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Table 2 Human resources implications of the factors

From: The importance of human resources management in health care: a global context

  Countries
Factors Canada United States Germany Developing countries
Number, composition and distribution of health care workers Human resources professionals (HRP) will need to assess needs throughout all regions of Canada. Given that health care delivery is a provincial and territorial responsibility, HRP will need to work with and through the 13 different provinces and territories in Canada. This will require a greater understanding of regional issues, practices, etc. While not formally entrenched in legislature as it is in Canada, health delivery is a more regional than national and therefore HRP will have many of the same issues as they have in Canada in terms of working at the state and local levels. As cited in the research, Germany currently has an oversupply of physicians and health other health professionals in certain regions. This imbalance will require HRP to work with the regional authorities to better understand the needs of specific regions and help plan for a better match between supply of and demand for health professionals. Developing countries face significant challenges in all five areas discussed in this paper. Therefore, as described in reference to Canada, the United States and Germany, HRP will have an active role in all areas as well. It is not just a matter of more health resources for developing countries, since these resources must be managed efficiently and effectively. Since one of the largest and most complex health care input are the human resources, it is clear that as developing countries increase the number of workers, HRP will have an active and important role to play.
Workforce training issues As shown in the research, a move towards a more interdisciplinary approach to health care delivery will require new skills on the part of health workers. HRP will have a significant role in helping to create a culture that encourages this type of health care delivery. The case studies cited in this paper show that HRP will have a significant role in helping to develop the appropriate culture in health organizations to ensure that delivery is as effective and efficient as possible. With the current oversupply of some health workers, HRP have the opportunity to develop and provide input into planning for future training that more accurately reflects current and anticipated needs. As in Canada and the United States, the move towards a more interdisciplinary approach will also be reflected here since the complexity of health care means that no one person can have all of the answers. Therefore, HRP will need to provide input on how to make this new approach work. With more limited resources available, workforce training issues can become challenging and HRP will have to help develop strategies that are appropriate and sustainable. These approaches could include an increased use of technology or a broadened role for different health workers such as nurses. HRP will have to work with existing health workers to help integrate these and other new approaches to how workers are trained.
Migration of health workers As with many countries, there are challenges in meeting the health needs of the remote areas of Canada. HRP will need to work with the provinces to develop programmes and incentives to encourage health workers to consider moving to these areas. The United States faces similar situations to that of Canada in this regard and HRP will have to work with the state officials to develop programmes and incentives to encourage health workers to consider moving to these areas. By addressing and helping to better balance the supply of health workers with the demand, there will be less migration of workers out of Germany. There are significant costs to a country in training a health care professional and if workers leave after being trained, the country will not receive any benefit from its training investment. HRP can help to ensure that there is less migration of workers out of Germany by working at the strategic planning levels to help better match supply and demand. This is an especially challenging area in developing countries, not only because of the extreme differences between the rural and urban areas, but also because of the increasing pressure from other countries to "poach" health care workers. By helping to develop policies and strategies such as those described above in "Workforce Training Issues", HRP can help reduce the migration of health workers from where they are needed.
Level of economic development in a country Although Canada is an economically well-developed country, it, too, is facing financial pressures in the area of health spending. As discussed earlier in this paper, HRP will need to be involved at the strategic level of health planning in order to be able to influence discussions on spending priorities in this area. HRP should no longer be seen as just implementers of policies developed by others. The United States, one of the wealthiest countries in the world, does not lack the means to obtain the latest health resources. Rather, the issue is that individuals do not always have the financial ability to gain access to these resources. This is shown by the fact that over 40 million Americans have no health care coverage. HRP will need to work with health care professionals at a senior, strategic level to address this pressing problem. Germany is economically well-developed, but it, too, is facing economic realities and the pressures of increasing health care costs. HRP can contribute to the development of a more efficient and effective health care delivery system by being involved at the strategic level rather than just being implementers of policies developed by others. This is a significant issue in developing countries where the resources for even the most basic health care needs may be difficult to obtain and sustain. By helping the health system to become more efficient and effective, HRP will help these countries make the most of the resources they have.
Sociodemographic, geographical and cultural While there are not many significant geographical or cultural issues, Canada is facing an ageing population, which will make significant and increasing health care demands. HRP will need to play an active role at the strategic levels in order to ensure their skills, abilities and contributions are considered at this level. The United States also faces an ageing population, which will make significant and increasing health care demands. As in Canada, HRP will need to play an active role at the strategic levels. Germany also faces the challenges of an ageing population and therefore has to make the health care system as efficient and effective as possible. HRP have the opportunity and responsibility to play an active role at the strategic level. Countries such as Canada and the United States are very similar in terms of these factors, so approaches that work in one country would not require much adjustment to work in another. Germany, while not being as similar as Canada and the United States are to each other, is a developed country and would be able to employ many of the human resource approaches to health care that would work in Canada and the United States. HRP have a great opportunity to identify and factor in the socio-demographic, geographical and cultural differences found in developing countries, since that is what they are trained to do. HRP will have a vital role in ensuring that approaches that may work in other countries are not applied without consideration of these differences.