Meet our guest speakers

Dr Francis Omaswa

Executive Director of the African Centre for Global Health and Social Transformation (ACHEST)

Formerly Director General Ministry of Health, Uganda

Founding Executive Director of the Global Health Workforce Alliance

Current Chair of Board of African Platform on Human Resources for Health

Principal Investigator Medical Education Partnership Initiative (MEPI)

Chancellor Busitema University, Uganda

Outline

• Definition of Fit For Purpose (FFP)

• Need for new thinking and effort

• Human Resource for Health Challenges• Human Resource for Health Challenges

• Competency Based Education

• Way forward

What is Fit For Purpose

• Good enough to do the job for which it was

designed

• Possess attributes required to achieve

intended objective

• Experts, Professionals, Leaders• Experts, Professionals, Leaders

What FFP is not

• Low quality Health Workforce (HWF) for the

poor only

• HWF with restricted market

• Origins of FFP HWF: Africa first missionaries

• FFP HWF: UK (surgeons); USA surgical

technicians

Why new directions?

• Global shortage: 4.3m, African shortage 1m

• Globalised connected world with inequities

• Tensions: Health Professionals vs Population

expectations: vocation or jobs, distribution,

commercialisation, working environmentcommercialisation, working environment

• Changing scope of practice; unmet skills

needs: Nurse Practitioners, Task Shifting,

Needs based training etc

Education: critical solution

• Underlying global HWF crisis is failure to train

and retain enough

• Education Institutions are factories: good

factory = good product; bad factory = bad

productproduct

• Sub Saharan African Medical Schools Study:

faculty shortages, infrastructure, private

sector

Environment in Africa

• Large population

• Limited resources

• Human Resource shortages

• Big Disease burden

Source: www.worldmappers.org

Leading causes of disease burden in Africa, 2000

Source: The World Health Report 2001, WHO

HS definition

African HWF spectrum

Super-specialists

Specialists

General

Practitioners

Contributing factors:

•Good governance, law and order

•Gender

•Social justice

•Social and economic development

National

Referral

Regional

Referral Practitioners

Mid-level

CHWs

Referral

District level

Sub-District level

Household & community

SH

AR

ED

AU health strategy

• Determine the categories of professional, auxiliary (mid-level) and community health workers that will provide an appropriate human resource mix for their needs

• Develop costed national human resources development and deployment plans, including revised packages and incentives, especially for working in disadvantaged areas

• Fund the establishment of the training capacity required to produce the desired number of health workers

• Build multi-purpose trained staff as the nucleus of health care delivery

Scale-up frameworkGOAL: HEALTH OUTCOMES

Integrated Health Service Delivery Networks

PRIORITISED SKILL MIX

"CLOSE-TO-CLIENT HEALTH TEAMS"Defined within country context

INDICATOR:

MDGs

Defined within country context

EXISTING CAPACITY DEVELOPMENT OF NEW CAPACITIES

FINANCIALPOLITICAL TECHNICAL

- Resources

- Incentives

- Partnerships

- Supportive environment

- Leadership

- Commitment

- Legislation

- Policy

- Partnerships

- Training

- Institutions

- Infrastructure

- Connectivity

- Partnerships

Critical success factors for scaling up

Study of GHWA Task Force on Education and Training

• 9 country experiences across regions

Critical factors identified:

• Political commitment and good governance– Sustained high level support, 'one' country-led health plan, significant

financial investment

• Enabling environment– Multi-sector participation, Good information systems, effective management

and leadership, labour market capacity and policy

• Workforce planning– Plan long term, act short-term and update regularly, commitment to

production / appropriate skill mix integrated teams, needs based, expansion of pre-service programmes

New directions

Competency /

Outcome Based Needs Based

EducationOutcome Based

EducationEducation

Competency based education

• Education aimed at imparting underlying

characteristics related to job performance

• Encompasses knowledge, traits, skills and abilities

• Fit for Purpose

Required competencies

• Prepared to work where services are most needed

• Able to respond to health needs of community

• Able to deliver quality care with available (limited)

resources

• Able to be leaders and change agents• Able to be leaders and change agents

• Continuous self directed learners

• Effective communicators

Achieving competencies

• Selection process for candidates• Right attitudes, belong to community (underserved areas)

• Training in real life practice environment

• Mentorship• Mentorship

• Team Based Learning

• Strong linkages with communities

Kampala declaration and agenda for global action

• Key elements:

– Building coherent national and global leadership for health workforce solutions

– Ensuring capacity for an informed response based on evidence and joint learning

– Scaling up health worker education and training with needs based skill mix

– Retaining an effective, responsive and equitably distributed health – Retaining an effective, responsive and equitably distributed health workforce

– Managing the pressures of the international health workforce market and its impact on migration

– Securing additional and more productive investment in the health workforce

Implication for countries

• Prioritise Education and Training of HWF

• Link with National Development Plans

• Plan long-term, act short-term and review frequently

• Link E &T to Population health needs & health

systemssystems

• Create Country Multi-stakeholder Alliances (CCF)

• Establish HWF Information Systems (Observatories)

Outline of this talk

• Outline of medical education in the UK

• Current perspectives in UK medical education

• Professionalism and Leadership

• Studying health and leadership

Meet our guest speakers

Dr Helen O’Sullivan

Senior Lecturer in Medical Education

Director of the Centre for Excellence in Evidence Based Learning and Teaching, Faculty of Health and Life Sciences, University of Liverpool

Medical education in the UK

• Two phases: undergraduate (medical student) and

postgraduate (junior doctors)

• The General Medical Council regulates medical education in

the UK

• At undergraduate level “Tomorrow’s Doctors” specifies

outcomes in three categories:

– The doctor as a scholar and a scientist

– The doctor as a practitioner

– The doctor as a professional

Junior doctors

• Undergo a further period of training

– Foundation years (2 years)

– Specialty training

Current perspectives on medical education

• Increasing interest in medical professionalism

• “a set of values, behaviours and relationships that underpins

the trust that the public has in doctors” 1

• Particular interest in how you develop and assess these

aspects

• Leadership has been established as a core competency for • Leadership has been established as a core competency for

medical students and junior doctors

1 Royal College of Physicians (2005) Doctors in Society: Medical Professionalism in a

Changing world. RCP. London.

Leadership development

• Healthcare provision in the UK is in a period of enormous

change:

– Technological advances

– Austerity

– Changes in society

• All healthcare professionals need to understand how to

manage change and provide leadership

• Leadership education is now required in undergraduate and

postgraduate education

Studying health care and health

• Advanced programmes of study such as Masters in health and

public health provide an opportunity for doctors and other

healthcare professionals to develop the appropriate

theoretical and practical skills to improve global health

• The key to successful improvements in health is to have

healthcare professionals who are also trained in leadership healthcare professionals who are also trained in leadership

and management

• By combining the study of the main disciplines of public heath

with management of health systems graduates from these

types of programmes can really make an impact on healthcare

and healthcare education in their communities, regionally and

nationally

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