Table 2 Cadrewise HRH-related strategies and actions for AAAQ dimensions recommended in the NHPIs
NHPI Year | Availability | Accessibility | Acceptability | Quality | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Cadre focused | Recommendations given | Strategy/Action not used | Cadre focused | Recommendations given | Strategy/Action not used | Cadre focused | Recommendations given | Strategy/Action not used | Cadre focused | Recommendations given | Strategy/Action not used | |
1983 | Othera | - Create a new HRH cadre | - Establish new training institutes - Increase the number of seats in existing training institutes - Task shifting and task sharing - Recruiting HRH from foreign countries - Retaining HRH within the country | Doctor | - Financial incentive | - Tele-consultation - Identify groups/individuals motivated to work in underserved areas - Remove professional isolation - Remove administrative barriers in recruitment like walk-in interviews - Mandatory rural postings | No recommendation focused on the acceptability of HRH | Other | - Formal training courses for unqualified HRH | - Grievance redressal and feedback system for patients - Maintain quality of HRH - Professional councils for all HRH cadres - Improving the training of HRH cadres - Standard licensing exam for all cadres - Conduct meetings to review common medical errors - Regular assessment of in-service staff | ||
Non-cadre-specificb | - Measure and monitor availability of HRH using information systems | AYUSHc | - Streamline and integrate traditional HRH cadres - Task shifting in underserved areas | Non-cadre- specific | - Changes in curriculum - Develop interpersonal/ soft skills | |||||||
Non-cadre- specific | - Attract and retain HRH from surplus sector/area/level of care/system of medicine to underserved areas - Increase production of HRH in underserved areas - Develop information systems and tools to measure and monitor the availability of HRH | |||||||||||
2002 | Doctor | - Develop information systems and tools to measure and monitor the availability of HRH - Establish new training institutes - Increase the number of seats in medical institutes - Task shifting and sharing | - Recruiting HRH from foreign countries - Retaining HRH within the country | Doctor | - Mandatory rural posting - Removing administrative barriers of recruitment - Task shifting and sharing in underserved areas - Tele-consultation | - Establish training institutes in underserved areas - Provide financial and non-financial incentives - Identify groups or individuals motivated towards serving underserved areas - Removing professional isolation - Develop information systems and tools to measure and monitor the geographical distribution of HRH - Streamline and integrate traditional medicine HRH in underserved areas | Non-cadre- specific | - Create and deploy HRH representative of sex, age, religion, etc. of the population being served | - Create HRH closer to the community - Deploy HRH in the local community - Induction training of new HRH - Create appropriate cadre-mix | Doctor | - Change the curriculum to suit all levels of care - Improve the training of HRH cadres - Continued medical education and training to HRH | - Regular assessment of in-service staff and performance-based incentives - Grievance redressal and feedback system for patients to identify areas of improvement for HRH - Standard licensing exam - Establish policy/rules for promotion, transfer, leave, salary, etc. for all HRH - Conduct meetings to review the common medical error - Formal training of unqualified HRH |
Nurse | - Increase the number of nursing institutes - Task-shifting and task-sharing - Develop information systems and tools to measure and monitor the availability of HRH | Nurse | - Task-shifting and multi-tasking of HRH cadres in underserved areas | Other | - Preferentially expand cadres with greater local acceptance | Non-cadre- specific | - Develop interpersonal/ soft skills in all cadres - Improving the training of HRH cadres | |||||
Other | - Establish new training institutes - Create a new HRH cadre (LMPd) | Paramedic (pharmacist) | - Task-shifting and multi-tasking of HRH cadres in underserved areas | Paramedic (pharmacist) | - Task-shifting and multi-tasking of HRH cadres | Paramedic (pharmacist) | - Changing the curriculum to suit all levels of care - Professional councils for all HRH cadres | |||||
Dentist | - Establish new training institutes | Other | - Create a new cadre (LMP) specifically for underserved areas | Doctor | - Develop socio-cultural competence in HRH | Nurse | - Improving the training of nurses | |||||
Paramedic (pharmacist) | - Task-shifting and multi-tasking | Non-cadre specific | - Task-shifting and multi-tasking of HRH cadres in underserved areas | |||||||||
Non-cadre specific | Create a new HRH cadre | |||||||||||
2017 | Doctor | - Establish new training institutes - Increase the number of seats in existing institutes - Task shifting and sharing - Create a new HRH cadre | - Recruiting HRH from foreign countries - Reducing emigration - Reduce attrition | Doctor | - Establish training institutes in underserved areas - Mandatory rural posting - Remove administrative barriers in recruitments - Increase production in underserved areas - Tele-consultation - Providing financial and non-financial incentives - Identify individuals/groups motivated to work in underserved areas - Task shifting and multi-tasking of HRH cadres in underserved areas | - Reduce professional isolation - Develop information systems and tools to measure and monitor the geographical distribution of HRH | Doctor | - Emphasize socio-cultural aspects in the medical curriculum - Mandatory rural posting | - Create appropriate cadre-mix - Create and deploy HRH representative with the composition of society in terms of sex, caste religion, etc - Pre-posting regional training (induction training) | Doctor | - Improving the training of HRH cadres - Standard licensing exam for all cadres - Continued medical education and training to HRH - Develop interpersonal/ soft skills in HRH cadres - Changing the curriculum to suit all levels of care - Give performance-based incentives | - Regular assessment of in-service staff - Patient feedback and grievance redressal system - Conduct meetings to review common medical errors |
Nurse | - Create a new HRH cadre - Establish new training institutes | AYUSH | Expand cadres with high local acceptance preferentially | |||||||||
Other | - Task shifting and multi-tasking of HRH cadres - Create a new HRH cadre - Establish new training institutes - Task shifting and task sharing - Increase the number of seats in existing institutes - Develop information system tools to measure and monitor the availability of HRH | Paramedic (pharmacist) | - Task shifting and multitasking of HRH cadres in underserved areas - Increase production of HRH in underserved areas | Paramedic (pharmacist) | - Expand cadres with high local acceptance preferentially - Deploy HRH in the local community | Nurse | - Improving training of HRH cadres - Professional councils for all HRH cadres - Continued medical education and training to HRH | |||||
Paramedic (pharmacist) | - Increase the number of seats in existing training institutes, - Task shifting and task sharing, - Develop tools to measure HRH (by IPHSe norms) | AYUSH | - Streamline and integrate traditional HRH in underserved areas - Tele-consultation - Task shifting and multi-tasking of HRH cadres in underserved areas | Nurse | - Expand cadres with high local acceptance preferentially | Other | - Improving training of HRH cadres - Formal training courses for unqualified HRH - Standard licensing exam - Professional councils - Develop interpersonal/ soft skills in HRH cadres | |||||
Non-cadre- specific | - Develop information system and tools to measure and monitor availability of HRH - Establish new training institutes - Increase number of seats in existing training institutes | Other | - Increase production of HRH in underserved areas - Task shifting and multi-tasking of HRH cadres in underserved areas - Remove administrative barriers in recruitment - Identify groups/individuals motivated to work in underserved areas - Create HRH cadre specifically for underserved areas | ANM | - Expand cadres with high local acceptance preferentially | Non-cadre- specific | - Continued medical education and training to HRH - Establish policy/ rules for promotion, transfer, leave, salary, etc. for all HRH cadres - Develop interpersonal/ soft skills in HRH cadres - Professional councils for all HRH cadres - Changing curriculum to suit all levels of care | |||||
ANM | - Task shifting and multi-tasking of HRH cadres in underserved areas | Other | - Create HRH closer to community -Expand cadres with high local acceptance preferentially - Task shifting and multi-tasking of HRH cadres | AYUSH | - Changing curriculum to suit all levels of care - Professional councils | |||||||
Nurse | - Task shifting and multi-tasking of HRH cadres in underserved areas - Create new HRH cadre specifically for underserved areas | Paramedics (pharmacist) | - Changing curriculum to suit all levels of care - Professional councils | |||||||||
Non-cadre-specific | - Provide financial and non-financial incentives | Dentist | - Professional councils for dentist | |||||||||