Transforming the Health Workforce in Support of Universal Health Coverage

120 Pages·2014·2.36 MB·English

Transforming the Health Workforce in
Support of Universal Health Coverage:
A gloab l toolkit for evaluating health
ow rkforce eud cation
st
eR port of the 1 eM eting
5–4 eD cemeb r 3102
rT na sforming the eH tla h oW rfk orce in
puS port of nU iev rs la eH tla h oC ev rga e:
A gol b la tooikl t for etaulav ing hetla h
ow rfk orce ecud ta ion
st
Report of the 1 Meeting
4–5 December 2013
© World Health Organization 2014
All rights reserved. Publications of the World Health Organization are available on the WHO web site (www.who.int)
or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland
(tel.: [phone]; fax: [phone]; e-mail:
A global toolkit for evaluating health workforce education I
Contents
Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . II
1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Day 1: proceedings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Opening session . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Addressing the agenda . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Summary of day 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Day 2: proceedings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Summary of day 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Next steps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Concluding remarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Annexes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Annex 1: Agenda . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Annex 2: List of participants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Annex 3: WHA resolution 66.23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Annex 4: Assessment tools for health workforce education (draft) . . . . . . . . . . . . . . . . . . 28
Annex 5: Terms of reference for the technical working group on health workforce
education assessment tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Annex 6: Technical working group subgroups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Annex 7: Asia Pacific Network on Health Professional Education Reform (ANHER) . . . . . . 34
Annex 8: Presentations by members of the Technical Working Group on Health
Workforce Education Assessment Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
II Transforming the Health Workforce in Support of Universal Health Coverage:
Executive Summary
This two day meeting focused on the implications for the implementation of Resolution WHA.66.23
Transforming health workforce education in support of universal health coverage, and on fnding
agreement on the terms it sets out. WHO was tasked with the responsibility of developing a standard
protocol and health workforce education assessment tool.
In view of the historical problem of not only a global health workforce shortage, but an urgent need
to ensure that such a health workforce has a broader training which more accurately refects their
everyday working practices, World Health Assembly Resolution 66.23 urges Member States:
„ to further strengthen policies, strategies and plans, as appropriate, through intersectoral policy
dialogue among the relevant ministries that may include ministries of education, health and fnance,
in order to ensure that health workforce education and training contribute towards achieving
universal health coverage;
„ to consider conducting comprehensive assessments of the current situation of health workforce
education with the application of, as appropriate, standard protocols and tools, once developed
by WHO;
„ to consider formulating and implementing evidence-based policies and strategies, taking into
account the fndings from the assessment in the previous paragraph, to strengthen and transform
the health workforce education and training, including but not limited to the promotion of inter-
professional, community-based and health systems-based education, linkages of pre-service
education to continuous professional development, and an accreditation system to ensure quality
of training institutes and competency of health workforces; with a view to better responding to the
health needs of people, taking into account the special needs of some Member States that have
limited economy of scale in local training;
„ to provide adequate resources and political support for the implementation of policies and strategies
as appropriate for the strengthening and transformation of health workforce education;
„ to share best practices and experiences on health workforce education.
Broad consensus was reached on the following key issues, along with a proposed way forward.
Standard protocol: It was agreed that this is a ‘road map’ and that the assessment tools will help
to assess progress on this map.
Unhelpful terminology was also reviewed in order to eliminate confusion. Further agreement was
reached on the following:
„ To use the term ‘health worker’ rather than ‘health professional’ so as not to exclude those health
workers who are not professionals. This is in line with the term ‘health workforce’ which is used in
the WHO World Health Report 2006.
There should be an assessment system which includes a library of tools, as the available information
on health education assessment tools appears to be patchy.
Components: The key components of health assessment tools should address the needs of the
target population as well as refect the competencies required by health workers and the ability of
institutions to impart the necessary training and education.
A global toolkit for evaluating health workforce education III
Tools
„ the tools should be able to take a ‘snapshot’ of the current situation and to also facilitate
transformation
„ the tools should make use of the learning opportunities which are competence-based
„ the tools need to be practical and user-friendly and also be able to capture the presence/absence
of specifc competencies and skills
Actions
„ Three subgroups were formed to take this work forward; Subgroup 1: to look at components,
conceptual frameworks presented. Subgroup 2: to generate a set of questions to interrogate the
tools; Subgroup 3: to assess the feedback from subgroup 1 and subgroup 2 and to then begin to
build an assessment protocol and tool.
„ A Concept Paper subgroup was also formed to allow the agreements and decisions following this
frst TWG meeting to be included in the present draft.
„ The following timeline was agreed:
By mid-2014 There should be agreement about which countries to test the tools.
October 2014 Begin country testing
November 2015 The report should be ready
January 2016 Present the report to the World Health Assembly the report to the
WHO Executive Board
May 2016 Present the report to the World Health Assembly the report to the
World Health Assembly.
A global toolkit for evaluating health workforce education 1
1. Introduction
The purpose of this two day meeting was to allow the newly-formed Technical Working Group on Health
Workforce Education Assessment Tools to convene its frst meeting during which it would address
the key objectives as stated below and share ideas and agree on how to implement WHA Resolution
66.23. This consultation brought together a multidisciplinary group which includes: health education
specialists, senior academics and persons responsible for governance of education institutions,
policy makers, experts in health systems and international health, health economics, research and civil
society representation. The meeting enabled the participants to challenge, discuss and recommend
actions on how to develop a standard protocol and tool for health workforce education assessment.
The meeting began by addressing the question of tool components and conceptual frameworks,
looking at existing tools, and target audiences.
Further to World Health Assembly Resolution (WHA.66.23), WHO was tasked with the following :
1. to develop a standard protocol and tool for assessment, which may be adapted to country
context;
2. to support Member States as appropriate in using the protocol to conduct comprehensive
assessments of the current situation of health workforce education;
3. to provide technical support to Member States in formulating and implementing evidence-based
policies and strategies in order to strengthen and transform their health workforce education;
4. to consult regionally in order to review the country assessment fndings and submit a report
providing clear conclusions and recommendations, through the Executive Board, to the Sixty-
ninth World Health Assembly;
5. to develop, based on the report, global and regional approaches, which may include strategies
to transform health workforce education, submitting these through the Executive Board, for
consideration by the Seventieth World Health Assembly
A Technical Working Group on Health Workforce Education Assessment Tools had been recently
formed to reviewand provide guidance to the WHO Human Resources for Health Unit on the scope
and use of health workforce education assessment tools at national, institutional, prequalifcation
and graduate levels.
The Technical Working Group on Health Workforce Education Assessment Tools met on 4-5 December
2013 in order to agree on the following nine objectives:
1. The terms of reference for the Technical Working Group on Health Workforce Education
Assessment Tools, to ensure clarity at the outset for the group.
2. The need for, and purpose of, a standard protocol and set of tools for assessment to support
Resolution WHA 66.23, to establish the foundation for future planning of the tools.
2 Transforming the Health Workforce in Support of Universal Health Coverage:
3. The targeted audience for these tools.
4. What kinds of components should be part of effective assessment tools.
5. What existing tools may be suitable to assess the health professional education continuum, in
order to begin to identify what is useful and where there are gaps.
6. The key overall milestones for the Technical Working Group, with timeline.
7. How best to confgure the group in order undertake the work effectively.
8. An action plan – what; how; by whom; and by when.
9. Immediate next steps.
Twenty two Technical Working Group members, in addition to three WHO personnel, and a WHO
medical intern participated in the meeting. At present, the total number of members of the Technical
Working Group is 41.
The target audiences will be largely Member States, their ministries of health, education and fnance
respectively, policy makers. The fnal document will be useful at all levels of the health system as well
as training institutions. The information contained within it will be evidence-based and of relevance
to academic institutions.
The meeting outcome was very positive with the Technical Working Group members keen to
collaborate and meet the objectives set out during this frst meeting. Critical issues are mentioned in
the Executive Summary, as well as Key Actions.