Research in Human Resources for Health

© Gilles Dussault

The research approach in the field of Health Human Resources (HRH) can be performed based on some strategic questions: Why study this topic? What are the main topics and priorities of the research? How to use the final results?

Learning more about the various aspects of HRH – behavior and performance determinants – have become increasingly more necessary to divulgate policies and management practices in the health sector. In December 2012, the countries members of the United Nations signed a resolution on Universal Health Coverage. Such goal can only be achieved if the access to sustainable health services systems is guaranteed. Basically, without a strong workforce, the goal of Universal Health Coverage will not be achieved. The title of the report (background paper), prepared for the 3^rd Global Forum on HRH held in Recife, November 2013, summarizes the idea: “A Universal Truth: there is no health without health workers” (¹).

The document points out that a workforce with four main features is necessary: availability, accessibility, acceptability and quality. First a country must have a sufficient number of qualified health workers that can perform multiple tasks and meet the needs and expectations of the population; that are accessible considering distances, service hours and costs; accepted by the population: language, values, cultural sensitivity, and with technical and social skills that result in quality services. The challenge is how to develop a workforce with this profile, and this is the main point to which the research must contribute.

After the publication of the “World Health Report: working together for health”(²) in 2006, the research in HRH had an exponential increase in quality and quantity. It was quickly identified the need to set priorities to focus on a timely production of knowledge, to establish the formulation and implementation of policies with impact on HRH, to optimize the performance of workers and thus meet the population needs and the goal of Universal coverage.

An exercise of identifying priorities has been launched by the World Health Organization (WHO) and by the Alliance for Health Policy and Systems Research, in which the following aspects were considered as priority research areas: the formation of HRH regarding its content, strategy, quality and effectiveness; the mechanisms of regulation effectiveness of the work quality in the public and private sectors; HRH funding, including the efficiency of various remuneration modes and incentives to improve productivity and the quality of the services offered; management, organization and working environment, conditions of employment to motivate workers; and planning, policies, and the relationships among actors from several areas, such as education, finance, public administration and others that also influence HRH(³) elements.

To complement the project it is important to identify some specific topics that deserve more attention. First of all, concerning availability and accessibility issues, it is necessary more information on how to predict the future needs of HRH. It means being able to estimate the needs in relation to services to be provided and “translate” this information into numbers, type of workers and the skills we need to form, integrate and retain from the labor market. In a context in which the younger generation is not sufficient to replace baby boomers who are now retiring, we have a major challenge: to convince qualified young people to work in the health sector. Another challenge is to attract and retain qualified professionals in areas with shortage of this type of employee and occasionally in the health sector. For this we need policies based on a valid knowledge of the factors that influence young people’s decisions regarding the choice of a vocational training and subsequently of type and location of practice. Therefore it is pertinent to know how incentives packages can be created to produce the desired effect.

In addition the research can provide information about another critical issue, regarding the best division and organization of work that can ensure the availability and accessibility to services. For instance, the issue of allocation of tasks between nurses and doctors and the qualitative and quantitative composition of the health team is critical for work efficiency in health.

To improve the acceptability of HRH, it is necessary to meet the expectations of the service users and also to know the HRH capability in meeting these expectations. The research may help defining appropriate selection criteria for the entry in vocational training, and content and training methodologies that allow the acquisition, maintenance and skill improvement.

It is important to understand the factors that determine quality, considering the acquisition of skills or the professional work to create capacities and conditions for production of quality services.

Finally, regarding policies, it is relevant to know the dynamics of the labor market, migration flows, management practices and to learn from past experiences through evaluative research.

The knowledge derived from research on HRH can be very relevant, but of little use if it cannot be helpful to other researchers and do not clarify its decisions and practices. In most countries, the knowledge production and decision-making are separate processes. We know some of the reasons for such gap: the research language is not so approachable; researchers are not familiarized with the complexity of the decision-making and management processes, and with the relation of decision-makers and managers with the research complexities; the schedules/time of decision-making and the conduction of research and the results are divergent. There are major efforts to approximate the decision research as, for example, through the work of HRH observatories. These initiatives should have continuity, because, even though knowing that public policies and management will never be defined just on the basis of the research results, it is indisputable that while ignoring their contributions the risk of making wrong decisions and consequently wasting precious resources increases.

REFERÊNCIAS

• ¹
  Campbell JG, Dussault J. Buchan F, Pozo-Martin M, Guerra Arias C, Leone A, et al. A Universal Truth: no health without a workforce. Forum Report. Geneva: Global Health Workforce Alliance WHO; 2013.
• ²
  Organização Mundial da Saúde (OMS). Trabalhando Juntos pela Saúde: Relatório Mundial da Saúde, 2006. Brasília: OMS; 2007.
• ³
  Ranson MK, Chopra M, Atkins S, Dal Poz MR, Bennett S. Research on human resources for health in non-affluent countries. Bull World Health Organ. 2010;88(6):435-43.

Publication Dates

• Publication in this collection
  Dec 2015