HEALTH WORKFORCE ISSUES UNDER IBRD HNP PROJECTS IN AFRICA

1
HEALTH WORKFORCE ISSUES UNDER IBRD HNP PROJECTS
IN AFRICA

• Edward Elmendorf and
• Kathryn LaRusso
• Oct. 28, 2004

2
BASIC HYPOTHESIS AND METHDODOLOGY

• Hypothesis Bank involvement in Human Resources
  for Health (HRH) in HNP Investments has been
  limited, at best
• Methodology Systematic compilation and synthesis
  of HRH data from all completion reports and OED
  project evaluation studies
• Data set 63 studies, 1974-2002
• Limitations desk study, ICRs/OED evaluaations,
  no field work or interviews

3
KEY FINDINGS

• IBRD HRH ENGAGEMENT SURPRISINGLY WIDE, BUT NOT
  DEEP
• HNP OPERATIONS HAVE SOME HEALTH WORKFORCE
  ACTIVITY (HWA) IN ALMOST ALL CASES
• ONLY 50 OF ICRs HAVE HWA COST DATA, WITH HWA 10
  OF COST AND TOTAL 93 MILLION

4
KEY FINDINGS, cont.

• FOCUS OF HWA ON TRAINING, MOSTLY IN-SERVICE,
  FREQUENTLY OF PROJECT PERSONNEL
• WIDE, IMAGINATIVE RANGE OF HWA SUPPORTED AD HOC
  BUT APPARENTLY NOT SYSTEMATICALLY
• IMPLICIT PARADIGM NARROW FOCUS ON PROJECT NEEDS
• LITTLE ATTENTION TO HEALTH WORKFORCE POLICY,
  PLANNING, PAY, DEPLOYMENT, OR ENGAGEMENT WITH
  PROFESSIONS
• WHY? NEW HYPOTHESES AND NEED FOR INTERVIEWS