HAF APPLICATION:  CASE STUDY IN PERU

Context and Health Workforce Challenge

In October 2007 countries in the Americas Region committed to 20 goals for human resources for health 2007-2015.  These high level, adaptable regional goals represent a renewed willingness and commitment from countries in the Americas to act and move collectively in addressing critical HRH challenges.  PAHO joined with the Capacity Project to introduce the HAF as a resource to countries as they develop and implement their plans to achieve these goals.  In September 2008, the HAF was introduced to the countries of the Andean region. These countries – Columbia, Chile, Ecuador, Venezuela, Peru, and Bolivia – participated in a HAF workshop to learn how to use the HAF to support and improve their national HRH planning. (See agenda for this workshop in Annex 1).

As a result of the HAF Workshop, the leadership in the Ministry of Health in Peru (MINSA) became very interested in using the HAF to strengthen planning for their HRH challenges.  Expecting the government to pass new laws mandating universal health insurance, a number of activities are being carried out, using the HAF as the conceptual framework for their work. 

Methodology and Process

In using the HAF to analyze needs and determine priorities, the Minister of Health was very eager to train senior leaders in MINSA in the economics of health so they would be better prepared to make budgeting and financial decisions. The USAID Capacity Project partnered with the MINSA and the Universidad de Pacífico to develop and deliver an economics course for non-economists in health systems management, focusing on the economics of meeting the HRH challenges facing Peru. (Course description is Annex 2).

As MINSA leaders explored the HAF Action Fields, a second priority for MINSA surfaced – the need strengthen the human resources (HRM) functions within the ministry, especially at the regional and district levels.  This priority stimulated interest and enthusiasm for adapting the PAHO- sponsored CHIRUS course for Peru to train HR leaders and managers to better plan and manage HRH.  An additional module training HR professions in the use of the HAF will be added to the CHIRUS course for both the Peru course and for other CHIRUS courses being carried out in other Andean countries. (See Annex 3 for description of CHIRUS and Annex 4 for the HAF module that is to be a part of this course)

The newly passed Universal Health Insurance law is to be implemented on a pilot basis in 3 regions in Peru.  One of the new tools just posted to the HAF website is the Resources Requirement Tool (RRT), developed through the Global Health Workforce Alliance (GHWA).  This is a tool to help policy makers budget and cost their HRH strategies.  The USAID Capacity Project in collaboration with PAHO is working with MINSA to adapt the RRT for Peru and train MINSA staff in its use. (Annex 5 is a description of the RRT)

Plans are being made for the Capacity Project in partnership with PAHO and MINSA/Peru to conduct a regional workshop for other Andean Countries to further explore how the HAF Finance Action Field can help countries develop better practices for financing HRH plans.  Using their experiences from using the RRT, Peruvian MINSA HRH staff will help teach the RRT to other countries in the Region.

Key Outcomes

The use of the HAF in Peru has resulted in several positive changes regarding how HRH challenges are being managed.  In that Peru chose to focus on the Finance Action Field, there are now 36 senior leaders in MINSA who are better able to address the economic aspects of strengthening HRH policies and practices.  There are both HR professionals and HR financial analysts who are skilled in using a major HRH budget and costing tool from the HAF Finance Action Field.  This tool is being used to cost Peru’s new universal health insurance package.

Relationships have been built and strengthened between education sector and health authorities.  A module on the HAF has been added to the CHIRUS course.  Leading schools of public health are participating in the CHIRUS course and are expecting to add HRM topics to their curricula. Beginning now and into the future HR professionals will be able to use the HAF in their work. The strengthened partnerships that came out of this collaborative work underscores the inter-relationships of the Action Fields of the HAF framework. The education initiative led to partnering between USAID, Capacity Project / TRG, PAHO, national universities, and Peru’s Ministry of Health. These different entities are finding new ways of working together to provide technical support to Peru, which should be sustainable for future international development outreach.

Samples and Examples

The following examples are included as Annexes:

Annex 1.  Agenda for workshop to introduce the HAF to HRH stakeholders

Annex 2.  Health economics course summary

Annex 3.  Description of CHIRUS course

Annex 4.  Description of the HAF Module included in the CHIRUS course

Annex 5.  Description of the Required Resources Tool (RRT)