The Philippine HRH Master Plan ( )

Transcription

1 The Philippine HRH Master Plan (25-23) F. Marilyn E. Lorenzo DrPH College of Public Health University of the Philippines, Manila First GHWA Conference Kampala, Uganda March 5,28

2 HRH Master Plan Goal Develop and install HHRMD systems that will support Philippine health sector reforms to improve health outcomes 2

3 II. Situational Analysis Weak Health System Inequitable 11. Inequitable distribution of of health professionals 1 Inadequacy in Budgeted Items for HRH resource in government and private facilities at the provincial and municipal levels Variable cost of health sciences education Lack of system for local recruitment and deployment Low Quality Proliferation of substandard schools (eg. nursing schools) 7. No rational basis for opening of health science schools Increased Migration of Health professionals Health Low Productivity y of Health Profession al 6.Poor Working Conditions; Limited Career Progression Opportunities; Unfavorable terns of employment Other 5. Other health health professionals going into nursing Dissatisfaction on 4.Compensation : Low; Large gap exists between salaries of government and private based health workers Salaries of resident doctors and nurses pale in comparison to professional s in other sectors Inappropriate or outdated skill and skill mix HR Standards outdated or inappropriate Lack of integrated HRH systems in general: Information system, HRH development, compensation/ benefits/ incentives, production, regulation, deployment/ placement, utilization, monitoring/ evaluation, policy and standard development, HRH planning Functions of organizations with HR roles are not integrated (DOH, PRC. CHED, DBM, POEA, DOLE, DILG, TESDA, Private Hospitals) National HHRD Plan of 1994 not implemented Inadequate HRH Management Systems 1. No integrated policies on HHR 2. Weak HRH info system to support other HR systems (eg. health facilities, HRH stock and needs) 3. Lack of Operations Research to rationalize HR standards 3

4 Situational Analysis Summary: Strengths / Opportunities 1. Presence of Organizations with HRH functions and existence of informal ties 2. DOH: Ability to solve HRH problems that surface 3. New emphasis on HRH globally and nationally 4. Competitiveness of Health Sciences Professions; Popularity of Health Sciences programs over other professional programs 4

5 Situational Analysis Summary: Weaknesses and Threats Government organizations have fragmented HRH functions Non- integrated organizational policies No evidence-based staffing standards politicized, limited and outdated Contractualization of HRH: Job Order, Labor List Lack of Functional HRH systems in general Inequitable distribution of HRH Inadequately budgeted items for HRH 5

6 Framework for Human Resource for Health Multiple Interests (Values) of the Key Stakeholders Health Workers Community Unions Health Facilities NGOs Federation of Health Prof Orgs LGUs External Environment Socio-economic Planning, Health Planning, Disease Conditions, Government Pressures and Regulation,Market Conditions,Union pressures, Stage of country s Development and Culture, HHR Needs and Resources HR Plan PRC, DOH, CHED -Policy and Standard Development -Monitoring and Evaluation of Policies -Information System -Research HR Management and Strategies DOH, Prof. Association, CSC Recruitment, Deployment/Placement Orientation, Supervisory System Production Stds, Non-labor Inputs, Career Pathways Development of HHR Systems Internal Environment Health Services, Sectoral Strategy, Job Technology, HR Characteristics Feedback system for control HR Production and Regulation Academe, PRC, CHED,TESDA HR Development PRC, DOH, CHED, Specialty Boards Academe/ Institutions -Continuing Education -Training HR Outcomes Competence Congruence Commitment Org Effectiveness Cost Effectiveness Productivity Readiness for Change and innovation Long Term Consequences Individual Well Being Organizational Effectiveness Societal Well Being Quality Work life Figure 1: National Health Human Resource Development Framework 6

7 Planning Bases Medium Term Development Plan NEDA UN Millennium Development Goals Devolution Inter-local Health Zones Health Sector Reform Health Needs (Disease Patterns; Triple burden of Disease) Health financing (Philhealth, commercial, community) Domestic HRH demand based on socio-demographic trends Foreign HRH demand based on known demand trends Regulatory standards e.g. AO 7, AO 147 National Health Plan

8 Planning Assumptions Implementation of HSRA until 23 Workforce plans based on following requirements: population equitable distribution based on needs, geographic characteristics and socio-economic factors Regulatory standards Phased HRHD planning feasible 12 HRH categories covered in first phase 11 HRH categories covered in second phase Each HRH category is assumed to have possible multiple roles as clinicians, educators and researchers EO 366 is implemented 8

9 Available Positions in the government and hospitals for various health professional groups Professions Doctors Nurses Dentists MedTech PT OT Pharmacist s Midwives Existing DOH/NGAs positions 6,91 12,159 1, ,39 No. of RHUs/MHCs/ BHS 2,296 2,296 2,296 2,296 11,537 Number of Positions Positions in Hospitals Public 7,285 27, ,645 Private 6,391 24, ,32 Total 13,676 51, ,965 Total 22,873 65,9 4,423 4, ,282 17,541

10 Assumptions: 1. Distribution of HW based on distribution of public (53.27%) and private (46.73%) hospital beds 2. RHUs/MHCs require only one health worker per type of profession 3. HW to hospital bed ratio based on AO Medtech, OT, PT, Pharm to hospital bed ratio assumed to be 1 per hospital except for birthing homes and infirmary 5. Admin positions (chiefs, supervisors) taken into account for doctors and nurses 6. Secondary care hospitals assumed to have 4 dept 7. Tertiary care hospitals assumed to have 7 dept 8. Tertiary care medical centers assumed to have 15 dept 1

11 Workforce projections for various health professional groups, Professions Projected Workforce Requirements Doctors 3,525 33,277 36,289 39,586 43,196 47,151 Nurses 17, ,788 22,63 221,1 241, ,244 Dentists 8,629 15,954 9,871 1,761 11,735 12,82 MedTech 6,386 6,393 6,633 7,33 7,553 7,779 PT 14,313 15,675 17,314 19,88 21,144 23,584 OT 1,769 11,713 12,774 13,94 15,218 16,618 Pharmacists 21,572 23,518 25,646 27,976 3,527 33,322 Midwives 17,338 18,897 2,63 22,469 24,513 26,751 11

12 Distribution of projected workforce to public and private sectors for various health professional groups, Doctors Nurses Dentists Midwives Professions Medical Technologists Physical Therapists Occupational Therapists Pharmacists Projected Workforce Requirements Public 21,996 18,253 7,862 5,774 8,435 6,41 14,959 15,45 25 Private 8,529 62, ,878 4,359 6,613 2,293 Public 23, ,13 14,536 5,78 9,238 6,972 16,38 16, Private 9,298 67,775 1, ,437 4,741 7,29 2,5 12

13 Difference between projected workforce for the public sector and existing positions for various health professional groups, Professions Doctors Nurses Dentists MedTech PT OT Pharmaci sts Midwives Existing positions in public sector (A) 16,482 41,86 4,3 3, ,221 Projected Workforce Requirements Projections (B) 21,996 18,253 7,862 5,774 4,147 3,146 14,959 15,45 25 Difference (A-B) -5,514-66,393-3,832-2,65-3,583-2,568-14,7 176 Projections (C) 23, ,13 14,536 5,78 4,55 3,413 16,38 16, Difference (A-C) -7,497-76,153-1,56-2,71-3,941-2,835-15,419-1,177 13

14 Difference between projected workforce for the public sector and existing positions for various health professional groups, Professions Doctors Nurses Dentists MedTech PT OT Pharmacists Midwives Existing positions in public sector (A) 16,482 41,86 4,3 3, ,221 Projections (B) 21,996 18,253 7,862 5,774 8,435 6,41 14,959 15,45 Projected Workforce Requirements 25 Difference (A-B) -5,514-66,393-3,832-2,65-7,871-5,832-14, , ,13 14,536 5,78 9,238 6,972 16,38 16, Projections (C) Differe nce (A- C) -7,497-76,153-1,56-2,71-8,674-6,394-15,419-1,177 14

15 Salary costs of projected workforce to public and private sectors for various health professional groups, 25-21, in Billions PhP Professions Doctors Nurses Dentists MedTech PT OT Pharmacists Midwives Public Projected Workforce Requirements 25 Private Public Private

16 Cost projections (Training) for various health profession groups for Philippines (in Billions Php) Professions Years MDs RNs DMD MW Pharm MT PT OT Total

17 Cost projections (Salaries) for various health profession groups for Philippines (in Billions Php) Professions Years MDs RNs DMD MW Pharm MT PT OT Total

18 Assumptions for workforce projections (Nurses) Regions Assumptions NCR CAR I II Preferred Nurses to Population Ratio Number of RNs at beginning of year 32,63 6,22 12,669 14,285 RN Attrition Rate 11.76% 7.32%.% 4.17% Current Population 11,24,743 1,56,867 4,491,386 3,87,476 Annual Population Growth Rate 1.19% 1.9% 1.39% 1.56% Current Salary Costs/RN 31,14 285,138 31,14 31,14 Current Cost to train RN Student 127,383 12,49 14,23 7,694 SES Weight Cultural Weight Geographic Weight RN Graduation Patterns

19 Assumptions for workforce projections (Doctors) Regions Assumptions NCR CAR I II Preferred Doctors to Population Ratio Number of MDs at beginning of year 14,391 1,68 1,869 2,764 MD Attrition Rate 3.3% 1.41% 57.89% 7.14% Current Population 11,24,743 1,56,867 4,491,386 3,87,476 Annual Population Growth Rate 1.19% 1.9% 1.39% 1.56% Current Salary Costs/MD 285, , , ,138 Current Cost to train MD Student 55, 55, 55, 55, SES Weight Cultural Weight Geographic Weight MD Graduation Patterns

20 General Assumptions 1. NSO population projections using medium assumptions 2. Wages from government rates (entry level) 3. Stock of HW derived from licensees (PRC data) adjusted for unemployment (11.4%) and migration (per category of HW) 4. Distribution of HWs across regions assumed to be the same as distribution of government HWs 5. Attrition rate assumed to be the same as that for government HWs 6. Adjusted for socio-economic, cultural, and geographic indices 7. Increased graduation patterns by 1% starting 26 for all regions except for NCR 2

21 The Proposed HRH Implementing Organization DTI DOF Funding PHIC/ International Donors like WHO Domestic Deployment DOLE & League of Municipalities and Cities NGOs DILG Int l Deployment POEA, DFA & OWWA POPCOM Retention, Compensation & Career Dev t DBM, PHA & LGUs Planning, Resource Mgmt, Coordination, Champion DOH BLHD, HHRDB,,IMS, HPDPB, BIHC, BHFS, NCFHD Partners Proposed Implementers of the Plan PITAC Production Academe & Accredited Professional Organizations Regulation PRC, Professional Regulatory Boards, CHED, TESDA & PHIC Data source: LGU s NEDA Support & coordinating agencies CSC 21

22 HRHMP Time Frame (Phase I) Year (25-21) HRHMP Outputs Phase I Finalization of HRH Master Plan Workforce planning in local levels Pilot: Staffing Plan, 15 Pilot ILHZs Establishment: HRH units and HRHIS Career Development Management Systems Interventions Competency-Based Job Analysis Interventions Program Development: domestic and international deployment Formulation: Evaluation scheme for 7 HRH systems Establishment : HRH Implementing Org. Monitoring the HRHMP: Comp. I 22

23 HRHMP Time Frame (Phase II) HRHMP Outputs Phase II Year (211-22) Deployment Projections: medium and long terms CDMS Implementation: expansion areas Programs implementation: Quality health science schools HRHIS expansion: 46 ILHZs Maintenance of HRHIS Staffing Components Implementation: 46 ILHZs Maintenance of HRHIO Conferences between private and public sectors Monitoring of the HRHMP 23

24 HRHMP Time Frame (Phase III) HRHMP Activities/ Outputs Phase III Year (211-22) CDMS Implementation (entire public sector) Implementation of 7 Management Systems Continued Evaluation of HR management Systems and HRHMP Monitoring of Staff Performance and Satisfaction Review of Master Plan Revision of HRH programs based on monitoring and evaluation Planning for the next master plan 24

25 Thank you!