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Strategies to Maximize Human Resources for Health Performance

Watch as Assefa Seme Deresse shares some strategized learned in the polio eradication campaigns to maximize human resource performance. (Step 4.6)
ASSEFA SEME DERESSE: Finally, let’s talk about strategies to maximize human resource for health performance. What are the strategies used to maximize the human resource for health performance? Some of the strategies to maximize human resource for health are as follows– recruitment, recruiting new health workers periodically. This helps to avoid burnout and demotivation. Second strategy is to shuffle health workers periodically. Shuffling health workers from insecure and hard-to-reach areas to closest safe places. Allocate health workers to areas based on population size and the status of polio to a low for optimal distribution. That is allocating more health workers to areas where we have more population. And the other strategies to recruit health workers from within communities.
This is so helpful in a way that the familiarity and sense of responsibility increases intent and productivity, as well as allows easy access to households such as teachers, woman’s organization, and religious leaders. Some of these strategies have trade-offs. For example, the first can help with motivation. But then you lose context to specific experience and knowledge. So the video we are about to watch addresses some of these issues. As you are watching the video, write out a list of best practice or lessons learned from these interviews.
The other strategy that is used to maximize human resource for health is the provision of refresher training to health workers. Refresher training should involve more than the same information again and again. They should really draw on health workers’ knowledge. We have to avoid complacency. We have to keep the health workers up to date. Introduction of supervisory accountability framework is another important strategy that we should take into account to maximize human resource for health. Stabilization mechanisms for periodic feedback, such as post-campaign check-ins and evaluations. Combinations of polio programs activities with other program to increase efficiency and reduce duplicative tasks. These are some of the strategies to use to maximize human resource for health.
A combination of tasks simplification, technological innovations, and adaptation of strategies to fit local circumstance has allowed the initiative to use a wide range of workers and volunteers from both inside and outside the health sector to deliver the polio vaccine during supplemental immunization activities and to monitor progress in virtually every area of every country, regardless of the health infrastructure, conflict, geography and/or culture. Supplementary immunization activities are highly labor intensive. Oral polio vaccines is administered to every child, regardless of prior immunization status. In many countries, national immunization days have been the largest polio collectivity ever conducted. Task simplification. What do we mean by task simplification?
The polio eradication activities were led, organized, supervised, and implemented by the existing routine immunization and surveillance staff and structures in all countries. However, the number of formally trained health workers was often insufficient, particularly in areas with high burden of polio. Consequently, Nationwide eradication efforts relied heavily on the mobilization and the management of an informal or voluntary workforce. Having recognized that universal implementation of strategies in many areas would rely heavily on illiterate, unskilled, and semi-skilled volunteers, tasks were adapted or modified accordingly. Example, favoring the oral polio vaccine over the inactivated polio vaccine as use of needles and syringes would have complicated the logistics of the campaign while putting minimally trained vaccinators at high risk through unsafe injection practice.
Monitoring and evaluation were simplified by the development of vaccine vial monitors. The task simplification method is on the field tasks were tailored to local realities. In Sudan, for example, local techniques for preserving fresh meat were used to keep vaccines cold in the absence of electricity and the refrigerators. Political advocacy has been another important mechanism for optimizing human resource for polio eradication, intensive political advocacy to access human resource of other government departments and the communications infrastructure. Workers from other ministries, like the ministry of education, ministry of labor and social affairs, have all been used for polio eradication.
Utilizing community resources is other optimizing mechanisms where local community resources were identified for almost every task, ranging for mapping and the micro-planning to vaccine transport. Training of trainers and of supervision were given particular attention. The non-monetary incentives and another optimizing mechanism where non-monetary incentives were widely used together with reimbursement of any personal costs incurred, such as provision of transport. Another important optimizing mechanism at the community level for human resource is supportive supervision– establishing an appropriate supervisor for community health workers so that appropriate number of supervisor be assigned for the number of health workers they are going to supervise in order to give support. Training resource supervisors to provide meaningful, regular and the performance evaluation and feedback for their supervisees.
Use supervision tools, data, and the feedback to improve quality for the next activity. Remuneration is another important optimizing mechanism, which include resources for incentives in health system resource planning and provide a financial package commensurate with the job demands, the complexity, the number of hours of training, the roles that community health workers undertake. Polio human resources particularly at the community level are important to support the work. These communications from the recent audit organization report are an essential part of quality service provision at the ground level.
We have to make sure that we have a contracting agreement for the paid care community health workers, establish agreements specific roles, what is expected of them, the responsibility they have to play, the working conditions, the remuneration, and of course the worker’s right. Having a career ladder in position is an important optimizing mechanism, creating pathway to other health work qualifications or community health workers role progression that to retain and motivate community health workers by linking performance with opportunities. And address regulatory and legal barriers against their career ladder.

Assefa Seme Deresse, MD, MPH School of Public Health, Addis Ababa University, Ethiopia

In this lecture, you will be asked to watch the video Interviews – Social Mobilization. As you watch, reflect on the following questions:

What are some best practices from the video? Which ones do you find most helpful or surprising? How could you implement these in your context?

After you watch the video on the external website, please return to this page to finish viewing the lecture. Then, take a moment to review the reading, WHO Guideline on Health Policy and System Support to Optimize Community Health Worker Programs: Selected Highlights

Share your thoughts on the lecture, video, readings, and these questions in the discussion section on this page.

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