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[afro-nets] HRH: Tackling the Human Resource Management Piece of the Puzzle (6)

  • From: "Peter Burgess" <peterbnyc@gmail.com>
  • Date: Wed, 2 Sep 2009 02:23:23 -0400

Dear Jennifer

Are you referring to the chart on page 76 of the WHO document of 2006?

If these are the remuneration data that are meant to respond to my query about remuneration data for different grades in the health sector and in different places, I would observe that my point is well made. These data in the WHO 2006 report are national averages ... and for just MDs and nurses ... and a plot that does not relate to any specific country, just to a country's GDP per capital.

I want to see data that are good for decision making ... and for accountability. What is the distribution of remuneration within the average ... what is the pay in the private clinic and the public clinic for an MD ... for a nurse ... with varying levels of experience and professional qualifications? How do these numbers vary from country to country. What about the other staff in the health sector ... the traditional birth attendants ... the community health workers (CHW) ... midwives ... etc.

In my view one of the reasons that the global health sector is a shambles is because very important issues like remuneration are reduced to simple graphs that tell you virtually nothing.

And while I would agree that there are many factors other than remuneration that impact on the HR dimension of the sector ... none of this matters, if the remuneration issue is not addressed with some seriousness, and a first step in doing this is to start having the data and looking at it.

My guess is that there will be a follow on question that relates to the available resources ... not enough money to pay decent salaries ... and if decent salaries are paid, then not enough money for medicine and other essential supplies and equipment.

We know from US experience that a lot of money does not mean great health outcomes. While some US healthcare is really great ... a lot is pretty pathetic. It is a question of organization and management. The same goes for global health. The evidence seems to be growing that available money is not being used in the most effective ways ... but nobody seems to want to talk much about this. Frankly ... the public deserves better.

For example ... can someone help me with something pretty basic? What is the difference in health outcome between a community that has a health clinic with MD, nurse and medicines and a similar community that does not have such a clinic. What are the health outcomes when the community is served by a CHW with some very basic medical knowledge and medications.

These are pretty important questions ... but they do not seem to be on the agenda. Why not ... I wonder!

All of my remarks may be out of place if, in fact, there are tables of data in the WHO report that I have not located ... I have looked at a pdf copy on a computer screen ... and may have missed something. In which case, I apologise.

Peter Burgess

Peter Burgess
Tr-Ac-Net Inc ... The Transparency and Accountability Network
Community Analytics (CA)
Integrated Malaria Management (IMM)
Microfinance Focus Magazine in New York
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