“Everything Changed”: An HR Manager’s Path to Strengthening the Health System
CapacityPlus Voices #14
Effective management of a country’s health workforce is a vital component of a strong health system. Too often, though, human resources management is a weak link in the chain. To support the Dominican Republic Ministry of Health, CapacityPlus conducted a three-part program in leadership and management for central and regional HR managers. Participant Diana Santana shares her dramatic transformation.
In the Dominican Republic, a young woman working in human resources at the Ministry of Health was unsure how she could make a contribution to improving the health sector. She knew how to do her job well, but she lacked confidence about making suggestions to improve things. “I thought that my opinions, my ideas, my views might not be well received,” Diana Santana recalls. So she held back.
Strengthening the management of a country’s health workforce is an essential component of improving the quality of key services like family planning, HIV, and maternal and child health. However, systems for managing human resources for health (HRH) are often weak, and the role of HR professionals can be widely misunderstood.
CapacityPlus is supporting the Ministry of Health’s efforts to strengthen HR management and improve health outcomes by providing high-quality services for all. In February 2012, CapacityPlus led the first part of an HRH leadership and management professional development program for 24 HR managers at the central and regional levels. Topics included HR professionals’ role as advocates for the health workforce; HR information systems; data-driven decision-making; and health workforce planning. Diana attended this course, and throughout the three days she was very quiet.
In November 2012, CapacityPlus supported a training-of-trainers course that equipped participants to facilitate the course themselves and receive feedback from their peers and CapacityPlus advisors. Diana tentatively assumed the role of cofacilitator for one of the topics and worked with her team to deliver their part of the course.
But while Diana remained quiet and had little to say, in fact she was absorbing every detail.
“Everything changed after the training I received from the CapacityPlus project that has taught me to grow as a person and as a professional,” Diana says. “The project has taught me to believe in myself.” 
In March 2013, Diana joined part three of the leadership and management program, a four-day course focused on labor market and workforce planning, recruitment, retention, workplace environment, performance management, and an introduction to monitoring and evaluation. Facilitator Lisa Howard-Grabman was surprised to notice a big change: “I didn’t even recognize her when I first saw her!” In addition to sporting a new short hairstyle, Diana “was much more present and confident in the group,” says Lisa. “It’s fun to watch that kind of transformation.”
Believing in herself, Diana feels a new strength. Now, “I can defend my views and negotiate with my superiors,” she states. “When something is not right—that is, not according to laws and regulations—I have to point it out and be able to explain why.”
And that’s exactly what she did.
Recently Diana refused to accept several unqualified candidates that a governor put forward. She and a colleague presented their reasons effectively, including the need to follow formal hiring procedures and to avoid a lawsuit from employees who would have been fired to make way for the unqualified candidates. “Our arguments were clear and precise and were accepted,” she says. “This was possible because the training has enabled us to understand the role of human resources management in improving the quality of health services.” 
In addition to the leadership and management program, CapacityPlus’s Human Resources Management Assessment Approach is designed to help policy-makers and managers understand key challenges facing their health systems and then respond to them. The tool focuses on four areas of HR management: health workforce planning and implementation, work environment and conditions, HR information systems, and performance management.
Diana is now making a strong contribution to her country’s health system. “Now I'm sure I can perform my job with quality,” she asserts. “I can face obstacles and deal with them for the benefit of health service users.”
You can read Diana’s story in her own words, available in English and Spanish.
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Read additional articles in the CapacityPlus Voices series.
Photo 1 (Diana Santana) and 2 (program participants) by Elisa Elena González
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