HRH Data-Online Version Survey Use Sources

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who countryassessment tool

on the uses and sourcesfor human resources

for health (hrh) data


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WHO Library Cataloguing-in-Publication Data

WHO country assessment tool on the uses and sources or human resources or health (HRH) data.

1.Health personnel. 2.Health manpower. 3.Evaluation studies. 4.Questionnaires. 5.Data collection. I.World Health

Organization.

ISBN 978 92 4 150428 7 (NLM Classication: W 76)

Wold Halth Oazato 2012

All rights reserved. Publications o the World Health Organization are available on the WHO web site (www.who.int)

or can be purchased rom WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland

(tel.: +41 22 791 3264; ax: +41 22 791 4857; e-mail: [email protected]). Requests or permission to reproduce or translate

WHO publications whether or sale or or noncommercial distribution should be addressed to WHO Press through theWHO web site (http://www.who.int/about/licensing/copyright_orm/en/index.html).

The designations employed and the presentation o the material in this publication do not imply the expression o any

opinion whatsoever on the part o the World Health Organization concerning the legal status o any country, territory, city

or area or o its authorities, or concerning the delimitation o its rontiers or boundaries. Dotted lines on maps represent

approximate border lines or which there may not yet be ull agreement.

The mention o specic companies or o certain manuacturers products does not imply that they are endorsed or

recommended by the World Health Organization in preerence to others o a similar nature that are not mentioned.

Errors and omissions excepted, the names o proprietary products are distinguished by initial capital letters.

All reasonable precautions have been taken by the World Health Organization to veriy the inormation contained in

this publication. However, the published material is being distributed without warranty o any kind, either expressed

or implied. The responsibility or the interpretation and use o the material lies with the reader. In no event shall the

World Health Organization be liable or damages arising rom its use.

Printed by WHO Document Production Services, Geneva, Switzerland / October 2012


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Human Resources or Health Unit (HRH)

Department or Health Systems Policies and Workorce (HPW)

Health Systems and Services (HSS)

who countryassessment tool

on the uses and sourcesfor human resources

for health (hrh) data


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Page ii

Country HRIS assessment tool at institutional level

Ackowldmt

This Tool was prepared by the World Health Organization (WHO) with nancial support

rom the Norwegian Agency or Development Cooperation (Norad), the United States

Agency or International Development (USAID), the United States Presidents EmergencyPlan or AIDS Relie (PEPFAR) and the European Union.

This tool was produced under the overall direction o Mario Dal Poz (Coordinator,

Human Resources or Health Unit, Department or Health Systems Policies and

Workorce, World Health Organization (WHO)). The primary author o the tool is:

Angelica Sousa.

We acknowledge the valuable contribution rom the country human resources or

health experts rom around the world, the World Health Organization and colleagues

rom the Centers or Disease Control and Prevention (CDC), the United States Agency

or International Development (USAID), USAID-unded CapacityPlus and IntraHealth,

Jhpiego and others. Particular thanks to all those who contributed to the Health

Inormation Reerence Group (HIRG) meeting in Nairobi, Kenya, 56 December 2011.

The ollowing persons provided detailed comments and advice on the earlier drats o

this tool, and raised valuable issues during its preparation: Naphtali Agata, Adam Ahmat,

Elisabeth David Joseph, John Dewdney, Yohana Diaz de Valle, Michael English, Paulo Ferrinho,

Mario Alberto Figueroa Alvarez, Jessica Gross, Neeru Gupta, Grace Irimu Thinwa, Isaac Kimani,

Rose Kiriinya, Jason Knueppel, Ramesha Krishnamurthy, Teena Kunjumen, Wuleta Lemma,

Devan Manharlal, Maurice Lenga, Bagele Mbayi, Jean Moore, Jane Mudyara, Patrick Mutinda

Mdindyo, Gideon Mutua, Evasen Naidoo, Edgar Necochea, Epiphane Ngumbu, Bernard Nkala,Francis Ntalazi, Jacinta Nzinga, Leonardo Pereira, Elsa Reis, Patricia Riley, Jean Robson,

Xenophon Santas, Anny Sarea, Abdou Sayo Farmo, Hernan Sepulveda, Dykki Settle,

Hussein Shabani Mavunde, Eiichi Shimizu, Tungamirirai Simbini, Amani Siyam,

Gerhard Vermaak, Peter Waithaka, Kate Waldman, Keith Waters, Agnes Waudo and

Alexandra Zuber.


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Page iii


Tabl o cott

Background 2

Objectives 2

Part 1: Mapping o institutions 3

Part 2: Questionnaire 5

Questionnaire at institutional level 6

Section 1: Institution inormation 8

Section 2: Data collection 9

Section 3: Data reporting and use 12

Section 4: Summary o ndings 14

Attachment 1: Examples o institutions that produce data on human

resources or health 15

Attachment 2: Type o data on human resources or health (question 2.10) 16

Attachment 3: Health Workorce Classication Mapping 18


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Page 2


Backod

There is widespread recognition o the need or accurate, timely and eective human

resources or health data to inorm the development o policies on human resources or

health in countries. However, many low and middle income countries have week inormation

systems that can generate data that could guide the policy dialogue to scale up the healthworkorce. To respond to this crisis the World Health Organization has directed its eorts and

achievements in leading the global research agenda to support countries to strengthen their

Human Resources Inormation Systems (HRIS). As part o these eorts the Human Resources

or Health Unit (HRH), WHO developed the Country Assessment Tool on the sources and

uses o HRH data to conduct a diagnosis on the quality o data on HRH and the degree to

which inormation is used or evidence-based decision-making. This diagnostic tool contains

questions intended to gather inormation on the uses, type and quality o data on HRH at

institutional level in countries. This step is critical to identiy strengths and weaknesses o the

current HRIS in countries. The resulting inormation can then be used to identiy priorities

and develop strategies to strengthen the HRIS at district, regional, or national level.

The country assessment tool on the sources and uses o HRH data is an adapted version o

the instrument designed by the Capacity Project, which collects inormation by institution,

and the data mapping template at national level on human resources or health developed

by the HRH, WHO. The current version o the instrument has been eld tested to evaluate the

uses and sources o inormation in Cape Verde, Guinea Bissau, Mozambique and Sao Tome

and Principe and it has recently been used in Guatemala and Rwanda to understand the

support required to assist countries to improve or develop their HRIS.

Objctv

The objectives o the instrument are to identiy the list o institutions involved in producing

data on HRH and to compile comprehensive inormation on the uses, type and quality o

data on HRH at institutional level in countries. The tool is divided in two parts:

1. Mapping o institutions

2. Questionnaire at institutional level:

2.1 Identication

2.2 Data collection

2.3 Use o data

2.4 Summary o ndings


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Page 3


P A r T 1

M A P P i n g O f i n s T i T u T i O n s


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Mapp xc to dty th lt o tttovolvd podc data o HrH

A requisite step to conduct the evaluation on the uses and sources or HRH data is to

conduct a mapping o institutions to identiy the institutions involved in producing data on

HRH. These institutions include ministries, licensing and registration or certication bodies,private sector organizations and outside the health sector, population census bureaus and

statistical oces, labour departments, and others. List in the ollowing table the institutions

identied as producers o HRH data (please reer to attachment 1 or an example o the

institutions). The institutions listed in this section will be interviewed using the questionnaire

in part 2. Attach additional sheets i more space is needed.

No. Name o the institution/agency


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Page 5


P A r T 2

q u e s T i O n n A i r e


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Page 6


qtoa at tttoal lvl

This questionnaire is intended to be applied in dierent institutions which produce data on

HRH based on the mapping exercise previously conducted by the interviewer to identiy the

list o institutions involved in producing data on HRH.

itcto o th tvw tool

This section will provide guidance on how to conduct the interview on the evaluation o

the uses and sources or HRH data at institutional level.

1 Role o the interviewer

The interviewer is responsible or asking questions, answering the respondents queries,

recording answers and editing the completed questionnaire. The interviewer must check

that the respondent has understood the questions by using interviewing techniques,

such as neutral probes, clarication and appropriate eedback, and determine whether

the answer given is appropriate. Listening to what the respondent is communicating,

both verbally and nonverbally, ensuring that the inormation is correct. The interviewer

must set the pace o the interview and keep the respondent ocused and interested.

The atmosphere should be comortable and pleasant at all times.

Beore going to the eld, the interviewer must know the questionnaire and how it is to be

administered. A thorough preparation as well as extensive practice will guarantee that this

is achieved.

2 Role o respondent

The role o the respondent is to cooperate with the interviewer and ollow instructions.

The respondent must listen to questions attentively without interrupting, take time

beore answering, and try to give an accurate and complete response as much as possible.

The respondent should ask or clarications whenever a question seems unclear and ask the

interviewer to repeat or rephrase it. Trying to answer an unclear question is likely to lead to

an incorrect response.

3 Introduction to the interview

The interviewer must clearly communicate the objectives o the survey to the respondent.

Knowing what is expected o the person will contribute to the accuracy in responses.

The interviewer should establish a good rapport by introducing himsel and the survey well.

Make a good impression

1. You are a proessional interviewer rom a legitimate and reputable organization.

2. The questionnaire is or gathering data or important, worthwhile research.

3. The respondents participation is vital to the success o the research.

4. The responses given will be condential and will only be used or research purposes.Respondents will have to sign an inormed consent orm, which explains about the

survey and what will be expected o them.


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The interviewer can use the ollowing introduction or decide which one works best.

Example of introduction:

Hello my name is and I work or The reason I am contacting you is because we are

conducting a survey on health workorce in your country and I would like to ask you a ew

questions. Let me assure you that whatever inormation you tell us will not be disclosed to

anyone and will only be used or research purposes.

Make a good interview start

1. You should be pleasant and assertive, and make the respondent eel at ease.

2. You should know the questionnaire thoroughly and be well prepared to answer

any questions.

3. You should speak slowly and clearly to set the tone or the interview.

4. You should adapt your introduction to the respondent, as dierent respondents

require dierent amounts o inormation.

5. You should be motivated and interested in the interview.


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scto 1: ittto omato

Make a separate copy o the questionnaire or each institution that is being surveyed.

1.1 Date(s) o assessment:

1.2 Institution:

1.3 Department name:

1.4 Type o institution (select only one):

A Ministry o HealthB Other ministries (speciy):

C Subregional health agency (e.g. district health oce)

D Health proessional regulatory body

E Other para-public agencies (e.g. military, police, social security)

F Worker unions/associations

G Nongovernmental or not-or-prot agency providing health services to

the public

H Private-or-prot agency providing health services to the public

I Training institutions or health proessionals

J Research institutions

K Labour organizations

L Other (speciy):

Complete the ollowing inormation or every person participating in completion o this

questionnaire. Attach additional sheets i more space is needed.

Name Job title or role

Telephone No.

(incl. country code) Email address


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Page 9


scto 2: Data collcto

Make a separate copy o Section 2 o the questionnaire or each type o data on human

resources or health collected in this institution.

2.1 Indicate the type o data on human resources or health collected in this institutionon a routine basis.

A Student enrolment

B Pre-service training in health-related elds (e.g. graduates)

C In-service training o health proessionals

D Health proessional licensing

E Health proessional registration

F Sta in a health acility

G Payroll

H Retired/discharged

I Perormance evaluation

J Leave management

K Planning and budget

L Other (speciy):

2.2 How oten is this data collected?

A Daily

B Weekly

C Monthly

D At least once a year

E In the last 1 to 2 years

F Within the last 3 to 5 years

G Not updated within the last 5 years

2.3 On which sectors o the health workorce do you collect this data? Check all optionsthat apply.

A Public

B Private-or-prot

C Semi-private

D Nongovernmental or not-or-prot organization

E Para-public agency (e.g. military, police, social security)

F Health training institution

G Other (speciy):


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2.4 How are the data collected? Check all options that apply.

A Paper orms

B Electronic les (speciy, e.g. Microsot Excel, Word, etc.):

C Mixed media (paper and electronic) (speciy, e.g. Microsot Excel, Word, etc.):

D Other (speciy):

2.5 How are the data compiled into a database or inormation system?

A Paper

B Electronic (e.g. spreadsheet, database, or other)

C None

2.6 Once compiled, are the data o health workers mapped and disseminated usinga standard classifcation or purpose o statistical comparability with other data

sources relevant to labour market analysis? Check all options that apply.

A National classication o occupation

B Common denitions rom the Ministry o Health

C International standard classication o occupations

D International classication o education

E None

F Other (speciy):

2.7 Are the data o health workers disaggregated by occupational category?

A 21 or more occupational categories

B 15 to 20 occupational categories

C 4 to 14 occupational categories

D Fewer than 4 categories

E Not disaggregated

2.8 Are the data o health workers disaggregated by the ollowing characteristics?Check all options that apply.

A Gender

B Age or age group

C Urban/rural

D State, province or other geographical delineation

E Country where health training was completed

F Country o birth

G Current status in the national health workorce (type o contract, temporary,

probation, permanent)


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H Public/private sector

I Graduates o all health training institutions

J Proessionals who let the health sector (e.g. death, retirement, career change,

leaving the country)

K Marital statusL Other (speciy in question 2.9)

2.9 Provide a short description on additional data relevant to human resources or

health analysis collected in this dataset:

2.10 List the type o data on human resources or health collected in this Institution

(please reer to attachment 2 and check all options that apply).

2.11 Indicate which o the ollowing population based surveys have been used to

complement the data on human resources or health collected by this institution?

Check all options that apply.

A Population census

B Labour orce surveys

C Health acility survey

D Other (speciy):

E None

2.12 List o printed or electronic documents received during interview(s) (e.g.vacancy

notices, sample employment contract, payroll stubs, employee continuing education

brochures, graduation booklet, sample position description and others). Catalogue

appropriately.


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scto 3: Data pot ad

3.1 Is there a plan or monitoring and evaluation o human resources or health

strategic objectives?

A Yes, implemented

B Yes, not ully implemented

C Plan is being developed

D No

3.2 Do you have a standard set summary o data or set o reports that you

produce regularly?

A Yes

B No

C Unsure3.3 Who are the principal users o the data and/or reports? Check all options that apply.

A Ministry o Health

B Other ministries (speciy):

C Other agencies (e.g. social security, parliament)

D Districts health oces

E Health acilities

F Private sector management

G Nongovernmental or not-or-prot organization

H Health proessional regulatory bodies

I General public

J Central statistical oce

K Health training institutions

L Research institutions

M Unkown

N Other (speciy):

O None

3.4 In what ormat do you disseminate the data and/or reports? Check all options

that apply.

A Paper-based documents

B Electronic-based spreadsheet

C Electronic document

D Online access

E None


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3.5 How oten are these data and/or reports produced?

A At least once a year

B In the last 1 to 2 years

C Within the last 3 to 5 years

D Not produced within the last 5 years

3.6 How have the national data on human resources been used in the last fve years?

Check all options that apply.

A Advocating or unds

B Infuencing policies

C Workorce planning

D Human resources management

E Health proessional qualication

F Education and training

G Other (speciy):

H Not used

3.7 Is the national data on human resources used to support human resources or health

planning, development and management processes at all levels? Check all options

that apply.

A National

B Subnational

C International

D Regional

E Other (speciy):

F Not used

3.8 What strategies are needed to improve the use o human resources data in practical

decision-making?

Other comments


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sect

ion4:summaryof

finding

Completetheollowinginormationoreveryinstitutionparticipatin

gincompletionothisquestio

nnaire,indicatingtheacronym

(e.g.Ministryo

Health

MoH)belowtheinstitutionro

wasshownintherstcolumn

asanexample.Attachadditionalsheetsimorespaceisneeded.

Institution1

Institution2

Institution3

Institution4

Institution5

Institution6

(e.g.MoH)

2.1

Indicatethetypeodataonhumanresourcesorhealthcollectedinthisinstitutiono

na

r

outinebasis.

2.2

H

owotenisthisdatacollected?

2.3

O

nwhichsectorsothehealthworkorced

oyoucollectthisdata?

2.4

H

owarethedatacollected?

2.5

H

owarethedatacompiledintoadatabase

orinormationsystem?

2.6

O

ncecompiled,arethedataohealthworkersmappedanddisseminatedusingasta

ndard

c

lassicationorpurposeostatisticalcomparabilitywithotherdatasourcesrelevantto

labourmarketanalysis?

2.7

A

rethedataohealthworkersdisaggregat

edbyoccupationalcategory?

2.8

A

rethedataohealthworkersdisaggregat

edbytheollowingcharacteristics?

2.11Indicatewhichpopulationbasedsurveysh

avebeenusedtocomplement

t

hedataonhumanresourcesorhealthcollectedbytheinstitution.

3.1

Isthereaplanormonitoringandevaluationohumanresourcesorhealth

s

trategicobjectives?

3.2

D

oyouhaveastandardsetsummaryoda

taorsetoreportsthatyouproduceregularly?

3.3

W

hoaretheprincipalusersothedataand

/orreports?

3.4

Inwhatormatdoyoudisseminatethedat

aand/orreports?

3.5

H

owotenarethesedataand/orreportsproduced?

3.6

H

owhavethenationaldataonhumanreso

urcesbeenusedinthelastveyears?

3.7

Isthenationaldataonhumanresourcesus

edtosupporthumanresourcesorhealth

p

lanning,developmentandmanagement

processesatalllevels?


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Attachmt 1Examples o institutions that could produce data onhuman resources or health

The table below gives some examples o institutions that may collect data on HRH as well

as a brie description o what kind o data could be produced by these institutions.

Institution/agency Type o data on HRH

National Institute o Statistics Number o health workers (occupation) by public/private sector

Ministry o Deence Number o military health workers (head counts)

Ministry o Health Number o health workers (head counts)

Ministry o Finance Payroll inormation o all public unctionaries

Migration Oce Records o all categories o migrant health workers

Ministry o Labour Number o health workers (head counts)

Ministry o Interior Administrative records o health workers (head counts)

Medical Council Registry o public, private and oreign doctors

Nurse Council Registry o public, private and oreign nurses

Nurse Association Registry o public, private and oreign nurses

School o Medicine Records o medical students

School o Nursing Records o sta and students rom nursing school

School o Midwiery Records o sta and students rom midwiery school

School o technicians on health Records o sta and students rom health technicians

Regional health centres Records o health workers at the regional level

Other health workers associations Registry o public, pr ivate and oreign health workers

Labour unions Registry o public, private and oreign health workers


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Attachmt 2Type o data on human resources or health (question 2.10)

Please check all options that apply and complete them i necessary. Please reer to the

denitions rom the Health Workorce Classication Mapping in attachment 3.

Health workers Mark

Health proessionals

Generalist medical practitioner/primary care medical doctors

Specialist medical practitioner

Nursing proessional

Midwiery proessional

Traditional and complementary medicine proessional

Paramedical practitioner or clinical ocer

Dentist

Pharmacist

Environmental and occupational health and hygiene proessional

Physiotherapist

Dietician and nutritionist

Audiologist and speech therapist

Optometrist and ophthalmic optician

Health proessional (not elsewhere classied) please speciy:

Health associate proessionals

Medical imaging and therapeutic equipment operator

Medical and pathology laboratory technicianPharmaceutical technician and assistants

Medical and dental prosthetic technician

Nursing associate proessional/nursing assistant

Obstetrics/midwiery associate proessional/midwie assistant

Traditional and complementary medicine associate proessional/complementary medicine technician

Dental assistant and therapist

Medical records and health inormation technician

Community health worker

Dispensing optician

Physiotherapy technician and assistants

Medical assistant

Environmental and occupational health inspector and associates

Ambulance worker/emergency medical technician

Health associate proessional (not elsewhere classied) please speciy:

Other health associate proessionals

Health service manager

Health care assistant/nursing aide

Home-based personal care worker or other home care aide

Other health service providers (not elsewhere classied) please speciy:


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Attachmt 2 (continuation)

Fill in all training elds which apply to you and, i necessary, complete them.

(SE secondary education; PS post-secondary non-tertiary education; TE tertiary

education)

Field o education Types o education programmes SE PS TE

Medicine Medicine

Nursing and midwiery

Nursing

Midwiery

Assistant nursing

Assistant midwiery

Dental studies Dentistry

Medical/health

services

Pharmacy

Clinical/medical services

PhysiotherapyOptometry

Medical technology

Ambulance service

Environmental health

Social work

Occupational health

Other elds associated with health please speciy:


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Page 25


Occup

ation

gro

up

ISCO

code

Denition

Examplesooccupations

classiedhere

Notes

Personal

care

workersin

healthse

rvices

notelsew

here

classifed

5329

Thisgroupcoverspersonalcareworkersinhealthservicesnotclassifedelsewhere

including,

orinstance,

dentalaide

s,hospitalorderlies,medicalimagingassistants,

pharmacyaidesandotherprovide

rsoroutinehealthandpersonalcaresupportservices.

Dentalaide,

rst-aidattendant,

hospitalorderly,medicalimaging

assistant,pharmacyaide,phlebotomist,

sterilizationaide

Otherhe

alth

servicep

roviders

(notelse

where

classifed

)

Thisgroupcoversothercategories

notclassiableasparticipatingintheormalorinormal

healthlabourmarketbutprovidinghealthservicesincluding,

orinstance,medicalinterns

andtraineeswhoareprovidingclinicalservicesaspartotheirbasicmedicaleducation.

Medicalstudentintern,

hospital

volunteer

1SeeInternationalStandardClassicationoOccupations:ISCO-08.

source:A

daptedromInternationalLabourOrganization

,InternationalStandardClassicationoOccup

ations:ISCO-08(http://www.ilo.org/public/eng

lish/bureau/stat/isco/index.htm).


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Department of Human Resources for Health

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1211 G 27

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HRH Data-Online Version Survey Use Sources