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Nonglak Pagaiya and Sanya Sriratana
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Shortage of doctors, nurses and PT. Surplus of dental personnel, if not well job ... Local recruitment, regional training and hometown placement esp, nurses, PT ... – PowerPoint PPT presentation
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Title: Nonglak Pagaiya and Sanya Sriratana
1
Planning for health workforce for primary care
services in 2 provinces in the Northeast Thailand
- Nonglak Pagaiya and Sanya Sriratana
- International Health Policy program
2
Presentation outline
- Why are-based HWF planning
- Objectives
- Results
- Policy implication
3
Health Service System
Center of Excellence
Prov/ reg hosp (100)
RURAL
District hosp 50,000 (83)
Health centre 5,000 (100)
4
1. Context/ factors effecting HWF demand
- Change in demo./ epidemiology
- Elderly increase up to 10 , 15 in 10 yrs
- Increase in chronic diseases
- Increase in accident/ emergency
- Reform
- universal coverage, increase utilisation
- civil service reform, limit number of HRH
- existence of organization promoting health
promotion
5
Health workforce (HWF) problems
- Mismatch between Supply and Demand
- Mal-distribution, rural vs urban
supply
Demand
6
Limitations of HWF planning
- Contextual changes, effecting HFW
- Inadequate evidence-based information
- Emphasize on number rather than quality and
planning process, limited stakeholders - Lack of area-based planning, not related to local
needs - Plan for each professional separately
- Methods for planning is limited to population
ratio
7
2. Objectives and Approach
- to assess the health workforce supply and demand
and to develop recommendations to redress the
mismatch between health workforce supply and
demand. - Approaches
- Develop the HFW forecasting model
- Collect baseline information
- Assess supply and demand (requirement)
- Develop recommendations for HFW planning
8
Baseline data for HWF forecasting Model
- Model assess HFW requirement base on health needs
and health demand approach - Population by age group
- Sickness and service utilization by age group
- Health facilities
- HWF, number, distribution, loss rate and gain
rate - Productivity and staffing norm
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Population by age group
Community setting
Facility setting
1? care
Com. care
HFW
HFW
2? care
HFW
HFW
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3. Results
1) Sickness and service utilization at primary
care (Curative and rehabilitation at health
centers)
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2) Baseline data of 2 provinces
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Community HWF Supply
13
3) HWF supply (2? care)Ubon
24
11
11
20
3
2
14
HWF supply (1? care) Ubon
1
5
2
21
5
1
15
(5) HWF supply (2 ? care) KK
27
12
11
7
7
2
16
(5) HWF supply (1 ? care) KK
2
4
3
2
2
1
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Service provision and task-shifting
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HFW requirements Ubon
19
HFW requirements KK
20
Community HWF supply and requirements
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4. Summary
- HWF problems
- Shortage of doctors, nurses and PT
- Surplus of dental personnel, if not well job
allocation - Inequitable distribution, esp primary vs
secondary care - Retention in rural, esp, primary care
22
Recommendations
- Area-based planning with HFW mechanism at local
and national level - Increase production, particularly
- Local recruitment, regional training and hometown
placement esp, nurses, PT - Increase production of auxialies, i.e., PT
auxiliaries and plan for their career path - Appropriate task-shifting
- Doctors and nurses curative
- Nurses and public health prevention
- Public health and nurse vs VHV and community HWF
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Recommendation (cont)
- 4. Shift from curative care to health promotion
and prevention at community levels - 5. Strengthen community health workforce, esp,
VHV , aged care providers and other volunteers - 6. Consider appropriate incentives (financial and
non-financial) to attract and retain doctors,
nurses, PH and PT at rural. - 7. Strengthen effective referal system btw health
centers and hospital including sharing resources
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