Health Profile Who

Human Resources for Health
Country Profile
Template
Human Resources for Health  Country Profile Template
Human Resources for Health

Country Profile
Country name
AHWO, March 2009

Acknowledgement
Make reference to the authors and editors and other contributors.

Content
1. Country context ............................................................................................................................ 10

1.1 Geography and demography .......................................................................................................... 10
1.2 Economic context. .......................................................................................................................... 10
1.3 Political context .............................................................................................................................. 11
1.4 Health status.................................................................................................................................... 11
2. Country health system ................................................................................................................. 13

2.1 Governance ..................................................................................................................................... 13
2.2 Service provision ............................................................................................................................ 13
2.3 Health care financing ..................................................................................................................... 13
2.4 Health information system ............................................................................................................. 13
3. Health Workers Situation ........................................................................................................... 14

3.1 Health workers stock and trends ................................................................................................... 14
3.2 Distribution of health workers by category/cadre ........................................................................ 15
3.2.1 Gender distribution by health occupation/cadre .......................................................... 15
3.2.2 Age distribution by occupation/cadre ........................................................................... 16
3.2.3 Region/province/district distribution by occupation/cadre ......................................... 16
3.2.4 Urban/rural distribution by occupation/cadre .............................................................. 17
3.2.5 Distribution by occupation/cadre .................................................................................................. 17
4. HRH Production ........................................................................................................................... 19

4.1 Pre-service education ..................................................................................................................... 19
4.2 In-service and continuing education ............................................................................................. 20
4.3 Health workforce requirements ..................................................................................................... 21
5. HRH Utilization ............................................................................................................................ 22

5.1 Recruitment..................................................................................................................................... 22
5.2 Deployment and distribution mechanisms .................................................................................... 22
5.3 The work environment ................................................................................................................... 22
5.4 Employment of health workers in the private sector ................................................................... 22
6. Governance for HRH ................................................................................................................... 23

6.1 HRH policies and plans ................................................................................................................. 23
6.2 Policy development, planning and managing for HRH ............................................................... 23
6.3 Professional Regulation ................................................................................................................ 23
6.4 HRH information ............................................................................................................................ 23
6.5 HRH research ................................................................................................................................. 24
6.6 Stakeholders in HRH...................................................................................................................... 24
CONTENT
4
Acronyms
5
Tables
Table 1.1 Percent Population Distribution by Age Group and year ....................................................... 10
Table 1.2 Population distribution by Sex ................................................................................................. 10
Table 1.3 Economic indicators ................................................................................................................. 11
Table 1.4 Main causes of morbidity and mortality ................................................................................. 12
Table 1.5 Health indicators ....................................................................................................................... 12
Table 3.1 Health worker/Population ratios at national level ................................................................. 14
Table 3.2 Distribution of health workers for 5 past years ....................................................................... 15
Table 3.3 Gender distribution by health occupation/cadre ..................................................................... 15
Table 3.4 Workers by age group and cadre ............................................................................................. 16
Table 3.5 Regional/District/province distribution of workers ................................................................ 16
Table 3.6 Urban/Rural distribution of workers ...................................................................................... 17
Table 3.7 Public/Private for profit/Faith based organization/private not for profit
distribution of health workers .................................................................................................. 17
Table 4.1 Number of Training Institutions by type of ownership .......................................................... 19
Table 4.2 Number of entrants and graduates by year XXY .................................................................... 20
Table 4.3 Projections for health workforce requirements for the coming years ................................... 21
6
Figures
7
Executive Summary
Within the framework of the process of establishment of the National Health Workforce Observatory,
this document is a template developed to help countries to draft their Country profile in human
resources for health
In order to address national HRH challenges, the actions to be undertaken must derived from solid
information and reliable research. Such a base of knowledge is essential to create the conditions of a
real awareness and to ensure of the effective actions of advocacy regarding HRH issues in the country.
The establishment of a National Observatory is recommended to facilitate production, sharing and use
of quantitative and qualitative information on HRH in order to support the development and
implementation of the HRH policies and plans. One of the main activities of the National Observatory
is to update periodically the HRH country profile.
The HRH profile is also helpful to compare the country’s HRH challenges and policy responses to
those of other countries in the region.
This template gives basic guidelines to how to describe the HRH stock and trends, imbalances in skill-
mix, distribution and mobility of health workers.
.
The HRH profile contributes also to reinforce the information system of the HRH and to make it
possible to better assess the situation of the HRH of the country at the regional and international level.
8
Introduction
The Introduction should not exceed two pages. The following headings should be addressed.
Purpose
The purpose of the HRH country profile is to serve as a tool for:
 Providing a comprehensive picture of the Health Workforce situation;
 Systematically presenting the HRH policies and management situation to help monitoring the HRH
stock and trends;
 Communication with and between policy-makers and stakeholders;
 Strengthening the HRH information system by establishing evidence for baselines and trends;
 Facilitating information sharing and cross-country comparisons
Methodology
Describe briefly the method of the analysis, the type and sources of data used.
Summary
Present the most important findings.
Scope of the HRH profile

The following areas have to be covered briefly in an outline:
 Comprehensive picture of the Health Workforce situation in the country
 Geography, demography, and economic situation.
 Country’s health services system, its governance and policies
 HRH stock and trends;
 HRH production including pre-service and post basic training processes;
 HRH utilization
9
1. Country context
This section will be brief and will provide an overview of the context and general information on the
country (5-6 pages).
1.1 Geography and demography
Give a brief outline of geography (location, terrain, climate) and demography (total population,
geographical, gender and age distribution of the population, population growth rate, etc..)
Fill tables below.
Table 1.1 Percent Population Distribution by Age Group and year (last available year and 10
year earlier if possible)
Age Group Year1 Year2 Year3 Year4 Year5 Year6

0–14 years
15–64 years
65+ years
Total
Total population
Source:
Table 1.2 Population distribution by Sex
Year Total Male Female Male/Female (%) Growth rate (%)

Year1
Year2
Year3
Year4
Source:
1.2 Economic context.
This section should offer a general overview of the country's current economic situation and major
macroeconomic indicators, such as GDP, GDP per capita, GDP growth, labour force, income or
wealth inequality, poverty, health proportion of GDP, HRH proportion of budget, health worker
unemployment, budget comparisons with education, military etc.
10
Table 1.3 Economic indicators
Last year
Indicators Year X1* Year X2*
available
GDP
National debt as % of GDP
Economic aid as % of GDP
Proportion of budget spent on health as % of GDP
Income per capita (in PPP)
Proportion of population living below poverty line
Proportion of population with malnutrition
Unemployment rate
Inflation rate
Source:
* It is preferable to have information with three years interval
Figure 1.1 Trends of Population growth rate and economic growth rate in the past 5 years (Type
of graphic: line)
1.3 Political context
Give a brief description of the country's governmental system, role of local government and of
elected representatives, parliamentary committees and their authority, etc.
1.4 Health status
Make a brief summary of main health indicators; main causes of morbidity and mortality (table 1.4);
factors affecting health status; and health indicators.table 1.5), such as life expectancy by sex,
mortality by sex, by age (infant, maternal, under-five), HIV/AIDS prevalence rate and safe water
access.
11
Table 1.4 Main causes of morbidity and mortality
Main causes of morbidity Value (%) Main causes of mortality Value (%)
1. 1.
2. 2.
3. 3.
4. 4.
... ...
Others Others
Source and year
Table 1.5 Health indicators
Indicators Both sex Male Female Source and year

Life expectancy
Crude mortality rate
Under-5 mortality rate
Maternal mortality rate
HIV/AIDS prevalence rate
% with access to safe water
% with access to sanitation
12
2. Country health system

This section provides an overview of the health services system and policy context. The following
areas have to be covered: Governance, Service provision, health care financing, access to and use of
services and health information systems.
2.1 Governance
This subsection describes how the health services system is organized and who are the main actors,
decision-making powers and policy directions. The information will include:
How the health services system is organized, how different type of providers are operating (public,
private, NGO) at regional and local levels, the relationship between them, how they are governed and
regulated;
The main actors, their roles and responsibilities in the overall governance and management structures;
A summary of health-related aspects of macroeconomic policies, national development policies and

PRSPs, public sector reforms (i.e. decentralization) and civil service reforms, as well as health
policies.
2.2 Service provision
This subsection describes the provision of personal and non-personal health services at different levels
and how different services are delivered (public health services, curative care, long-term care, and
rehabilitative services), the infrastructure for the delivery of the services, community participation in
health activities.
2.3 Health care financing
This subsection describes the sources of funds (public, social security, out-of-pocket, aid); how the
funds are allocated (to regions, facilities, sectors); how the funds flow; how services are paid for; the
levels of health expenditure; and main areas of expenditure.
2.4 Health information system
This subsection describes briefly how the health information system is organised:
 Is the system decentralized?
 Are there statisticians assigned to the various levels ?
 If yes, do they have computers and access to internet?
 Does the system have some mechanisms of validitating the data collected?
 Does the system use standardized definitions and procedures to collecting HRH data?
 How the system collects HRH data?
13
3. Health Workers Situation

This section presents the health workforce in the country and trends of its evolution during last years.
These data concern the health workers in all sectors (public, semi-public, private for profit and private
not for profit including Faith based organizations sector).
If certain categories or cadres which appear in the proposed tables, do not tally with those used in the
country, there are in appendix the definitions of each category (annex 2) with a table of equivalence
(annex 3) which one can consult in order to better correspond the national professional categories or
cadres with the harmonized definitions.
3.1 Health workers stock and trends
Describe the total number of the health workers available (employed or not) by category in the whole
sector (public and private). Use in the table 3.1, the latest data available and please provide the data
available in previous two data points.
Underline the Health workforce trends (increase or decrease).
Table 3.1 Health worker/Population ratios at national level

(See definition of each occupational category in annex)
Year 1 Year 2
Health occupational categories/cadres HW/1000 HW/1000
Number Number
Population Population
Generalist medical practitioners
Specialist medical practitioners
Nursing professionals
Nursing associate professionals
Midwifery professionals
Midwifery associate professionals
Paramedical practitioners
Dentists
Dental assistants and therapists
Pharmacists
Pharmaceutical technicians and assistants
Environmental and occupational health & hygiene
workers
Physiotherapists and physiotherapy assistants
Optometrists and opticians
Medical imaging and therapeutic equipment
operators
Medical and pathology laboratory technicians
Medical and dental prosthetic technicians
Community health workers
Health management workers/Skilled administrative
staff.
Other health support staff
TOTAL
Source and year
Note: See definition of each occupational category in annex
* Please itemize on separate sheet of the names of cadre
14
Remark: If the data exist for more than two years, it is possible to create additional columns in the
table below to emphasize better the trends of Health workers and ratios in the country.
3.2 Distribution of health workers by category/cadre
Distribution of workers by category,and by gender (table 3.3), age (table 3.4), region/province (table
3.5), urban/rural (table 3.6), public-private for profit - faith based organization (table 3.7).
Table 3.2 Distribution of health workers for 5 past years
3.2.1 Gender distribution by health occupation/cadre
The analysis can be done on the basis of following questions:

 What are the categories/cadres where women are more/less represented?
 Comment on the gender situation in the labour market in the public and/or private sector?
Table 3.3 Gender distribution by health occupation/cadre

Occupational categories/cadres Total Female % Female

Dentists
Pharmacists
Environmental and occupational health & hygiene workers
Physiotherapists and physiotherapy assistants
Medical imaging and therapeutic equipment operators
Health management workers/Skilled administrative staff.
TOTAL
Source and year
*Please itemize on separate sheet of the names of cadre ????
15
3.2.2 Age distribution by occupation/cadre

Describe the distribution of workers by age group as per table 3.4 indicate the retirement age for the
country civil servants.
Table 3.4 Workers by age group and cadre
Health occupational categories ≤30 Yrs 31-40 41-50 ≥51

Physicians generalists
Physicians specialists
Nurses
Midwives
Dentists
Pharmacists
Laboratory workers
Environment & public health workers
Health management and support workers
Source and year
3.2.3 Region/province/district distribution by occupation/cadre
Describe major variations in the distribution of workers by region
Table 3.5 Regional/District/province distribution of workers
Occupational category/cadre Total % % %

Number Region 1 Region 2 Region 3 …
Population
Physicians generalists
Physicians specialists
Nurses
Midwives
Dentists
Pharmacists
Laboratory workers
Other health workers
TOTAL
Source and year
16
3.2.4 Urban/rural distribution by occupation/cadre

Describe major variations in the distribution of workers by
Table 3.6 Urban/Rural distribution of workers

Occupational category/cadre Total % % HW/ 1000 Pop HW/1000 Pop

Number Urban Rural in urban in rural
Dentists
Pharmacists
Environmental and occupational health &
hygiene workers
Physiotherapists and physiotherapy
assistants
Medical imaging and therapeutic
equipment operators
Medical and pathology laboratory
technicians
Health management workers/Skilled
administrative staff..
Source and year
*Please itemize on separate sheet of the names of cadre
3.2.5 Distribution by occupation/cadre
Table 3.7 Public/Private for profit/Faith based organization/private not for profit distribution
of health workers (See definition of each occupational category in annex)
Occupational category/cadre Total % Public % % Faith %private

Number sector Private based not-for -
sector organization profit
Dentists
17
Occupational category/cadre Total % Public % % Faith %private

Number sector Private based not-for -
sector organization profit
Pharmacists
Pharmaceutical technicians and
assistants
hygiene workers
assistants
Medical imaging and therapeutic
equipment operators
Medical and pathology laboratory
technicians
Health management workers/Skilled
administrative staff..
Source and year
*Please itemize on separate sheet of the names of cadre
18
4. HRH Production
This section details the strategies, requirements, mechanisms and capacities for HRH production and
maintenance, and covers :
a) pre-service education of health workforce,

b) In-service and continuing education
c) Health workforce requirements
The issues to be covered in this section are existing policies & strategic documents on production,
supply basic training requirements for each category of health professionals (type of educational
institutions) requirements for specialization and further training (duration, type of educational
institutions); bonding arrangements linked to education; setting educational standards, regulation,
accreditation; capacities for education; number and distribution of educational institutions and
teaching cadres; evaluation and relevance of the training programs, etc.).
4.1 Pre-service education
In this subsection describe who is responsible for pre-service education, links between the two
ministries of Health and Education, and mechanism of co-ordination concerning the quantity and
quality of training in the health training institutions.
Indicate the number of Health Training Institutions in the country as shown in table 4.1
Table 4.1 Number of Training Institutions by type of ownership
Type of training institution Type of ownership Total

Public Private not for Private for
profit, FBOs Profit
Medicine
Dentistry
Pharmacy
Nursing & Midwifery
Health sciences
Paramedical (indicate the type of cadre)
Environment & public health
Total
FBO : Faith based Organization
Describe the number of the annual enrolments in the Health Training Institutions and of the number of
health workers who have been produced in different institutions of the country as indicated in table
4.2 and table 4.3.
19
Table 4.2 Number of entrants and graduates by year XXY
Number of entrants Number of graduates Total

Year Year Year Year Total Year Year Year Year output
Cadre 1 2 3 4 input 1 2 3 4
Physicians
Nurses
Midwives
Dentists
Pharmacists
Laboratory workers
Environment & public
health workers
(please indicate by
cadre)
Total
How is defined the number of workers to educate? Does the Ministry of Health have direct control
over the production of the training institutions? If not, who decides?
Are there any education policies? Please describe if there are any changes in education systems, i.e
changes in nursing education, emerging new professional categories, etc
Assess the capacities of health professions education institutions in terms of

 Physical, which refers to available facilities (buildings, classrooms, laboratory, university
residences);
 Technical, which refers to available trainers and skills;
 Organizational/operational, which refers to the managerial structures and processes (management
control level, decision-making mechanisms, etc.), to other inputs (budget, equipment, pedagogical
tools, etc.) and to support staff needed to deliver effective training.
Please describe if there are any accreditation mechanisms.
4.2 In-service and continuing education
In this subsection, describe

 How the post-service training is provided in the public and private sector.
 How it is organized, coordinated, planned and monitored.
 How often curricula are reviewed, by which mechanism,
 Describe the difficulties and challenges faced by training institutions
 Partnerships between public, not for profit and Private for profit health training institutions and the
main issues
 Accreditation mechanisms
20
4.3 Health workforce requirements
If this information is available, indicate in the table the number required for the next 5 next years by
occupation/cadre (table 4.4).
Table 4.3 Projections for health workforce requirements for the coming years
Cadre Year 1 Year 2 Year 3 Year 4 Year 5 Year …
21
5. HRH Utilization
Describe the issues related to utilization and performance of HRH and how they respond to labour-
market dynamics.
5.1 Recruitment
In this section, describe

 how workers are recruited;
 how recruitment is managed at different levels;
 what proportion of graduates are recruited.
5.2 Deployment and distribution mechanisms
Describe deployment and distribution mechanisms and career systems.
5.3 The work environment
Describe :
 Payment mechanisms (remuneration, benefits)
 Incentives and motivation systems;
 staff turnover and stability,
 attrition, (including level of absenteeism and reasons for absenteeism; informal payments etc)
 management structure
 supervision mechanisms
5.4 Employment of health workers in the private sector
Please describe the conditions in the private sector employment addressing the issues in 5.1 -5.3.
22
6. Governance for HRH

Describe how HRH policies are developed, implemented and monitored.
6.1 HRH policies and plans
Is there HRH policies and plans? If yes, describe their links to health policy, macroeconomic policies
and other development policies; status of policy implementation. If no policy and plan, how this
situation is handled
6.2 Policy development, planning and managing for HRH
Describe how policies and plans are developed and implemented, and who is involved:
organizational structures in place to manage the HRH function at all levels;
capacity of the HRH department/division in the ministry of health;
staffing profile of the HRH staff in the department/division;
status of the department;
Describe the decentralization process, such as delegation of authority at local level and capacity at
local level in relation to health workforce, i.e.
who fires and hires at district level?
who determines pay and is salary paid by local government or national MOH?
Who decide disciplinary actions - final decisions taken where?
Who evaluate Health workers performance and at what level?
6.3 Professional Regulation
Describe the main regulatory bodies of HRH, registration process, etc.
6.4 HRH information
In this section, describe if :

There is a national plan for monitoring and evaluation of national HRH strategic objectives
There is a functional Human Resource Information System (HRIS)
HRIS is computerized
HRIS linked to the Health Information System
HRIS uses other sources of information such as HRH surveys, office of statistics, census data,
professional associations, unions).
How often national HRH statistics are updated
How well the HRH information system works and how reliable it is;
the reporting requirements from private, NGO/FBO sectors;
23
6.5 HRH research
Are there any HRH-specific research programmes; how are they funded; how the results of research
are used for policy-making, what the national HRH research questions/research priorities are.
6.6 Stakeholders in HRH
Mapping of national and international stakeholders in HRH and their roles (regulatory, research, data);
existing interaction mechanisms; HRH-related initiatives; and external support (a tabular format will
be provided).
24
Annex 1: Health workforce status
Skill level Total Total Urban Rural Public Private

women
Dentists
Pharmacists
hygiene workers
assistants
Medical imaging and therapeutic equipment
operators
Medical assistants
Traditional and complementary medicine
practitioners
Other health service providers
Health care assistants and other personal
care workers in health services
Other science professionals and technicians
Health service managers
Medical records and health information
technicians
Other health management and support
workers
25
Annex 2: Definitions of health workforce data

Health Workforce: Aggregated Data
In the aggregated data, the health workforce is grouped into the following 10 categories:
Physicians
Includes generalists and specialists.
Nurses
Includes professional nurses, auxiliary nurses, enrolled nurses and other nurses, such as dental nurses
and primary care nurses.
Midwives
Includes professional midwives, auxiliary midwives and enrolled midwives. Traditional birth
attendants, who are counted as community health workers, appear elsewhere.
Dentists
Includes dentists, dental assistants and dental technicians
Pharmacists
Includes pharmacists, pharmaceutical assistants and pharmaceutical technicians
Laboratory workers
Includes laboratory scientists, laboratory assistants, laboratory technicians and radiographers.

Includes environmental and public health officers, sanitarians, hygienists, environmental and public
health technicians, district health officers, malaria technicians, meat inspectors, public health
supervisors and similar professions.

Includes traditional medicine practitioners, faith healers, assistant/community health education
workers, community health officers, family health workers, lady health visitors, health extension
package workers, community midwives, institution-based personal care workers and traditional birth
attendants.

Includes a large number of occupations such as dieticians and nutritionists, medical assistants,
occupational therapists, operators of medical and dentistry equipment, optometrists and opticians,
physiotherapists, podiatrists, prosthetic/orthetic engineers, psychologists, respiratory therapists, speech
pathologists, medical trainees and interns.

Includes general managers, statisticians, lawyers, accountants, medical secretaries, gardeners,
computer technicians, ambulance staff, cleaning staff, building and engineering staff, skilled
administrative staff and general support staff.
26
Annex 3: Health workforce classification mapping
Notes
Definition Examples of occupations Excluded occupations -
Occupation Code included here classified elsewhere Additional comments
Generalist medical 2211 Generalist medical practitioners Medical doctor (general), Specialist physician-2212, Occupations included in this category
practitioners (physicians) apply the principles and General practitioner, Family Paediatrician-2212, require completion of a university-level
procedures of modern medicine in medical practitioner, Surgeon-2212, Psychiatrist- degree in basic medical education plus
preventing, diagnosing, caring for and Primary health care 2212, Traditional medicine postgraduate clinical training or equivalent
treating illness, disease and injury in physician, District medical practitioner-2230, for competent performance. Medical
humans and the maintenance of general doctor-therapeutist, Paramedical practitioner- trainees who are non-university graduates
health. They may supervise the Resident medical officer 2240 should not be included here. Medical
implementation of care and treatment specialising in general interns who have completed their
plans by other health care providers, and practice university education in basic medical
conduct medical education and research education and are undertaking
activities. They do not limit their practice to postgraduate clinical training are included
certain disease categories or methods of here. Although in some countries ‘general
treatment, and may assume responsibility practice’ and 'family medicine' may be
for the provision of continuing and considered as medical specialisations,
comprehensive medical care. these occupations should always be
classified here.
27
Notes
Specialist medical 2212 Specialist medical practitioners Specialist physician General medical Occupations included in this category
practitioners (physicians) apply the principles and (internal medicine), practitioner-2211, Dental require completion of a university-level
procedures of modern medicine in Surgeon, Anaesthetist, practitioner-2261, Dental degree in basic medical education plus
preventing, diagnosing, caring for and Cardiologist, Emergency surgeon-2261, postgraduate clinical training in a medical
treating illness, disease and injury in medicine specialist, Physiotherapist-2264, specialisation (except general practice) or
humans using specialised testing, Ophthalmologist, Psychologist-2634 equivalent. Medical trainees who are non-
diagnostic, medical, surgical, physical and Obstetrician, university graduates should not be
psychological techniques. They may Gynaecologist, included here. Resident medical officers
supervise the implementation of care and Paediatrician, Pathologist, training as specialist practitioners (except
treatment plans by other health care Preventive medicine general practice) are included here.
providers. They specialise in certain specialist, Psychiatrist, Although in some countries 'stomatology'
disease categories, types of patient or Radiologist, Resident may be considered as a medical
methods of treatment, and may conduct medical officer in specialist specialisation, stomatologists should be
medical education and research activities training included under 'Dentists'-2261.
in their chosen areas of specialisation.
Nursing 2221 Nursing professionals plan, manage, Professional nurse, Professional midwife-2222, Occupations included in this category
professionals provide and evaluate nursing care Specialist nurse, Nurse Associate professional normally require completion of tertiary-
services for persons in need of such care practitioner, Clinical nurse, nurse-3221, Associate level education in theoretical and practical
due to effects of illness, injury, or other General nurse-midwife, professional midwife-3222, nursing. Nursing professionals who spend
physical or mental impairment, or potential Public health nurse, Nurse Paramedical practitioner- the majority of their working time in
risks for health. They work autonomously anesthetist 2240 maternal and newborn health care
or in teams with medical doctors and other services should be included under
health workers. They may supervise the 'Midwifery professionals'-2222.
implementation of nursing care plans, and
conduct nursing education activities.
Nursing associate 3221 Nursing associate professionals provide Associate professional Professional nurse-2221, Occupations included in this category
professionals basic nursing care for people who are in nurse, Assistant nurse; Specialist nurse-2221, normally require formal training in nursing
need of such care due to effects of ageing, Licensed practical nurse, Associate professional services. Associate professional nurses
illness, injury, or other physical or mental Enrolled nurse midwife-3222, Community who spend the majority of their working
impairment. They implement care, nurse attendant-3253, time in maternal and newborn health care
treatment and referral plans established Nursing aide (hospital or services should be included under
by medical, nursing and other health clinic)-5321, Nursing aide 'Associate professional midwives'-2223.
professionals. (home)-5322
28
Notes
Midwifery 2222 Midwifery professionals plan, manage, Professional midwife Nursing aide-5321, Occupations included in this category
professionals provide and evaluate midwifery care Associate professional normally require completion of tertiary-
services before, during and after nurse-3231, Associate level education in theoretical and practical
pregnancy and childbirth. They provide professional midwife-3232 midwifery.
delivery care for reducing health risks to
women and newborns, working
autonomously or in teams with other
health care providers.
Midwifery 3222 Midwifery associate professionals provide Associate professional Professional midwife-2222, Occupations included in this category
associate basic health care and advise before, midwife, Assistant midwife Associate professional normally require formal training in
professionals during and after pregnancy and childbirth. nurse-3221, Midwifery midwifery services. Midwifery attendants
They implement care, treatment and attendant-5321 with little or no formal training should be
referral plans to reduce health risks to included under 'Health care assistants'-
women and newborns as established by 5321.
medical, midwifery and other health
professionals.
Paramedical 2240 Paramedical practitioners (advanced Clinical officer, Surgical Emergency paramedic- Occupations included in this category
practitioners practice clinicians) provide advisory, technician, Physician 3258, Medical assistant- normally require completion of tertiary-
diagnostic, curative and preventive assistant, Primary care 3256, General medical level training in theoretical and practical
medical services in a variety of settings. paramedic, Advanced care practitioner-2211, Surgeon- medical services. Workers providing
They work autonomously or with limited paramedic, Feldsher 2212 services limited to emergency treatment
supervision of medical doctors, and apply and ambulance practice should be
advanced clinical procedures for treating included under 'Ambulance workers'-3258.
and preventing diseases, injuries, and
other physical or mental impairments
common to specific communities.
29
Notes
Dentists 2261 Dentists apply the principles and Dentist, Dental practitioner, Dental prosthetic Occupations included in this category
procedures of modern dentistry in Dental surgeon, Oral and technician-3214, Dental normally require completion of university-
diagnosing, treating and preventing maxillofacial surgeon, assistant-3251, Dental level training in theoretical and practical
diseases, injuries and abnormalities of the Endodontist, Orthodontist, hygienist-3251 dentistry or related field. Although in some
teeth, mouth, jaws and associated tissues. Paedodontist, Periodontist, countries ‘stomatology’ and 'dental, oral
They use a broad range of specialised Prosthodontist, and maxillofacial surgery' may be
diagnostic, surgical and other techniques Stomatologist considered as medical specialisations,
to promote and restore oral health. occupations in these fields should always
be classified here.
Dental assistants 3251 Dental assistants and therapists provide Dental assistant, Dental Dental aide-5329, Dental Occupations included in this category
and therapists basic dental care services for the hygienist, Dental therapist mechanic-3214, Dental normally require formal training in dental
prevention and treatment of diseases and prosthetist-3214, Dental hygiene, dental-assisting or related field.
disorders of the teeth and mouth, as per technician-3214, Dentist-
care plans and procedures established by 2261
a dentist or other oral health professional.
Pharmacists 2262 Pharmacists store, preserve, compound, Hospital pharmacist, Pharmacologist-2131, Occupations included in this category
test and dispense medicinal products. Industrial pharmacist, Retail Pharmaceutical technician- normally require completion of university-
They counsel on the proper use and pharmacist, Dispensing 3213 level training in theoretical and practical
adverse effects of drugs and medicines chemist pharmacy, pharmaceutical chemistry or a
following prescriptions issued by medical related field. Pharmacologists and related
doctors and other health professionals. professionals who study living organisms
They contribute to researching, preparing, are not included here (classified under Life
prescribing and monitoring medicinal science professionals).
therapies for optimising human health.
Pharmaceutical 3213 Pharmaceutical technicians and assistants Pharmaceutical technician, Pharmacist-2262, Occupations included in this category
technicians and perform routine tasks associated with Pharmacy assistant Pharmacy aide-5329, normally require basic medical and
assistants preparing and dispensing medicinal Pharmacology technician- pharmaceutical knowledge obtained
products under the supervision of a 3141 through formal training. Pharmacology
pharmacist or other health professional. technicians and related associate
professionals who work with living
organisms are not included here
(classified under Life science technicians).
30
Notes
Environmental and 2263, Environmental and occupational health & Environmental health Specialist medical Occupations included in this category
occupational health 3257 hygiene workers plan, assess and officer, Occupational health practitioner (public health)- normally require formal training in
& hygiene workers investigate the implementation of and safety adviser, 2212, Specialist nurse environmental public health, occupational
programs and regulations to monitor and Occupational health and (public health)-2221, health and safety, sanitary sciences, or a
control environmental factors that can safety inspector, Occupational therapist- related field. Environmental protection
potentially affect human health, to ensure Occupational hygienist, 2269, Environmental workers who study and assess the effects
safe and healthy working conditions, and Radiation protection protection professional- on the environment of human activity are
to ensure the safety of processes for the adviser, Sanitarian, Health 2133 not included here (classified under Life
production of goods and services. inspector, Food sanitation science professionals).
and safety inspector
Physiotherapists 2264, Physiotherapists and physiotherapy Physiotherapist, Paediatric Occupational therapist- Occupations included in this category
and physiotherapy 3255 assistants provide physical therapeutic physical therapist, 2269, Osteopath-3259, normally require formal training in physical
assistants treatments to patients in circumstances Orthopaedic physical Chiropractor-3259, rehabilitation therapy or a related field.
where functional movement is threatened therapist, Physiotherapist Podiatrist-2269
by injury, disease or impairment. They assistant, Physical
may apply movement, ultrasound, heating, rehabilitation technician,
laser and other techniques. Massage therapist,
Electrotherapist,
Acupressure therapist,
Shiatsu therapist,
Hydrotherapist
Optometrists and 2267, Optometrists and opticians provide Optometrist, Optician, Ophthalmologist-2212 Occupations included in this category
opticians 3254 primary eye health and vision care Orthoptist normally require formal training in
services. Optometrists and ophthalmic optometry, orthoptics, opticianry or a
opticians provide diagnosis management related field.
and treatment services for disorders of the
eyes and visual system. Dispensing
opticians design, fit and dispense optical
lenses for the correction of reduced visual
acuity.
31
Notes
Medical imaging 3211 Medical imaging and therapeutic Medical imaging technician, Radiologist-2212 Occupations included in this category
and therapeutic equipment technicians test and operate Diagnostic medical normally require formal training in medical
equipment radiographic, ultrasound and other radiographer, Medical technology, radiology, sonography,
operators medical imaging equipment to produce radiation therapist, nuclear medical technology, or a related
images of body structures for the Magnetic resonance field.
diagnosis and treatment of injury, disease imaging technologist,
and other impairments. They may Nuclear medicine
administer radiation treatments to patients technologist, Sonographer,
under the supervision of a radiologist or Mammographer
other health professional.
Medical and 3212 Medical and pathology laboratory Medical laboratory Pathologist-2212 Occupations included in this category
pathology technicians perform clinical tests on technician, Medical normally require formal training in
laboratory specimens of bodily fluids and tissues in laboratory assistant, biomedical science, medical technology,
technicians order to get information about the health of Cytology technician, Blood or a related field. Technicians conducting
a patient or cause of death. bank technician, Pathology laboratory tests on specimens from
technician animals are not included here (classified
under Veterinary technicians).
Medical and dental 3214 Medical and dental prosthetic technicians Medical appliance Dental assistant-3251, Occupations included in this category
prosthetic design, fit, service and repair medical and technician, Prosthetist, Dispensing optician-3254 normally require basic medical, dental and
technicians dental devices and appliances following Orthotist, Prosthetic anatomical knowledge obtained through
prescriptions or instructions established by technician, Orthotic formal training. Technicians who construct
a health professional. They may service a technician, Dental and repair precision medical and surgical
wide range of support instruments to technician, Denturist instruments based on engineering
correct physical medical or dental knowledge alone are not included here
problems such as neck braces, orthopedic (classified under Science and engineering
splints, artificial limbs, hearing aides, arch associate professionals).
supports, dentures, and dental crowns and
bridges.
32
Notes
Community health 3253 Community health workers provide health Community health worker, Nursing aide-5322, Home Occupations included in this category
workers education, referral and followup, case Community health aide, care aide-5322, Village normally require formal or informal training
management, and basic preventive health Community health healer-3230 recognized by the health and social
care and home visiting services to specific promoter, Village health services authorities. Providers of routine
communities. They provide support and worker personal care services, self-defined health
assistance to individuals and families in care providers and traditional medicine
navigating the health and social services practitioners are not included here.
system.
Medical assistants 3256 Medical assistants perform basic clinical Medical assistant, Clinical Clinical officer-2240, Occupations included in this category
and administrative tasks to support patient assistant, Ophthalmic Physician assistant-2240, normally require formal training in health
care under the direct supervision of a assistant Dental assistant-3251, services provision. Clinical care providers
medical practitioner or other health Physiotherapy assistant- with advanced training and skills to
professional. 3255, Medical prosthetic provide independent medical diagnostic
technician-3214, Medical and treatment services should be
imaging assistant-5321 classified under 'Paramedical
practitioners'-2240.
Traditional and 2230, Traditional and complementary medicine Acupuncturist, Ayurvedic Acupressure therapist- Occupations included in this category
complementary 3230 practitioners apply procedures and practitioner, Unani 3255, Shiatsu therapist- normally require knowledge and skills
medicine practices based on the theories, beliefs practitioner, Chinese herbal 3255, Hydrotherapist-3255, acquired from formal education, or
practitioners and experiences indigenous to different medicine practitioner, Chiropractor-3259, informally through the traditions and
cultures, used in the maintenance of Homeopath, Naturopath, Osteopath-3259 practices of the communities where they
health and in the prevention or treatment Bonesetter, Herbalist, Witch originated. Faith healers who treat human
of physical and mental illnesses. doctor, Village healer, ailments through spiritual therapies,
Scraping and cupping without using herbal preparations or other
therapist physical interventions, are not included
here. Occupations that rely on traditional
forms of massage and the application of
pressure, such as acupressure and
shiatsu therapists, are classified in
'Physiotherapy technicians and
assistants'-3255.
33
Notes
Other health This category may include a wide range of Ambulance paramedic- Occupations included in this category
service providers occupations connected with health service 3258, Emergency medical normally require formal training in a health
provision. technician-3258, Dieticians or social service-related field.
and nutritionists-2265,
Audiologists and speech
therapists-2266, Podiatrist-
2269, Occupational
therapist-2269,
Chiropractor-3259,
Osteopath-3259,
Psychologist-2634, Social
workers and counsellors-
2635
Health care 5321, Personal care workers perform routine Hospital orderly, Nursing Nurse (associate Occupations included in this category
assistants and 5322, patient care services as per care plans, aide, Patient care assistant, professional)-3221, Nurse generally do not require extensive health
other personal care 5329 practices and procedures established by a Dental aide, Midwifery (professional)-2221, care knowledge or training. Personal care
workers in health health professional. attendant, Psychiatric aide, Community health worker- workers may work in a variety of settings
services Medical imaging assistant, 3253 including private homes as well as health
Home care aide, Pharmacy facilities (hospitals, medical and dental
aide, Dental aide, practice facilities, rehabilitation centres,
Sterilization aide, Faith and other types of residential facilities with
healer or without on-site nursing care services).
Other science This category may include a wide range of Pharmacologist-2131, Occupations included here normally
professionals and occupations connected with physical and Biologist-2131, require formal training in a physical or life
technicians life sciences research and applications to Biotechnologist-2131, Cell science-related field.
solve human health problems. geneticist-2131,
Environmental protection
professional-2133,
Environmental research
scientist-2133, Medical
physicist-2111,
Bacteriology technician-
3141, Pharmacology
technician-3141
34
Notes
Health service 1342 Health service managers plan, coordinate Health facility administrator, Aged care service The main tasks and duties for jobs in this
managers and supervise the provision of clinical, Medical nursing home manager-1343, Senior occupational category include guiding and
personal care and community health care administrator, Clinical government official-1112 directing the activities of organizations,
services. manager, Director of departments and other workers. Education
nursing care, Hospital and training requirements may vary
matron, Community care depending on the position and national
coordinator, Chief public context — likely including some
health officer combination of formal education, on-the-
job training and work experience.
Medical records 3252 Medical records and health information Medical records clerk, Medical secretary-3344, Occupations included in this category
and health technicians assess, manage and Medical records technician, Data entry clerk-4132, normally require knowledge of medical
information implement health records processing, Health information system Filing and copying clerk- terminology, legal aspects of health
technicians storage and retrieval systems in medical technician, Health 4415 information, health data standards, and
facilities and other health care settings to information clerk, Medical computer- or paper-based data
meet the legal, professional, ethical and records analyst, Clinical management as obtained through formal
administrative records-keeping coder, Disease registry education and/or on-the-job training.
requirements of health services delivery. technician Clerks who perform general secretarial or
clerical duties are not included here
(classified under Clerical support workers).
Other health This category may include a wide range of Health policy analyst-2422,
management and workers performing a variety of Government licensing
support workers administrative, clerical, and other tasks official-3354, Aged care
and duties to support the provision of service manager-1343,
health services and functioning of health Staff training officer-2424,
systems. Medical secretary-3344,
Computer technician-3513,
Data entry clerk-4132,
Filing and copying clerk-
4415, Receptionist-4226,
Building caretaker-5153,
Cook-5120, Ambulance
driver-8322
35
ANNEX 4: Mapping education and training to the international standard classification

Field Definition Examples of education programmes included here
Medicine The study of the principles and procedures used in Basic medical education: programmes for the training of medical doctors/physicians
preventing, diagnosing, caring for and treating illness, Paramedical programmes: training of paramedical practitioners/advanced practice clinicians
disease and injury in humans and the maintenance of (includes tertiary level programmes not leading directly to the award of a medical research
general health. qualification)
Nursing and The study of providing health care for people who are in Basic nursing education: programmes for the training of nursing professionals (tertiary level)
midwifery need of such care due to effects of illness, injury or Basic midwifery education: programmes for the training of midwifery professionals (tertiary
impairment, or potential risks for health, and assisting level)
physicians and other health professionals diagnose and Assistant nursing education: programmes for the training of nursing associate professionals
treat patients. Assistant midwifery education: programmes for the training of midwifery associate
professionals
Dental studies The study of diagnosing, treating and preventing Dentistry: programmes for the training of dentists (tertiary level)
diseases and abnormalities of the teeth and gums. It Dental care services: programmes for the training of dental assistants, dental therapists,
includes the study of designing, making and repairing dental prosthetic technicians and related occupations (e.g. dental-assisting, dental hygiene,
dental prostheses and orthodontic appliances. It also dental nursing, dental laboratory technology)
includes the study of providing assistance to dentists.
Medical services The study of physical disorders, treating diseases and Pharmacy: programmes for the training of pharmacists (tertiary level)
(health sciences) maintaining the physical well-being of humans, using Physiotherapy: programmes for the training of physiotherapists (tertiary level)
non-surgical procedures. Medical technology: programmes for the training of medical imaging and therapeutic
equipment technicians (e.g. medical X-ray techniques, radiology, radiotherapy, sonography)
Medical laboratory technology: programmes for the training of medical and pathology
laboratory technicians
Medical prosthetics: programmes for the training of medical prosthetic technicians
Other programmes for the training of health professionals and associate professionals (e.g.
emergency medical treatment, nutrition & dietetics, optometry, speech pathology)
Environmental, public The study of the relationships between living organisms Programmes in services to the community dealing with items that affect public health (e.g.
and occupational and the environment that affect public health. Includes hygiene standards in food and water supply)
health the study of recognizing, evaluating and controlling Programmes in occupational health and safety (e.g. ergonomics, health and safety in the
environmental factors associated with the workplace. workplace, industrial hygiene)
36
ANNEX 4: Members involved in the working group

Name Position/title Organization Contact address
37

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Human Resources for Health

Human Resources for Health

AHWO, March 2009

Make reference to the authors and editors and other contributors.

1. Country context ............................................................................................................................ 10

2. Country health system ................................................................................................................. 13

3. Health Workers Situation ........................................................................................................... 14

4. HRH Production ........................................................................................................................... 19

5. HRH Utilization ............................................................................................................................ 22

6. Governance for HRH ................................................................................................................... 23

Scope of the HRH profile

1.1 Geography and demography

Fill tables below.

Age Group Year1 Year2 Year3 Year4 Year5 Year6

Table 1.2 Population distribution by Sex

Year Total Male Female Male/Female (%) Growth rate (%)

1.2 Economic context.

Table 1.3 Economic indicators

* It is preferable to have information with three years interval

1.3 Political context

1.4 Health status

Table 1.4 Main causes of morbidity and mortality

Table 1.5 Health indicators

Indicators Both sex Male Female Source and year

2. Country health system

A summary of health-related aspects of macroeconomic policies, national development policies and

2.2 Service provision

2.3 Health care financing

2.4 Health information system

3. Health Workers Situation

3.1 Health workers stock and trends

Table 3.1 Health worker/Population ratios at national level

3.2 Distribution of health workers by category/cadre

Table 3.2 Distribution of health workers for 5 past years

3.2.1 Gender distribution by health occupation/cadre

The analysis can be done on the basis of following questions:

Table 3.3 Gender distribution by health occupation/cadre

Occupational categories/cadres Total Female % Female

3.2.2 Age distribution by occupation/cadre

Table 3.4 Workers by age group and cadre

Health occupational categories ≤30 Yrs 31-40 41-50 ≥51

3.2.3 Region/province/district distribution by occupation/cadre

Describe major variations in the distribution of workers by region

Table 3.5 Regional/District/province distribution of workers

Occupational category/cadre Total % % %

3.2.4 Urban/rural distribution by occupation/cadre

Table 3.6 Urban/Rural distribution of workers

Occupational category/cadre Total % % HW/ 1000 Pop HW/1000 Pop

3.2.5 Distribution by occupation/cadre

Occupational category/cadre Total % Public % % Faith %private

Occupational category/cadre Total % Public % % Faith %private

a) pre-service education of health workforce,

4.1 Pre-service education

Table 4.1 Number of Training Institutions by type of ownership

Type of training institution Type of ownership Total

Table 4.2 Number of entrants and graduates by year XXY

Number of entrants Number of graduates Total

Assess the capacities of health professions education institutions in terms of

Please describe if there are any accreditation mechanisms.

4.2 In-service and continuing education

In this subsection, describe

4.3 Health workforce requirements

Cadre Year 1 Year 2 Year 3 Year 4 Year 5 Year …

In this section, describe