Денсаулық сақтау жүйесіндегі кадрлар: маңыздылығы мен дамуы

People acting to improve health outcomes

Health human resources (HHR) – also known as human resources for health (HRH) or health workforce – is defined as "all people engaged in actions whose primary intent is to enhance positive health outcomes", according to World Health Organization's World Health Report 2006. Human resources for health are identified as one of the six core building blocks of a health system. They include physicians, nursing professionals, pharmacists, midwives, dentists, allied health professions, community health workers, and other social service and health care providers. Health human resources are further composed of health management and support personnel: those who do not provide direct patient care but add important value to enhance health system efficiency, effectiveness and equity. They include health services managers, medical records and health information technicians, health economists, health supply chain managers, medical secretaries, facility maintenance workers, and others. The field of HHR deals with issues such as workforce planning and policy evaluation, recruitment and retention, training and development of skilled personnel, performance management, health workforce information systems, and research on health workforce strengthening. Raising awareness of the critical role of human resources in the health care sector particularly as exacerbated by health labour shortages stemming from the Covid 19 pandemic has placed the health workforce as one of the highest priorities of the global health agenda.

In some countries and jurisdictions, health workforce planning is distributed among labour market participants. In others, there is an explicit policy or strategy adopted by governments and systems to plan for adequate numbers, distribution and quality of health workers to meet health care goals. For one, the International Council of Nurses reports:
The objective of HHRP [health human resources planning] is to provide the right number of health care workers with the right knowledge, skills, attitudes, and qualifications, performing the right tasks in the right place at the right time to achieve the right predetermined health targets. An essential component of planned HRH targets is supply and demand modeling, or the use of appropriate data to link population health needs and/or health care delivery targets with human resources supply, distribution and productivity. The results are intended to be used to generate evidence based policies to guide workforce sustainability. In resource limited countries, HRH planning approaches are often driven by the needs of targeted programmes or projects, for example, those responding to the Millennium Development Goals or, more recently, the Sustainable Development Goals. The WHO Workload Indicators of Staffing Need (WISN) is an HRH planning and management tool that can be adapted to local circumstances. It provides health managers a systematic way to make staffing decisions in order to better manage their human resources, based on a health worker's workload, with activity (time) standards applied for each workload component at a given health facility.

The main international policy framework for addressing shortages and maldistribution of health professionals is the Global Code of Practice on the International Recruitment of Health Personnel, adopted by the WHO's 63rd World Health Assembly in 2010. The Code was developed in a context of increasing debate on international health worker recruitment, especially in some higher income countries, and its impact on the ability of many third world countries to deliver primary health care services. Although non binding on the Member States and recruitment agencies, the Code promotes principles and practices for the ethical international recruitment of health personnel. It also advocates the strengthening of health personnel information systems to support effective health workforce policies and planning in countries.

The WHO estimates women comprise approximately 70% of the global health workforce, but gender equality remains elusive. Women’s contributions to health and social care services are markedly undervalued; health labour markets around the world continue to be characterized with gender based occupational segregation, inadequate work conditions free from gender bias and sexual harassment, gender pay gaps, and lack of gender parity in leadership. Numerous HHR studies have shown women healthcare providers earn significantly less on average than men despite similar professional titles, qualifications and job responsibilities. Meanwhile, an estimated 75% of HHR leadership roles are held by men.