| Session Title: Evaluating Human Resources for Health Systems Strengthening: Experiences From the United States Agency for International Development's (USAID) Capacity Project |
| Multipaper Session 764 to be held in Suwannee 11 on Saturday, Nov 14, 10:55 AM to 11:40 AM |
| Sponsored by the Health Evaluation TIG |
| Chair(s): |
| Laura Gibney, IntraHealth International, lgibney@intrahealth.org |
| Abstract: Increasing access to basic health care, and responding to critical needs like HIV/AIDS, malaria, family planning and maternal health, relies on mobilizing health care leaders and workers where they are most needed. Yet shortages and poor distribution of health workers pose serious problems in many developing countries. The Capacity Project is a global USAID-funded initiative to help countries build and sustain the health workforce in low-resource settings. The Project is assisting 16 countries to strengthen human resources for health (HRH). Faced with the challenging objective of developing technical assistance in a relatively new area and doing this on a health systems level, the Project has developed evaluation strategies that respond to the important influence of context that characterizes human resource management. We will share our lessons learned regard to the meaning of context within human resources for health as well as recommendations for future HRH evaluation. |
| The Role of Context in Evaluating Human Resources for Health Systems Strengthening |
| Daniel de Vries, IntraHealth International, ddevries@intrahealth.org |
| Linda Fogarty, Jhpiego, lfogarty@intrahealth.org |
| Erik Reavely, Independent Consultant, ereavely@nc.rr.com |
| Elizabeth Bunch, IntraHealth International, ebunch@intrahealth.org |
| The aim of HRH systems strengthening is to build capacity among HR leaders and practitioners to develop and implement strategies to achieve an effective and sustainable health workforce. Lessons learned from the Capacity Project suggest a central role of context in evaluating HRH intervention outcomes. First, because the technical work aims to change national-level HRH systems, measuring evidence of this change is challenging because it takes time, only indirectly affects health outcomes and depends heavily on a country's historical and cultural context and starting point. Second, the nature of HRH capacity-building requires a participatory approach wherein unforeseen directions of the intervention are reflected in evaluating success. Third, balancing global evaluation needs with local priorities proved challenging, particularly in the context of insufficient technical evaluation skills in field countries. This paper will introduce the HRH context and review how an engaged evaluation practice has dealt with these challenges. |
| Indicators for Evaluating Human Resources for Health Capacity-Building |
| Linda Fogarty, Jhpiego, lfogarty@intrahealth.org |
| Daniel de Vries, IntraHealth International, ddevries@intrahealth.org |
| Erik Reavely, Independent Consultant, ereavely@nc.rr.com |
| Elizabeth Bunch, IntraHealth International, ebunch@intrahealth.org |
| Evaluating the effects of health capacity-building interventions has been called more of an art than a science. The Capacity Project, working to build the capacity of human resources for health (HRH) systems in low-resource settings, developed and tested indicators and approaches to monitor and evaluate interventions to plan, develop and support the health workforce. Indicators measure qualitative change in national and sub-national HRH systems and are flexible enough to account for the evolving country context, corresponding technical needs and responding interventions. However, they lack rigor and standardization. Interviews from 30 HRH technical and program experts were analyzed to inform evaluation indicator refinement to better capture country context factors and strengthen HRH evaluation approaches. Results advocate for an even broader set of HRH-related indicators, requiring the same flexibility, but with well-defined milestones, reflecting country-specific needs and changes. Recommendations for strengthened HRH evaluation methods and measures will be discussed. |