operations.
Capacity Expansion
Scaling up HR infrastructure to support growing medical demands.
Education Partnerships
Developing alliances with educational institutions for talent pipeline

Challenges:
Unequal distribution: A significant shortage of healthcare workers persists,
particularly in rural areas.
Inadequate skill mix: Imbalance between the number of specialists and general
practitioners, leading to limited access to specialized care.
High vacancy rates: Complexities in the healthcare act and slow recruitment
processes contribute to unfilled positions.
Limited focus on non-physician workforce: Inadequate investment in training
and development of nurses, midwives, and other allied health professionals.

Workforce distribution: there is an imbalances in the distribution of health
workers between urban and rural areas. Many healthcare professionals prefer
working in urban centers to better facilities and living condition, leaving rural
areas unserved.
Lack of coordination between academia bodies and HR utilizing bodies
Low recording and reporting of private, non-governmental HR in the system.

To address above challenges:
Government should work in collaboration with international organization and
NGOs on various initiatives such as:
Expanding medical education and training program to increase the number of
skilled professionals.
Collaborating with international agencies to facilitate knowledge exchange and
capacity building program
Implementing incentive program to encourage healthcare professional to work.
Strengthening regulatory bodies to monitor and regulate the healthcare
workforce effectively.

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