Health Workforce Policy, Planning, and Management

Basic HRH Indicators
Indicator Description/Definition Method of Calculation Source
Stock (and density) of HRH Total no. of health human resources (relative to the population).

Total no. of health workers in a given country/(Total population of the same country)

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Skills mix Distribution of HRH by occupation, specialization, or other skill-related characteristic.

No. of physicians, nurses, and midwives (or other categories of health service providers)/Total no. of health workers

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Geographical distribution Rural to urban distribution of HRH.

Density of human resources for rural areas of the country (total physicians, nurses, and midwives per 10,000 population)/Density of human resources for urban areas of the country (total physicians, nurses, and midwives per 10,000 population)

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Age distribution Distribution of HRH by age group.

No. of health workers of a given age group/ Total no. of health workers

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Gender distribution Distribution of HRH by sex.

No. of female (or male) health workers/Total no. of health workers

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Institutional sector Distribution of health workers by sector of activity.

No. of health workers employed in the public (versus private or nongovernmental) sector/Total no. of health workers

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% of primary health care physicians No. of primary health care physicians as a percentage of the total no. of physicians.

Total no. of primary care physicians x 100/ Total no. of licensed physicians in the country

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Policy
Indicator Description/Definition Method of Calculation Source
Level of development of an HRH unit At least two key informants (and the best results will be obtained by involving three key informants) should classify the characteristics of the unit of human resources for health from the checklist provided.

See table in Appendix B

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HRH self-sufficiency policy Existence of self-sufficiency policy. Self-sufficiency in HRH emphasizes strategic investment in country infrastructure development to enhance its overall capacity to achieve a more optimal, stable, and appropriately distributed health workforce through more effective recruitment and retention policies and programs.

Yes/no

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% of health jobs covered by health and safety policies Health and safety policies for health workers include any measures that are provided to ensure the quality and safety of the health services workplace, such as up-to-date and repaired equipment, clean environments, structurally safe work areas, the provision of safety training, health insurance coverage, and the provision of health care services.

Total no. of jobs in the health sector covered by health and safety measures x 100/Total no. of jobs in the health sector

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Human Resources Management/Planning
Indicator Description/Definition Method of Calculation Source
National HRH planning and management strategy National HRH strategy developed, including a set of SMART indicators and targets, and with costed (budgeted) prioritized workplan for implementation and monitoring at the national and subnational levels.

Yes/no

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HRH expenditure, total and per capita HRH expenditure, total, per capita, and as a proportion of total expenditure on health (in national currency units, in US dollars, and in international dollars).

Total HRH expenditure/Total population or total expenditure on health

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HRH expenditure by category Breakdown of HRH expenditure by place of work (hospitals, ambulatory centers, public health offices), sector (public, private for-profit, private not-for-profit), employment status (regular employees, self-employed workers), occupational function (health service providers [direct patient care], health system management and support personnel).

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Management budget % of budget allocated to human resources management (HRM) or human resources development (HRD) annually.

Budget allocated to HRM or HRD/Total budget

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CPD budget planning Existence of budgetary provision for in-service/continuing education training.

Yes/no

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Staff requirement planning Existence of institutional models for projecting, monitoring, and evaluating staffing requirements.

Yes/no

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% of health services and program managers certified in health management Health services and program managers are understood to be any professional that has been chosen to lead health institutions. Specific requirements for public health and management competencies, including ethics training, require certification in public health and management whether through a university course or in-service training. The contents of these courses develop public health and management competencies, and greater comprehension of ethical principles necessary for the effective performance of those management functions.

No. of managers with health management courses x 100/Total no. of managers leading health units and programs

See follow-up questions in
Appendix B

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Development of primary health care teams Each of the questions on primary health care service delivery will be awarded between 0 and 10 points depending on level of country team development and the range of services provided. The scores for each question will be totaled to provide an overall country indicator.

See table in
Appendix B

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Strategy for handling labor conflicts Effective negotiation mechanisms and legislation to prevent, mitigate, or resolve labor conflicts and ensure essential services if they happen. Essential services are defined as those critical, nonelective health care services whose provision is required to save or sustain human life.

Essential services legislation currently exists: yes/no

Formal negotiation mechanisms currently exist: yes/no

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Foreign credential recognition Existence of mechanisms for foreign health professionals credential recognition.

Yes/no

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Human Resources Information Systems (HRIS)
Indicator Description/Definition Method of Calculation Source
Existence of an HRIS advisory body Regular meetings and consultations among national and international stakeholders in health, development, and information management to steer and monitor implementation of the HRH information and monitoring system.

Yes/no

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National HRIS coordinating mechanism Existence of a national coordinating mechanism with a dedicated unit with sufficient resources (human, financial, and technical) to develop, implement, and monitor the information system.

Yes/no

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HRIS used for HRH decision-making Contents of the HRH information system used to inform decision-making among health authorities at the national and subnational levels on a regular basis (e.g., annual planning and management review).

Yes/no

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Timeliness of the HRH information and monitoring system National HRH information and monitoring system populated with data at the subnational and national levels on a regular basis (e.g., quarterly/annually).

Yes/no

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Validation of the HRH information and monitoring system Comprehensive review of all available HRH data sources conducted and used to update and calibrate the national HRH information and monitoring system on a regular basis (e.g., biennially/quinquennially).

Yes/no

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Consistency of the HRH information and monitoring system All indicators and data within the HRH information and monitoring system use a common set of definitions and classifications allowing for consistent comparisons over time, across sources, and at the international level.

Yes/no

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Disaggregation of data All relevant indicators and data within the HRH information and monitoring system can be disaggregated by cadre, gender, geographical area, sector, or other characteristics.

Yes/no

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