Table 1 HRH-related constraints and possible variables to measure constraints
Constraint | Possible indicator | Data availability and potential source |
|---|---|---|
Individual characteristics | Â | Â |
   Gender | Proportion of women in the workforce by skill level | MoH statistical data and/or workforce census |
   Social class and ethnicity of staff | Representation of health workers from minority groups | MoH statistical data and/or workforce census |
   Demand for medical training | Number of applicants per training position | Medical training institutions |
   Disease | HIV/AIDS prevalence rates among health workers | MoH statistical data and/or surveys |
Health service level | Â | Â |
   Team building and interaction | Number of team meetings and supervisions | Survey |
   Surpluses, shortages and skill mix at health service level | Proportion of health staff working in correctly staffed services | MoH statistical data and/or surveys |
   Physical working environment | Proportion of health staff working in correctly equipped services | MoH statistical data and/or surveys |
Health sector level | Â | Â |
   Salary level and monetary incentives | Salary grids in absolute terms | MoH and/or MoF statistical data |
   Performance management and productivity | Existence of frameworks for managing the collection and use of performance evidence (including carrier plans) | MoH policy documents surveys on productivity |
   Composition of workforce and skill mix | Shortages or surpluses of staff in particular occupations or professions / Appropriately skilled workers for addressing priority diseases (e.g. HIV/AIDS, malaria, TB) | MoH statistical data and/or workforce census |
   Geographical imbalances | Distribution of appropriately skilled workers across regions | MoH statistical data and/or workforce census |
   Retention policy | Existence of retention policy | MoH policy documents |
   Health sector reform | Improvements in performance and responsiveness to adjust staff roles | Surveys |
   HRH policy and planning | Planning of future HRH availability and requirements | MoH policy documents |
Training capacities | Â | Â |
   Training | Number of trainees per skill level | Medical training institutions |
   Retraining | Number of re-trainees per skill level | Continuous medical training institutions |
Socio-political and economic context of a country | Â | Â |
   Multisectoral approaches | Quality of exchange among different interest groups and ministries | Policy documents and/or complementary assessments |
   Migration | Number of health staff migrating | MoH statistical data and/or workforce census |
   Governance and overall policy framework | Political stability, priority attached to social sectors, decentralization, civil service rules, etc. | Policy documents and/or complementary assessments |