Use of the HAF in HR strategic planning: National Tuberculosis Program
National Tuberculosis Programs start developing Human Resources for Health (HRH) strategic plans. Internal and external stakeholders are involved in this strategic planning process. Multi stakeholders’ workshops are organized to map the current Human Resources (HR) situation in TB programs and define future ambitions and strategies. In this strategic planning process, the HRH Action Framework (HAF) has been a useful tool, used to create a common understanding among stakeholders, structure information and facilitate planning.
During the strategic planning workshops, the HAF has been used at different stages and with different purposes, for example:
- At the start, to create a common understanding of HRH in TB control and to identify the stakeholders to involve in the planning and implementation of HRH policies.
- To assess the current HR situation in TB control using a SWOT analysis. The SWOT analysis often results in a huge amount of information. The HAF proved to provide a very useful way to cluster this information and generate a clear overview of Strengths, Weaknesses, Opportunities and Threats of the current situation.
SWOT analysis, using HAF action fields to cluster the information (an example)
|Policy||Clear guidelines for TB and Leprosy control||Lack of HR policies at level of MOH||Draft HRH strategic plan of MOH National and international political will for TB control (MDG 6)||Political instability Restructuring of the MOH|
|Finances||Financial support by partners||TB funding too much donor dependent –> not sustainable||Funding from partners for training and supervision||Lack of financial resourcesWorld wide economic crisis|
|Education, supervision, professional sharing|
|Health workers’ competencies||Well trained Provincial and District Coordinators||Community Health Workers not competent enough Poor attitude of HCW towards TB|
|In service training||Standard training curricula and training course materials are available||Lack of training of HCWs and CHWs Lack of regular refresher training for laboratory staff||Technical partners with expertise in training and supervision.|
|Pre-service training||No involvement of TB program in pre-service curricula of medical schools|
|Supervision||Well organized supervision structure at provincial and district level||Supervision has a strong focus on control|
|Professional sharing||Quarterly review meetings for provincial and district health staff||In some provinces provincial and district laboratory staff doesn’t participate in quarterly meetings|
|Leadership||Commitment for HR plan and HR interventions||Inadequate mandate of Central Unit in developing and implementing HRH policies||Weak transparency in decision making related to staff and finances|
|Partnership||Collaboration and coordination with development partners||Limited collaboration with training institutes / medical schools Weak cooperation with HIV/Aids program||Donors and development partners have a strong focus on strengthening HRH||Limited collaboration with medical schoolsFinancial donor dependency|
|Staffing and workload||Community health workers available||High staff turn overHigh workload and staff shortage||National workforce planning||Poor information on workforce planning by the MOH|
|HR Management Information System||Global Fund reporting –> data on training available||No data base for training||Data from HR information system from the MOH|
|Job descriptions||No up to date job descriptions|
|Staff motivation||Poor staff motivation because of poor working conditions and limited career development possibilities|
|Work environment and working conditions||Poor infrastructure and equipment of health facilities and laboratories|
|Safety||TB/IC policy is under development||Weak infection control in clinic and laboratory||Risk of MDR / XDR for HCWs|
|Transport||Poor satisfaction of district staff on transport for supervision|
|Salaries and incentives||Differences in salaries between civil servants and NGO staff|
- This clustered SWOT analysis facilitated the process to develop comprehensive strategies based on the current situation.
The handbook “Planning the development of human resources for health for implementation of the Stop TB strategy” is a guide for HR strategic planning in TB control. The handbook presents the HAF as an important tool for HR strategic planning.