PIAT: Human Resources for Health Sub-National Policy Impact Assessment Tool

Data collection focus and unit of analysis is sub-national level, aggregation at national level

Global Health Workforce Alliance

Publication details

Publication date: 2011


A weak knowledge base hinders effective human resources for health (HRH) policy development, planning, program operations, monitoring and evaluation. To inform policy makers and funders as to whether interventions to address the HRH crisis are likely to have an impact there is need to collect sound data that can be used to conduct periodic assessments as well as contribute towards evaluation of impact. Such data are currently hard to find in one place.

The HRH sub-national policy impact assessment tool (PIAT) is for use as part of regular HRH policy implementation, monitoring and evaluation system, for data collection and/or aggregation using available sources at sub-national level. The tool is considered necessary to: a) keep an overall picture while focussing on details, b) translate policy into measurable objectives, detailed plans, intermediate outputs and indicators, c) share results with relevant actors to solicit views on changes needed in policy, and d) for purposes of design prior to policy implementation to help highlight areas of focus and needs so that mechanisms can be put into place as needed before starting.

The Sub-National level PIAT will help collect and track core WHO HRH indicators:

  • Density of health workers per 10,000 population using ISCO categories up to 4 digits for ease of comparison across countries.
  • Distribution of health workers by sex, region, rural/urban, occupation, workplace (e.g., public, PNFP, PHP), level of facility (e.g., health centre, hospital)
  • Graduates of health professional education and training institutions per 100,000 population

The sub-national PIAT aims to collect information relevant to all HAF components, and conforms with the CCF process.

Data availability is a challenge and may limit the possibilities for analysis that can be done. Where basic sub-national HRH data are lacking, the proposed tool can help highlight the areas that need to be addressed. The proposed policy impact assessment tool is also an attempt to assist documentation and accountability efforts. It helps to provide a tool that countries can use to collect and track key data relevant to HRH as a periodic exercise to help inform programming and resource allocation decisions, as well as promote dialogue and advocacy.