Global Health Workforce Alliance Concept Note: A global strategy on Human Resources for Health for Post-2015

Transcription

1 Annex This concept note sets out a process, coordinated by the Global Health Workforce Alliance (the Alliance), to renew and re-energize human resources for health at global, regional, national and community levels in order to maximize future health gain. 2. The Alliance was created in 2006 as a common platform for action on Human Resources for Health (HRH). It is a partnership of national governments, civil society, international agencies, finance institutions, researchers, educators and professional associations, providing added value through advocacy, communication and collaboration. 3. The health workforce will be central to achieving health and wider economic, gender and social objectives in a post development agenda. The on-going challenge of health workforce deficits, combined with ageing populations and changes to the broader determinants of health, require the global community to re-appraise and re-evaluate the effectiveness of the decade of action on the health workforce and instill these lessons in a new, contemporary agenda. 4. The paper presents an overview of the objective, background, scope of work and governance arrangements of a global consultation on HRH taking place in the period April to November 2014 (Annex 1). The consultation results from ongoing collaboration between the Board of the Alliance, USAID, the World Bank and the World Health Organization. Objective 5. The primary objective of the consultation is to inform the development of a global strategy on Human Resources for Health that will be relevant to the post-2015 development agenda ( ). Background 6. The last decade has seen great progress on HRH. Notable milestones include the Joint Learning Initiative (JLI) 2004, the World Health Report (WHR) 2006, creation of the Global Health Workforce Alliance (2006), the Kampala Declaration and Agenda for Global Action (2008) and the WHO Code of Practice (2010), in addition to a number of World Health Assembly (WHA) resolutions and other political and policy processes which have recognized the centrality of the health workforce to the attainment of health objectives. 7. Key accomplishments include greater engagement from countries and their development partners to address the complexity of HRH challenges, shifting towards country ownership and sustainability. Some of these partnerships have resulted in increased investments at country level (e.g. PEPFAR, GFATM, World Bank Multi Donors Trust Fund). 8. There is however concern that the global milestones and accomplishments have not resulted in greater progress at country level. Many of the original countries determined as experiencing a workforce crisis continue to experience significant challenges. Meanwhile, new dynamics resulting from the global financial crisis are affecting domestic and international funding for the health sector and impacting on health labor markets. Questions are being raised as to the level of global commitment to strategically and significantly address human resources for health and enable the attainment of Universal Health Coverage (UHC). 07 April

2 9. The 3 rd Global Forum on HRH in November 2013 provided new momentum and engagement, with HRH being recognized as critical to the achievement of UHC and central to the post-2015 agenda. 56 Member States of the WHO made commitments to address the availability, accessibility, acceptability and quality of the health workforce. Country representatives adopted the Recife Political Declaration on Human Resources for Health: renewed commitments towards universal health coverage. The political declaration was subsequently discussed at the Executive Board of the WHO (Jan 2014), with agreement for further discussion at the 67 th World Health Assembly (May 2014). 10. At the 16 th meeting of the Alliance Board, held immediately following the 3 rd Global Forum, members reviewed the role of the Alliance and in light of new developments decided to revisit with some urgency the Alliance s Strategy : Advancing the Health Workforce Agenda within UHC. Three key actions were identified: convene a broad set of actors to inform a new vision that will re-energize the HRH field ; include a future-oriented look beyond the Alliance s mandate to 2016; and build new momentum for action for the next decade. The creation of a working group to develop a strategy for the HRH movement encompassing the Alliance, its members and the global community, was agreed (Annex 2) In parallel, global deliberations to inform the post-2015 development agenda continue. The technical and political processes are converging. The Open Working Group on Sustainable Development Goals (OWG) will report their findings in September at a High-Level Meeting at the United Nations General Assembly, and the UN Secretary-General is expected to provide a synthesis report in the final quarter of The UNSG s report will lay the ground for detailed intergovernmental negotiations in The OWG has released a document describing 19 focus areas for the post-2015 Sustainable Development Goals (SDGs). The 19 focus areas do not limit further discourse or imply these are already fixed as post-2015 priorities. They do however signal some emerging consensus on issues of major relevance. From an HRH perspective the OWG list includes at least seven focus areas with direct and indirect linkages to the future HRH agenda: poverty eradication, health and population, education, gender equality, economic growth, infrastructure and peaceful/non-violent societies. 13. Other technical reports of interest to the future HRH agenda include two reports from the UNSG s Sustainable Development Solutions Network: Health in the Framework of Sustainable Development and Indicators for Sustainable Development. Both of which argue for a future emphasis on the equitable delivery of health services to an increasing percentage of national populations, consistent with the aspirations for UHC. Global consultation on HRH 14. It is against this background that the Alliance is coordinating the global consultation, with the objective to inform a future strategy on HRH that will be relevant to the post-2015 development agenda ( ) for all countries at all stages of socio-economic development. 15. The consultation will build on earlier work on the HRH implications of UHC, with additional analyses of: future scenarios in the period ; multi-sectoral government activities, such as the ILO s work with its Member States on strengthening social protection systems, and; opportunities arising 1 See ToR for GHWA Global HRH Strategy Development Working Group (Annex 2)- undergoing revision 07 April

3 from the anticipated economic, demographic, and epidemiologic transitions in many low- and middle-income countries. Scope of work 16. The consultation will be an open process to collate evidence and elicit new thinking. Guiding principles for the consultation are in Annex The scope includes 8 themes that can contribute to the overall development of a forward-looking strategy. Each theme is mapped against Sousa et al s (2013) Comprehensive health labour market framework for UHC in Annex 3. The 8 themes are not exhaustive, but will provide opportunities to inform further thinking. Each will be coordinated through a Thematic Working Group (TWG): 18. The list of TWGs and indicative titles of the groups are below: TWG 1: The drivers of change in health labour markets; TWG 2: The role of transformative education; TWG 3: Data and measurement of HRH availability, accessibility, acceptability and quality; TWG 4: Accountability and alignment for post-2015: the roles and responsibilities of state and non-state actors. TWG 5: Leadership, governance and policy alignment in public/private health systems; TWG 6: The drivers of change in Fragile States; TWG 7: Improving productivity and performance: the roles of regulation, professional associations and standards; TWG 8: Building on human capability beyond the health sector; 19. Each TWG will comprise 2 co-chairs and a group of individual experts drawn from the constituencies of the Alliance. The TWGs will lead the collation of evidence, with consultation opportunities facilitated through the Alliance s e-forum. 20. The outputs from each TWG are as follows: A strategic paper (maximum 3,000 words) with bold new ideas and proposed paths and platforms for an audience of national authorities, UN agencies, donors, countries, NGOs, professional associations and other HRH stakeholders. A synthesis of key messages (maximum 500 words) A presentation for dissemination at the 3 rd Global Symposium on Health Systems Research in Cape Town in September The Alliance will utilize the 8 papers to inform next steps on a forward-looking, global agenda for HRH. Governance of the Consultation 22. The 8 TWGs will operate under the oversight of the GHWA Board working group, co-chaired by Estelle Quain and Frances Day-Stirk. Each TWG will submit initial terms of reference and subsequent drafts of the analyses and papers produced for review and feed-back by the GHWA Board working group. 07 April

4 23. The communications from the co-chairs of the thematic working groups will be channeled through the co-chairs of the GHWA Board working group, who, in turn, will seek the inputs of the other members of the working group as required. 24. The secretariat (established at the Prince Mahidol Award Conference to oversee the operations of the 8 TWGs ) will be subsumed within the GHWA Board working group, and the members of the former invited to join the latter; the functions of the secretariat will also be taken over by the GHWA Board working group. 25. The functions of the thus expanded GHWA Board working group will be revised in a new version of its TOR (Annex 2), to be discussed and approved by the GHWA Standing Committee at its May meeting. Attachments: Annex 1. Overview: Towards a Global Strategy on Human Resources for Health Annex 2: ToR for GHWA Board Working Group undergoing revision Annex 3: Comprehensive health labour market framework for UHC 07 April

5 Annex 1: Towards a Global Strategy on Human Resources for Health Overview 07 April

6 07 April

7 Annex 2: Terms of Reference for GHWA Board Working Group (undergoing revision) 07 April

8 Annex 3: Comprehensive Health Labour Market Framework for UHC 07 April