Dr Richard Mwesigwa Infectious Diseases Institute (IDI)-Uganda 19 th April 2012
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Transcript of Dr Richard Mwesigwa Infectious Diseases Institute (IDI)-Uganda 19 th April 2012
Innovations for HR challenges in Resource Limited Settings:
Lessons from a rural HIV/AIDS program in Mid western Uganda
Dr Richard MwesigwaInfectious Diseases Institute (IDI)-Uganda
19th April 2012
Background
Kampala
Expanded Kibaale Kiboga Project
• Capacity building HIV/AIDS project
• Focusing on Health systems strengthening
• Implemented in Mid western Uganda.
HR for Health Situation
• Average Health Worker : population ratio– Medical doctors 1:8,373 ; Nurses 1:1,212
• 70% doctors serve 12% of population
• EKKP- Staffing level 47% of MOH standard
• Low salaries (Doctors <280USD/month)
• Lack of social amenities
Realities on ground
Capacity pyramid
Skills
Staff
Structures
Tools
Facilities
Systems Roles
Cognisance of local context: Policies, trust
Default IDI model for capacity Building
requires
Enables effective
use of
*Potter C and Brough R
Capacity pyramid II
Local context: Culture, Policies, Ownership
Skills
Staff
Structures
Tools
Facilities
Systems Roles
Time to implement change
Easier
Harder
Local context interventions
• District/HW involvement for ownership
• Support for comprehensive HR planning and management
• Better advocacy facilitated by understanding of HR needs
• Stakeholders meetings for coordination
Structures, systems and roles• Integration in existing structures
• Task shifting
• Helping hands (Volunteers, PHA Network, Interns)
• HR boosting (Support recruitment of Critical staff)
• Camping strategy & Integrated Static Outreaches (ISOs)
Staff
• Motivation to enhance commitment
– Facilitation (airtime, motorcycles)
– Recognition (frontline- hero programme & Reward for performance)
– Support for career development
Facilities (Working environment)
• Cleaning and
re-arrangement
• Remodelling/ Renovations
Imparting Skills
• Training focuses on teams and not individuals
• Mentorship using Short Term Technical Assistance Teams (STTATs)
• IDI/MOH have supported training of District based trainers
Provision of Tools
• Equipment
• Policy documents and guidelines
• Buffer supplies
• Supply of data tools
Lessons learnt
• Proper planning is key to optimizing outputs with available resources
• Cognizance of local context is critical in designing HR for Health interventions.
• Non monetary rewards can keep staff motivated
Lessons learnt II• District leadership involvement is key in
designing sustainable interventions
• Task shifting to lower cadre workers is possible with adequate supervision
• Integration in existing structures ensures sustainability
Thank you