1 / 9

Leadership (f)or participation?

Leadership (f)or participation?. Development policies on Human Resources for Health from Alma Ata until today by Maren Bredehorst, MPH International Conference “ global – gerecht – gesund“ Forum V, Workshop “ Health workers: Ethical Aspects and Dimensions“ Berlin, 17-16 September, 2010.

hua
Download Presentation

Leadership (f)or participation?

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Leadership (f)or participation? Development policies on Human Resources for Health from Alma Ata until today by Maren Bredehorst, MPH International Conference “global – gerecht – gesund“ Forum V, Workshop “Health workers: Ethical Aspects and Dimensions“ Berlin, 17-16 September, 2010

  2. Introduction Historical perspectiveon development policies in health and their implications for Human Resources for Health (HRH) Example: Republic of Malawi Focus on the concepts of leadership, professionalism and community participation contradictions of underlying principles? challenges and options for health professionals / experts?

  3. ‘Human Resources for Health’ policies in Malawi (1964-1993, Banda-era) • post-independence: manpower and facilities • under-five clinics 1973-75 • Primary Health Care 1978(pilot: paid PHC workers; then turn to volunteers / Health Surveillance Assistants) • Increased sensitivity for workforce profile (skills) and management in 1986-95 National Health Plan • College of Medicine 1991, emphasis on community health

  4. ‘Human Resources for Health’policies in Malawi (1994-present, multi-party system) • HIV/AIDS: increasing workload and health worker attrition • attempts at strategic HR planning • Academic training: Bachelor and Master programmes – but no formal career paths • Health Sector-Wide Approach with Human Resources Emergency Plan • Global Fund applications(incl. Health Systems Strenthening)

  5. Volunteering and professionalism • Alma Ata Declaration incorporates both: • a) spirit of self-reliance and self-determination; participation; community health workers • b) train existing health cadres for PHC implementation;develop a scientific base • Malawi’s Health Surveillance Assistants: ambivalent role, core cadre for service delivery in communities • Professional view: Who regulates and supervises increasing numbers of volunteers and auxiliaries? (Dräger et al. 2006)

  6. Leadership concepts in health • shift from ‘social dimension of PHC’ (Flahault 1986)towards capacity development / governance / stewardship • ‘good practice’ principles for leaders:Health outcomes, Evidence-based, Aligned, Long-term, Transformational, Harmonized (WHO 2007) • leaders as ‘brokers’ for PHC and moderators of political processes; • participation as ‘transparent processes’, ‘empowerment of health professionals’(WHO 2008) WHR 2008: Primary Health Care – now more than ever

  7. Challenges and options for health professionals / experts Approach to health: needs vs. rights - from professionally-led to user-led initiatives? - empowerment? Professionalisation: organizational vs. occupational- third logic besides market and bureaucracy- collective action under the global aid regime? Knowledge systems: standardisation vs. openness- information needs of development institutions- social research for alternative knowledge / value systems Rappaport (1981) Evetts (2006)Escobar (1995)

  8. Conclusion Leadership and community participation (and their link) have often been neglected in HRH policies Participation should be established as a value / principle in the process of professionalisation in Public Health Reflective practice is required Political nature of health has to be recognised by all stakeholders, at all levels

  9. - Thank you for your kind attention! - References : Dräger S, Gedik G, Dal Poz MR (2006) Health workforce issues and the Global Fund to fight AIDS, Tuberculosis and Malaria. Human Resources for Health 4:23 Escobar A (1995) Encountering Development. The making and Unmaking of the Third World. Princeton University Press Evetts J (2006) Short Note: The Sociology of Professional Groups : New Directions. Current Sociology 54: 133 Flahault D, Roemer MI (1984) Leadership for Primary Health Care. Levels, functions and requirements based on twelve case studies. WHO, Geneva Rappaport J (1981) In Praise of Paradox. A Social Policy of Empowerment over Prevention. American Journal of Community Psychology 9 (1): 1-25 WHO (2008) World Health Report 2008: Primary Health care – now more than ever. WHO, Geneva WHO (2007) Towards better leadership and management in health. WHO/HSS/healthsystems 2007.3 Photos: M. Bredehorst 2009; Map and flag of Malawi: www.wikipedia.org

More Related