Tuberculosis (TB)

Human resources development (HRD)


Human resource development (HRD)

The HRH action framework and HRD for implementation of the Stop TB Strategy

Services for TB control are implemented through and by the existing health workforce within the national health system. Establishing and understanding the roles, functions, and responsibilities for development of the health workforce at different levels of the system and among different stakeholders is essential in developing a strategic approach. This will ensure that the NTP is able to foster adequate staffing, development, retention, and performance of the health workforce involved in implementing the Stop TB Strategy.

The list below describes the role and functions for developing different aspects of HRD for comprehensive TB control based on the HRH Action Framework presented in the previous page. To enable implementation of the Stop TB Strategy, NTPs need to establish the organizational structure at the central level of the programme. This includes, but is not limited to:

  • assigning a dedicated focal person or point person for HRD in the NTP (in bigger countries this corresponds to a full-time job);
  • appointing an HR coordination group with representatives from training institutions, health workers, concerned professional organizations, and other disease control programmes; and
  • determining roles and functions for HR management at subnational levels (within the context of NTP).

Although not an exhaustive list, the list provides the guiding principles; the overall structure and situation will vary from country to country. The HRD functions within the NTP should be carried out in close collaboration and coordination with the overall HRH department to ensure optimal efficiency and results.

Policy

Role of Ministry of Health HRH Department (overall HRH)

  • Develops and implements HRH policies related to health service mission and goals (policies related to all components of the HRH framework).

Role of National Tuberculosis Programme (NTP)

  • Assesses needs for HR policy revisions to enable the implementation of the Stop TB strategy (e.g., task shifting; hiring of additional staff above current staffing stands; incentives for disadvantaged geographical placements; HR needs in special situations; needs for and participation in special tasks forces and coordination groups).
Finance

Role of Ministry of Health HRH Department (overall HRH)

  • Ensures the personnel budget is in line with the expenditure needed to develop, deploy, and sustain an adequate health workforce (this includes expenses for salaries, allowances and benefits, pre-service and in-service training, staff development, rural posting/difficult area posting packages, and support to basic management functions such as information systems). Budgets should include both recurrent costs such as salaries and incentives, training costs, and general running and administrative costs.
  • Works with Ministry of Public Service and Ministry of Finance to streamline financial planning and management for HRH.

Role of NTP

  • Aligns with and uses TB specific funds to support overall health workplace development.
  • Ensures the allocation of TB specific funds; enables the implementation of the strategic plan for HRD for comprehensive TB control.
  • Ensures donor coordination for financial support to the implementation of the strategic HRD plan for comprehensive TB control.
  • Develops mechanisms for contracting for TB services.
Education including pre-service (basic), postgraduate, in-service, and continuing education

Role of Ministry of Health HRH Department (overall HRH)

  • Ensures future basic training needs are linked to long term health workforce plans and projections.
  • Ensures that pre-service (basic) training programmes and courses are up-to-date and prepare health workers for their future roles and functions.
  • Ensures accreditation and certification for all basic and continuing education.
  • Ensures specific minimum competences required for each category of health worker as a basis for certification (including minimum standards for training and evaluation).
  • Ensures that all continuing education is based on health service needs, is competency based, and follows de facto health authority guidelines.
  • Standardizes continuing education programmes.
  • Develops and monitors systems for "pass" and "fail" for all training programmes.
  • Ensures adequate number of institutions to train all required health cadres and that the capacity of those training institutions is maintained and strengthened.

Role of NTP

  • Develops/revises in-service training programmes for different categories of health workers involved in the implementation of the Stop TB strategy according to the functions.
  • Develops/revises TB training material for the above.
  • Ensures that all continuing education is based on health service needs for TB control, is competency based, and follows NTP guidelines.
  • Ensures objective competency based evaluations systems are in place and used for all TB training programmes.
  • Selects and trains course facilitators for the different TB training programmes (paying particular attention to the technical and educational competencies of the future facilitators, as well as the ability to encourage course participants to develop skills in independent thinking and problem solving).
  • Prepares organization of TB training courses (long term, as well as short term) in close collaboration and coordination with other priority health programmes and interventions.
  • Ensures involvement of existing training institutions to strengthen educational quality of training activities.
  • Ensures continuous learning for all heath workers involved in the implementation of the Stop TB strategy.
  • Establishes the NTP organizational structure for follow up after training.
  • Trains TB supervisors for follow up of staff training.
  • Ensures pre-service training programmes meet the competency needs for the implementation of the Stop TB Strategy.
Partnerships

Role of Ministry of Health HRH Department (overall HRH)

  • Collaborates with ministries of finance and education.
  • Ensures effective linkages among public sector, private sector, and community networks.
  • Creates structures to allow community representation in health services
  • Facilitates joint planning for HRH between local NGOs, community based and religious organizations, and district health offices.

Role of NTP

  • Ensures linkages with other public sector, private sector, and community networks with common linkages to TB; for example, HIV/AIDS national programmes, medical associations, faith-based organizations, bilateral and international organizations.
Leadership

Role of Ministry of Health HRH Department (overall HRH)

  • Provides committed, visionary leadership - including guidance and support to others to face challenges and make progress in improving health outcomes under complex conditions.
  • Helps partners grow and develop.
  • Advocates for and guides reform of human resource policies.
  • Provides leadership development for managers at all levels.
  • Ensures compliance with labour laws.
  • Manages HR information system.

Role of NTP

  • Provides visionary leadership and advocacy for TB control programme needs.
  • Ensures leadership development for managers at all TB programme levels; empowers managers to solve problems at service delivery level, ensuring needed resources are available.
  • Provides supportive supervision to develop work plans and monitor performance.
Human resource management

Role of Ministry of Health HRH Department (overall HRH)

Personnel management

  • Provides long term HR planning.
  • Ensures that posts are appropriately classified.
  • Organizes recruitment and selection
  • Manages issues related to hiring, transfer, and promotion.
  • Manages salaries, benefits and allowances, and financial incentives.
  • Administers discipline, grievance procedures, and termination.
  • Ensures compilation of and updating of employment policy manuals.
  • Maintains relations with unions and professional associations.

Performance management

  • Develops and reviews job descriptions based on national health policies, and plans and ensures health workers are provided with the relevant job descriptions.
  • Ensures capacity development in supportive supervision in all areas of the health service.
  • Develops systems over planning and evaluating performance.
  • Develops and monitors strategies for staff motivation and retention, including career structures for all areas.
  • Develops systems for regular continuing education for all health workers.

Role of NTP

Personnel management

  • Assesses staffing needs at all levels, including the central level, for the implementation of the Stop TB strategy.
  • Contributes financial resources to TB staff retention strategies and incentive packages for rural postings.
  • Determines minimum data requirement for adequate HR management.
  • Ensures all TB HRD activities conform to overall HR management systems and policies currently in place.
  • Communicates staffing problems (e.g., vacant posts, severely understaffed health centres) identified during supervisor visits.

Performance management

  • As necessary, updates and lists functions and tasks by level and by professional category, covering all components of the Stop TB strategy.
  • Develops/revises job descriptions for staff involved in TB control to correspond with current policies and recommendations, e.g., the introduction of management of MDR-TB.
  • Coordinates capacity development (competence and staffing) for supportive supervision - for implementation of the Stop TB Strategy - with other high priority programmes.
  • Contributes expertise and resources to the development and implementation of strategies for TB staff motivation and retention (not only financial).
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