STRATEGIC FRAMEWORKSTRATEGIC FRAMEWORK

HUMAN RESOURCE DEVELOPMENT HUMAN RESOURCE DEVELOPMENT IN THE PERIOD OF 2011-2020IN THE PERIOD OF 2011-2020

(Draft)(Draft)

December 2010December 2010

The necessary role of this framework:

Three biggest challenges of human resource:-Lack of staff numbers-quality is not enough-located unequally among geographical areas, levels and specialties.

-Government requested to develop this long-term plan-Provinces/cities have increasing needs on HR, but is not met.

CURRENT HUMAN RESOURCECURRENT HUMAN RESOURCE

Fig1. Total number of health professionals during 2003 - 2008

241498 244987259583 271149 280521

349491

0

50000

100000

150000

200000

250000

300000

350000

2003 2004 2005 2006 2007 2008

Table 1. Distribution of health professional (2003 – 2008)

2003 2004 2005 2006 2007 2008

MD 47587 48215 50106 52413 54910 56208

Assistant doctor 48325 48059 49674 48519 48738 49213

Pharmacist 6266 6360 10669 10700 10270 19861

Nurse 48157 49534 52115 57003 61158 67075

Midwife 16218 17610 18313 19242 20920 22943

Traditional

healer317 293 295 656 677

Technician 10242 10400 10782 12221 12495 44975

1986 1996 2006 2007 2008

No of health staff/ 10.000 capita

43,1 28,1 32,2 32,9 40,5

No of MD/10.000 capita

3,2 4,4 6,23 6,45 6,52

No of Pharmacist/10.000 capita

0,09 0,07 1,27 1,21 1,22

Table 2: Basic number on health professional

Type of training Number %

MD (university and postgraduate level) 54.910 19,7

Pharmacist (university and postgraduate level) 10.270 3,7

Nurse, midwife (secondary level and higher level) 70.316 25,1

Assistant doctor 48.738 17,4

Elementary nurse and midwife 11.762 4,2

Secondary pharmacist 12,059 4,3

Elementary pharmacist 9.374 3,3

Technician (all levels) 13.205 4,7

Other staffs 49.210 17,6

Total 279.844 100%

Table 3: Distribution of health professional by types and levels

Fig 3: Distribution of health staffs by education level (2009)

Fig 4. Distribution of health staffs by working levels

CURRENT STATUS OF HEALTH CURRENT STATUS OF HEALTH PROFESSIONAL TRAININGPROFESSIONAL TRAINING

Distribution of health science universitiesDistribution of health science universities

Khoa Y ĐH QG HN

Học viện Y Dược học Cổ truyền (2003)

Trường ĐH Y Dược Huế (1957)

Trường ĐH Y Hải Phòng (1979)

Trường ĐH Y Thái Nguyên (1968)

Trường ĐH Y Hà Nội (1902)

Trường ĐH Y Dược Cần Thơ (1979)

ĐH Y Dược TP Hồ Chí Minh (1947)

Trường ĐH Y khoa Phạm Ngọc Thạch (2007)

Trường ĐH Dược Hà Nội (1902)

Trường ĐH Y tế công cộng (2001)

Trường ĐH Điều dưỡng NĐ(2006) (2004)

Khoa ĐD, Khoa KHSK – ĐH Thăng Long (2006)

Khoa Y, ĐH Yersin (2004)

Tr ng ĐH KT Y t H i D ng ườ ế ả ươ(2007)

Khoa Y, ĐH Tây Nguyên (1997)

Trường ĐH Y Thái Bình (1968)

Khoa ĐD và KTYH, ĐH Hồng Bàng* (2006)

Public school Private school New school

ĐH Y khoa Vinh

Khoa ĐD- ĐH Thành Tây

Khoa Y-ĐH Quốc gia HCM

Khoa Y ĐH An Giang

Khoa Y, ĐH Yersin (2004)

Khoa ĐD- ĐH Duy Tân

Khoa YD-ĐH Đà Nẵng (2007)

Học viện quân Y- BQPKhoa Y ĐH Tây

Bắc

- Currently, there are 24 health science universities/schools:18 public universities/schools;05 private (nursing training) universities/schools; 01 belong to Ministry of Defence;

- In preparation to establish 2 new training institutes (Tây bắc & An Giang).

- Distribution of these schools is unequal among geographic and socio-economic areas

- There is no coducted research on the quality of teachers/lecturers.

- There is no compulsory training program for teachers

- There is no comprehensive project on training of trainers, including international support project

- Better teachers prefer working at bigger schools in Hanoi and HCM city. (Prof. and A.Prof by 33%)

- Some schools have no or just one or two professors

Number of Enrollment over years

Type of training 2000 2005 2010

Medical 3500 4000 6700

Pharmacy 700 1200 2800

Nurse 300 1600 3600

Technician 200 400 900

Public health 70 350 500

Total 4770 7550 14500

Number of new graduated students

Level of training 2000 2005 2010

PhD 90 150 250

Master 500 700 1450

Specialist degree II (CKII) 200 300 700

Specialist degree I (CKI) 2000 2000 2500

Internship 100 110 270

Total 28902890 32603260 51705170

- Budget for equipment and construction at schools, which belong to MoH, is low. There is no regular budget for upgrading teaching and technical equipment. Most of sources depend on ODA

- National program for education system provides to 11 MoH training institutes an amount of 4 to 8 bil VND

- Budget for one student/year is 7.5 mil VND - Regular expenditure increases 10-15% annually

while number of enrolled students surge into double after every 5-6 years

- There are 34 junior colleges.

- Only one college provides training on reparing technical equipment

- In the last two years, there is a big number of SMS upgraded to junior colleges. However, investment for these schools is very limitted. Many of them received no more infrastructure investment after two years.

Junior colleges

- There are 44 public SMS in provinces and cities.

- All provinces/cities have either SMS or junior colleges or both, except new established provinces.

- There are some private schools participated in training health professionals at secondary level

Secondary medical schoolSecondary medical school

CHALLENGES INHUMAN RESOURCE DEVELOPMENT

Human resource-Training programs do not match with human resource plan, socio-economic development plan-It is difficult to recruit staffs in some areas: anatomy, lab test, metal health, TB, leprosy-In provincial and district levels: lack of health staffs in both quantity and quality. Few MD, who have CKII or master degrees, works in district level-Applying Decree No 43/2006/ND-CP => limit number of health staffs in order to reduce the payment-Wage and income of health staffs is still very low

Trainings for staffs

-Number of graduated students (medical and pharmacy) do not meet the need of health care system

-The training quality has been improved but it doesn’t match with technology development and the need of community

-Low capacity in regional training system integration. Face to the risk of falling behind.

-Without clear orientation and direction for Training on Technical transformation.

-Still many difficulties in training health professionals

- Training management is not systematic, there are many gaps because the roles of MoH and MoET, people committee and other ministries have not been described clear yet.

- New junior colleges haven’t got enough capacity to train staffs at college level.

- Vocational training in health sector is limitted

- Training and recruiting doesn’t match each other

- Government Investment for trainings is limitted

Policy on recruiting and treatment

-Insufficient regulations: provinces themselves can not decide number of permanent health stafts.

-Retaining policy is not strong enough to attract health staffs, especially in mountain, remote, island areas and in some “not attractive” specialties.

-Allowance is too low, not updated, not adequate with the special working condition of health sector.

PLAN’S OBJECTIVESPLAN’S OBJECTIVES

GENERAL OBJECTIVESGENERAL OBJECTIVES

To provide enough HR with good quality, appropriate structures and distribution, to contribute in improving health service quality, family planning activities, health protection and health care for people, toward the equity, efficiency and development.

SPECIFIC OBJECTIVESSPECIFIC OBJECTIVES

1. Establish and develop a network of health professional training institutions, which fit with social-economic development in each areas of the country.

2. Develop an appropriate HR structure fit with health system, to meet with the basic requirements on HR for all specialties in order to implement the tasks of protecting and improving people’s health condition.

3. Adjust the HR recruitment and retaining policy.

3. Indicators3.1. Human resource

- 41 health staffs (all kinds)/10,000 capita in 2015 and 52 health staffs/10,000 capita in 2020;

- 8 MD/10,000 capita in 2015 and 10/10,000 capita in 2020;

- 2 pharmacist/10,000 capita in 2015 and 2,5 pharmacist/10,000 capita in 2020;

- 12 nurses/10,000 capita in 2015 and 20 nurses/10,000 capita in 2020;

- 5 med. technicians/10,000 capita in 2015 and 8 med. technicians/10,000 capita in 2020;

- 14 other staffs /10,000 capita in 2015 and reduce to 11.5 other staffs/10,000 capita in 2020

3.2. Training health staffs

- In 2015, strive to be qualified to establish two Health Science Universities in Hanoi and HCM city based on the basis frameworks of Hanoi medical university, HCM Med and Pharm university and some new established schools. Up to 2020, these two Universities will develope to the same scale and emphersize the training quality with popular universities in regional areas; some schools/faculties in these universities will be able to provide training courses in foreign language with international training programs.

- Up to 2015, 03 more medical and pharmacy schools/faculties will be established inside the politechnique universities, in order to provide enough HR for health care and family planning.

- More than 70% (in 2015) and 100% (in 2020) health science universities, junior colleges and SMS will meet the standard criteria of MoH and MoET on infrastructure, professional environment for training.

In 2015, ensure that all provinces, cities belonging to national level have public or private junior colleges or SMS, among them 80% are colleges.

In 2015, number of foreign students will be about 0.5 to 1% of total number of undergraduate students.

Up to 2015, all health science schools have renovated their training programs and regularly updated their training programs.

In 2020, overcome the lack of HR for health and family planning in grass-root level in difficulty areas; ensure the HR for “low atractive” specialties.

In 2020, health science universities will have their own practical hospitals, ensure the teaching, research and practical conditions, and in the same time to participate in providing health services.

In 2020, more than 90% university lecturers and more than 70% college lecturers have postgraduate degrees; more than 75% university lecturer and 20% college lecturer are PhD; more than 50% of SMS teacher have postgraduate degrees.

In 2020, at least 5% undergraduate students and 20% college and SMS students study in private health science schools.

SOLUTIONS FOR HRDSOLUTIONS FOR HRD

I.I. POLICY AND MECHANISMPOLICY AND MECHANISM

-Adjust, modify and issue the policy in recruiting health staffs, preferential allowance for them to fit with actual working condition of the health sector, to ensure the attraction and retaining health staffs to work in health sector, especially in low attraction section such as: preventive medicine, grass-root level, difficulty areas, and some specialties,…

-Curriculum on implementing preferential allowance must be details, accurate and fit with actual condition to ensure that health facilities could implement them easily.

-It is necessary to have appropriate financial mechanism (to allocate the government budget to pay for health staffs after having the adjustment) to ensure health staffs will have preferential allowance right after related regulations are issued and valid.

II.II. TRAINING HEALTH PROFESSIONALTRAINING HEALTH PROFESSIONAL

1. Develop training institutions, teachers and renovate training methods and programs

University: - Establish Health Science Universities in Hanoi and HCM city, Hue Med and Pharm schools will become focal school.-Other health science schools will provide training in all kinds of health staffs with increasing number of students.-These schools will decrease number of students in college and secondary level, and they are not limitted in enrollment.

Junior colleges

-Each socio-economic area has at least one focal junior college, provide multi training programs and multi-level with number of students from 800 to 1000, among them, college students are 80%.

-Other junior colleges have number of students from 500 - 800

SMS Only exist in some socio-economic difficult provinces. Number of students per school is 400 to 600.

Private schools -Have different size depending on the social labor needs and the schools’ capacity.-Have right to provide all kinds of training program whenever the schools meet the conditional requirements.

Types of training

- Regular training-Training under contracts at specific address-Step up training-Nominated training-Training for employees-Second degree training-Certificate training according to the demand of leaners

Training projects

Group 1:-Training health professional based on social needs (including contract training for specific address, technology transference training, nominated training)-Project to support Vinh Med and Pharmacy School -Project to establish Taynguyen Med University-Project to establish Med and Pharm faculty in Taybac University-Training project for high skills health professionals, health managers and hospital managers.

Group 2:-Project of using government bond to improving infrastructure for 15 universities and 65 junior colleges, SMS in public sector.-ADB project on “Human resource for health development” to develop training system for health sector-Project on developing high quality HR for health in period 2011-2010.-Project on training HR using modern training program (for some training programs)

Group 2 (cont):

-Project on training of trainers of health science schools, including strengthening their capacity in active teaching methods, how to develop training materials-Project on strengthening health training management and accreditation-Project on renovation training program, textbook and teaching methods

Project/program need supportsProject/program need supports

• Projects to improve infrastructure and training equipment for universities

• Training of trainer project• Education renovation and accreditation project• Project to cooperate with popular international

universities to provide distance learning course• Comprehensive survey on HR for health in the whole

country• Pilot study on HR management, coordination models for

some difficulty recruitment areas• ….

THANK YOU!THANK YOU!