Ensure that an accountable stakeholder leadership group oversees a defined process for bringing an evidence-based policy decision to action

Having a strong stakeholder leadership group has become an increasingly important means of ensuring follow-through on decisions made, pushing for further action, and alerting stakeholders to new or unresolved HRH issues. The establishment of TWG subcommittees can be useful to deepen strategic thinking and further attribute ownership of key HRH strategy areas, such as retention (Howard-Grabman and Jaskiewicz 2013). A multisectoral stakeholder leadership group can play a critical role in taking stock of the political landscape as well as establishing and monitoring HRH goals, targets, and indicators, including reporting on outcomes achieved to date (Health Policy Initiative 2010). Ghana’s HRH stakeholder leadership group, for example, applied leadership guidelines developed by CapacityPlus to ensure that a strong secretariat supported the involvement of a broader group of stakeholders to drive the development of the 2012–2016 National Human Resource Policy and Strategy for the Health Sector (McCaffery et al. 2013). It is also important to have a high-level body or department to which the stakeholder leadership group’s regular reports of implementation progress can be directed, so as to maintain accountability for following through on policy decisions. As found in Zambia, stakeholder leadership group members’ ongoing advocacy for health workforce retention issues can bring additional strategy components to the table to be addressed (Zulu et al. 2013). Indications that a stakeholder leadership group has achieved some momentum in bringing a policy to action include demonstrated funding allocations (such as budget line items), an implementation workplan, and/or a monitoring and evaluation plan.

Example
In Uganda, as around the world, no single department or ministry is exclusively in charge of HRH issues, though leadership in this area is often spearheaded by the MOH. To overcome some of the challenges experienced by the HRH TWG and other TWGs, in 2013 the Uganda MOH approved guidelines for governance and management structures to stipulate how TWGs relate to policy decision-making. Specifically, the TWGs function to prepare and review policies, and the HRH TWG shall “review health workers production, deployment/recruitment and exit from workforce…and propose new HRH interventions” (MOH 2013, 19). These guidelines helped to ensure that the TWGs’ terms of reference and scopes of work were clearly defined, as well as to outline membership criteria and representation. In consideration of issues that remain unaddressed, the HRH TWG is now working to periodically evaluate its performance on ongoing efforts to improve health worker retention and other challenges, and to consider which opportunities may exist to support decision-making to take forward additional HRH strategy interventions.

Example

In Uganda, as around the world, no single department or ministry is exclusively in charge of HRH issues, though leadership in this area is often spearheaded by the MOH. To overcome some of the challenges experienced by the HRH TWG and other TWGs, in 2013 the Uganda MOH approved guidelines for governance and management structures to stipulate how TWGs relate to policy decision-making. Specifically, the TWGs function to prepare and review policies, and the HRH TWG shall “review health workers production, deployment/recruitment and exit from workforce…and propose new HRH interventions” (MOH 2013, 19). These guidelines helped to ensure that the TWGs’ terms of reference and scopes of work were clearly defined, as well as to outline membership criteria and representation. In consideration of issues that remain unaddressed, the HRH TWG is now working to periodically evaluate its performance on ongoing efforts to improve health worker retention and other challenges, and to consider which opportunities may exist to support decision-making to take forward additional HRH strategy interventions.

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