Country Action for the Health Workforce: A Powerful Framework

In Papua New Guinea, Mary Roroi sought to help strengthen the country’s health workforce. And in Pakistan, Dr. Zulfiqar Khan was facing the same challenge. They discovered a tool that’s proving helpful.

“We have introduced the HAF to the human resources officers who are working at the National Department of Health, and we have also advocated that to our faith-based organizations,” says Roroi. She is the principal advisor for health sector workforce training at the National Department of Health.

HAF stands for the HRH Action Framework. It’s designed to help governments and health managers develop and implement strategies that will strengthen the health workforce—from better distribution to improved retention and fewer gaps in skills.

A comprehensive approach
Roroi explains how the HAF helped her understand the value of a strong information system for the health workforce. “I have realized that it is very important to agree on the information system that can be accepted by the country, because that will be used as the indicators for HRH monitoring. I believe if we have that information system [to show us] where there are gaps, with some way of working out what the requirements are [to fill the gaps], it then becomes a very good tool in advocating to the stakeholders who have been identified using the Action Fields.”

The HAF includes six Action Fields (HR Management Systems, Leadership, Partnership, Finance, Education, and Policy) and four-step Action Cycle (Situational Analysis, Planning, Implementation, and Monitoring and Evaluation). Each Action Field and Cycle is linked to tools, guidelines, indicators, and resources.

Strategic planning
“I work for WHO Country Office, Pakistan,” says Dr. Khan. “I am technical officer for health systems development and focal person for human resources for health.” He learned about the HAF at a meeting and engaged in group work to develop strategic objectives. “The six areas [Action Fields] which the HAF talks about helped us a lot to develop these strategic areas because it has further explanations—for example, who could be the potential leaders and what could be their role, and how to bring them together. It is really very helpful.”

Referring to the Action Cycle, Dr. Khan reports that his team is making progress. “The first step is to do situational analysis, and we have done that.” He used the HAF extensively in dialogues to develop a strategic framework for the health workforce in Pakistan. “The HAF improved the output of the meetings and kept us focused,” he notes. The group identified 42 specific challenges, most of which were covered under the six Action Fields.

Bringing stakeholders together
As Roroi notes, stakeholder involvement is key. The World Health Report 2006 states that taking action on the health workforce “necessitates that stakeholders work together through inclusive alliances and networks—local, national, and global—across health problems, professions, disciplines, ministries, sectors, and countries.”

Toward this end, the Global Health Workforce Alliance (GHWA) developed a process called Country Coordination and Facilitation; the HAF can be applied to support stakeholder engagement and leadership. “In regard to establishing the CCF process we have already gone ahead and used the HAF tool,” says Roroi.

Putting the HAF to work
The HAF website was developed as an initiative of GHWA and represents a collaborative effort between USAID and the World Health Organization. As a GHWA partner, the Capacity Project and now CapacityPlus contributed to the development of the HAF from the beginning. CapacityPlus is currently the website administrator.

Many countries and programs have used the HAF to guide their health workforce strategies and plans. The HAF website features case studies containing practical information from Uganda, Kenya, Peru, and Vietnam. Check out the website (http://www.capacityproject.org/framework/), and contact CapacityPlus to learn more.

A version of this piece was originally published as Voices#3, on the CapacityPlus website.