Professional Documents
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Gaps in Health Human Resource
Gaps in Health Human Resource
RESOURCE
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INTRODUCTION
MODERN TECHNOLOGY HAS THE POWER TO
PREVENT SICKNESS AND ASSURE EARLY
CURE.
vibrant health system.
well–trained, motivated and professional
human infrastructure
a wide array of community-based workers,
nurses and other paramedics and doctors-
dynamic outcomes.
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INDIAN HEALTH CARE
SECTOR
US $,billion
Years
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Market growth – 18% annually.
Private player – 86%.
Health tourism – expected to rise up to US $
2,200 billion by 2011.
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Health Human Resource
Heart of the health care systems, yet, a
neglected component.
It is a process of planning , directing, development and
Utilization of human resources in an organization.
Implementing objectives, policies, and procedures that
enhance employee contributions to the organization
through increase in productivity, quality of work life
and legal compliance.
Satisfactorily meets societal and employee needs,
demands and expectations.
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Present Scenario
Despite of new, up-to-date and complete
country and international database of
health workers, disparities across countries
are large.
Physician /nurse ratio are three to four times
more in high income countries as
compared to lower ones.
“Human crisis in health” – a global issue.
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Human Resources ‐ Who are
the health workers?
The National Classification of Occupations used by
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Medical equipment operators
Dieticians and nutritionists
Optometrists
Physiotherapists
Traditional medicine practitioners
Faith healers
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FACTORS REFLECTING GAPS IN
HEALTH HUMAN RESOURCE
Imbalance (Urban & Rural; Government &
Non Government).
Health care providers.
Low productivity of personals.
Mal distribution.
Poor work environment.
Vacant posts.
Shift to private sectors.
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Migration.
Motivational lags.
Gaps in managing HR in health care
institutions.
Audits.
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Imbalance (urban & rural;
government & non
government)
Rural sector is lagging behind to provide
healthcare services effectively to achieve
quality in healthcare services.
Reasons
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Rural population which is 70 % of Indian
population finds it difficult to get
healthcare access-Dr. Naslin Choparia
(Neurologist, Jahangir Hospital Pune)
People in rural areas do not come with a
disease but they come with family of
disease and reason for this is they are not
getting treated at primary level of
infection.-Dr. Shirin Vyankatraman
( Gynecologist )
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Scenario in Public sector
Sub centre- 7% lack ANM (11,190).
MHW – 50% lack.
Current need – 200,000 ANM.
PHC - Availability- One staff nurse/PHC.
Requirement – At least 3/PHC.
700 PHC without Doctors.
Current need- 24,000 MBBS Doctors
and 46,000 AYUSH Doctors.
CHCs – shortfall of specialists, average 50%.
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Health Care Providers
The number of trained health workers has
been inadequate, but in recent years there
has been a scarcity of almost all cadres of
workers.
Production of health workers has not kept
pace with needs, especially with increasing
burden of disease.
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Exhibit: The ratio between allopathic doctor
and population was 1 for 1665 persons in
the country (60 doctors for 100, 000
population) while in Australia, Canada, the
United Kingdom and the United States of
America, it was 249.1, 209.5, 166.5 and
548.9 respectively.
The ratio between nurse and population in
India was 1:1205 as against 1:100-150 in
Europe8.
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Reference : WHO survey 2006
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Low Productivity of
Personals
Shortage of skilled personals e.g. skilled
managers to handle HR.
Lack of continuous training programs.
Fake practitioners.
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Quality of Personals
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Percentage shortfall of specialists as compared to
requirements based on existing infrastructure
73.6
69.0
p 68.7
e 60.1
r
c
e
n
t
a 64.8
g
e
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MALDISTRIBUTION
Nearly all countries have mal distribution, which
is worsened by unplanned migration. The
urban concentration of workers is a problem
everywhere.
Improving within country equity requires
attracting health workers to rural and marginal
communities – and retaining them.
There is also a mal distribution between public
and private sectors in many countries.
International equity is worsened by unplanned
international migration, with the loss of nurses
and doctors crippling health systems in many
poor sending countries.
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What Can Be Done????
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Public- Private Partnership
Contracting of PHCs to NGOs
Alternative Sources
>AYUSH Doctors
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POOR WORK ENVIRONMENT
Scarcity of resources.
Inadequate supplies and facilities.
Limited monetary and non-financial
incentives to retain and motivate health
workers.
Unheard voices of the health workers.
Consequences
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Vacancy position-Percentage of sanctioned post vacant
p
e 32.0
r
c
e 22.1
n 18..0
t 13.8
a
g 8.8
e
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Percentage of PHCs working without doctors, lab tech,
Pharmacists
41
p
e
r
c
e
n 17
t
a
g 5..3
e
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Migration to Greener
Pastures
Indian Nurses
Indian Doctors working
Registered in the United
in Australia
Kingdom
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Migration
Major donors Major Both donor &
recipients recipient
India, Pakistan Sri US UK Canada Australia UK Germany Canada
Lanka, Philippines South Germany
Africa, Nigeria Ghana,
UK, Canada Germany,
New Zealand
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Gaps in managing HR in health
care Institutions
Human resource plays a very significant role in
effective performance of a hospital which
depends to a great extent on the quality of its
staff.
Management also faces problems in dealing
with skilled as well as unskilled staff.
e.g Doctors perhaps have education/knowledge
superiority when compared with management
professionals. They do not consider the
management professionals at par with them
and therefore, there is a problem of
adjustment
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There is need to develop positive attitude
towards all the jobs of the hospital.
Sacking/suspension/discharge is a easy way
out to get rid of the staff we do not like but
retaining them in job is a real difficult job
and only an able hospital administrator can
do it.
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Bridging the gaps
There is a critical need of capacity building
in human resource management in health
sector.
Gaps or challenges in HR are severely
limiting the capacity of health service
organization and health care professionals
to meet needs of the population.
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Basic model to overcome the
crisis.
Numeric adequacy coverage
Skill mix Access
Social outreach and
Equitability
Efficiency
Satisfactory Remunerationmotivation and Health of
Work environment Effectiveness Population
System support
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References
Regional Health Forum – Volume 10, Number
1, 2006.
Joint Learning Initiative (JLI). “Human
Resources for Health: Overcoming the
Crisis.” JSI (John Snow,Inc.) Research and
Training Institute Strategic Report.
Cambridge, Mass.: JSI, 2005.
WHO. The World Health Report 2004 -
Changing history. Geneva:World Health
Organisation, 2004.
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Presented by…
Bipin Thomas
Arpita Chaudhuri
Rebecca Lal
Chaitali Chaudhari
Pooja Bharti
Jyoti Sinha
Nishidha Rasal
Deepti Joshi
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