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Cross-sectoral issues between Health
and Education in Human Resources in
fragile and conflict-affected states
HEART seminar on Human
Resources in Fragile and
Conflict-affected States
Royal Society, London 9th June 2016
Introductions
 Name
 Organisation
 Role/specialism
HEART 2
NAME INSTITUTION
Alvaro Alonso-Garbayo ReBUILD team at LSTM
Chris Berry DFID
Chris Joynes EDT
Elisabeth Resch OPM
Helen Mobey EDT
Jo Keatinge DFID
Katharine Holmes EDT
Lizzie Smith DFID
Nick Hooton ReBUILD team at LSTM
Nicola Watt DFID
Nigel Pearson Independent Consultant
Patrick Douglas EDT
Peter-Sam Hill OPM
Rashid Zaman OPM
Sam Franzen OPM
Sophie Witter ReBUILD team at QMU
Susy Ndaruhutse EDT
Tim Martineau ReBUILD team at LSTM
Willy McCourt Independent Consultant
HEART Consortium Members
www.heart-resources.org
3
4
Programme
 Introduction, Tim Martineau (Liverpool School of
Tropical Medicine) and Joanna Buckley (OPM)
HEART 5
Recruitment to retention ‘pipeline’
Adapted from: Vujicic et al, 2006
• Initial posting
• Induction
• Bonding
• Career choice
• Science grades
• Capacity
• Need (quality
& quantity)
• Registration
• On payroll
• ROI
Selection
• criteria
• process
Recruitment to retention ‘pipeline’
Adapted from: Vujicic et al, 2006
• Shortage of
health workers
in Africa in
2013 = 4.2M
• Shortage of
18M health
workers to
meet SDGs
• 100M children no 1o
Education
• 18 countries with
Lower 2o pupil :
teacher ratio >30:1
Comparing HR in health and educations sectors in MLICs
Similarities
 largest public sector workforce
 difficult to staff in remotest areas
 traditionally high proportion of
females
 historically high engagement of
FBOs
 increasing privatisation of
professional training and service
delivery
 both sectors have dedicated HR
targets in their respective SDGs
 ?powerful unions
 ?use of performance-based
incentives
Differences
 complexity of cadres in health vs
simpler structure in education
 high level of international migration
of health professionals vs lower for
education sector
 less predictable workloads in health
(Hanson 2015)
 ?greater use of task-shifting in
health
HEART 8
Few examples of work across health and education
Context of fragile and conflict-affected states
 Since 2010, all major donors have published frameworks for programming in
FCAS development projects need to be sensitive to how interventions shape
the broader state-building and conflict dynamics within which they operate.
 DFID increased spending in FCAS to 30% of UK ODA by 2014-15, representing
an 86% increase since 2010. In November 2015 HMG made a commitment to
allocate 50% of all DFID’S spending to fragile states and regions.
 This commitment, combined with the reduction in number of DFID priority
countries from 43 to 28 following the 2011 Bilateral Aid Review, and
commitment to spend 0.7% GNI on ODA have led to a significant absolute
increase in DFID’s expenditure on FCAS.
 Range of scenarios of FCAS:
– Humanitarian assistance (less in education)
– Reconstruction phase
– Development phase
– Transition from one to another
Challenges of working in fragile and conflict-affected states
 Being conflict sensitive – who you engage with, how and where. Adverse
impacts of certain health interventions e.g. Taliban's offensive against the polio
vaccinations in Pakistan.
 Access – e.g attacks on hospitals in Syria and Afghanistan.
 Lack of strong institutions – gaps in regulatory, legislative and policy framework
e.g. Somalia.
 Questions of equity of access
 Limited infrastructure e.g. roads, electricity, water
Objective of the session
 explore the potential for cross-sectoral learning,
and attempt to draw out some initial lessons
about challenges and effective strategies that
could further strengthen human resources in the
fields of education and health in complex
contexts and redress the current sectoral silos
Programme
 Introduction, Tim Martineau (Liverpool School of
Tropical Medicine) and Joanna Buckley (OPM)
 The health perspective, Sophie Witter (Queen
Margaret University)
 The education perspective, Chris Joynes (Education
Development Trust)
 Tea and coffee break
 Lessons learnt (Chris Berry and Lizzie Smith, DFID)
 Floor discussion
 Wrap-up and conclusions
HEART 13
Floor discussion in HR in health and education in FCAS
 What are the most important common challenges?
 What are the differences?
 Where could there be greater collaboration
between the two sectors? (programme design,
research, etc)
 What specific help do donors and governments
want?
Thank you

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Human Resources in Fragile and Conflict-Affected settings - cross sectoral issues between health and education

  • 1. Cross-sectoral issues between Health and Education in Human Resources in fragile and conflict-affected states HEART seminar on Human Resources in Fragile and Conflict-affected States Royal Society, London 9th June 2016
  • 2. Introductions  Name  Organisation  Role/specialism HEART 2 NAME INSTITUTION Alvaro Alonso-Garbayo ReBUILD team at LSTM Chris Berry DFID Chris Joynes EDT Elisabeth Resch OPM Helen Mobey EDT Jo Keatinge DFID Katharine Holmes EDT Lizzie Smith DFID Nick Hooton ReBUILD team at LSTM Nicola Watt DFID Nigel Pearson Independent Consultant Patrick Douglas EDT Peter-Sam Hill OPM Rashid Zaman OPM Sam Franzen OPM Sophie Witter ReBUILD team at QMU Susy Ndaruhutse EDT Tim Martineau ReBUILD team at LSTM Willy McCourt Independent Consultant
  • 4. 4
  • 5. Programme  Introduction, Tim Martineau (Liverpool School of Tropical Medicine) and Joanna Buckley (OPM) HEART 5
  • 6. Recruitment to retention ‘pipeline’ Adapted from: Vujicic et al, 2006 • Initial posting • Induction • Bonding • Career choice • Science grades • Capacity • Need (quality & quantity) • Registration • On payroll • ROI Selection • criteria • process
  • 7. Recruitment to retention ‘pipeline’ Adapted from: Vujicic et al, 2006 • Shortage of health workers in Africa in 2013 = 4.2M • Shortage of 18M health workers to meet SDGs • 100M children no 1o Education • 18 countries with Lower 2o pupil : teacher ratio >30:1
  • 8. Comparing HR in health and educations sectors in MLICs Similarities  largest public sector workforce  difficult to staff in remotest areas  traditionally high proportion of females  historically high engagement of FBOs  increasing privatisation of professional training and service delivery  both sectors have dedicated HR targets in their respective SDGs  ?powerful unions  ?use of performance-based incentives Differences  complexity of cadres in health vs simpler structure in education  high level of international migration of health professionals vs lower for education sector  less predictable workloads in health (Hanson 2015)  ?greater use of task-shifting in health HEART 8
  • 9. Few examples of work across health and education
  • 10. Context of fragile and conflict-affected states  Since 2010, all major donors have published frameworks for programming in FCAS development projects need to be sensitive to how interventions shape the broader state-building and conflict dynamics within which they operate.  DFID increased spending in FCAS to 30% of UK ODA by 2014-15, representing an 86% increase since 2010. In November 2015 HMG made a commitment to allocate 50% of all DFID’S spending to fragile states and regions.  This commitment, combined with the reduction in number of DFID priority countries from 43 to 28 following the 2011 Bilateral Aid Review, and commitment to spend 0.7% GNI on ODA have led to a significant absolute increase in DFID’s expenditure on FCAS.  Range of scenarios of FCAS: – Humanitarian assistance (less in education) – Reconstruction phase – Development phase – Transition from one to another
  • 11. Challenges of working in fragile and conflict-affected states  Being conflict sensitive – who you engage with, how and where. Adverse impacts of certain health interventions e.g. Taliban's offensive against the polio vaccinations in Pakistan.  Access – e.g attacks on hospitals in Syria and Afghanistan.  Lack of strong institutions – gaps in regulatory, legislative and policy framework e.g. Somalia.  Questions of equity of access  Limited infrastructure e.g. roads, electricity, water
  • 12. Objective of the session  explore the potential for cross-sectoral learning, and attempt to draw out some initial lessons about challenges and effective strategies that could further strengthen human resources in the fields of education and health in complex contexts and redress the current sectoral silos
  • 13. Programme  Introduction, Tim Martineau (Liverpool School of Tropical Medicine) and Joanna Buckley (OPM)  The health perspective, Sophie Witter (Queen Margaret University)  The education perspective, Chris Joynes (Education Development Trust)  Tea and coffee break  Lessons learnt (Chris Berry and Lizzie Smith, DFID)  Floor discussion  Wrap-up and conclusions HEART 13
  • 14. Floor discussion in HR in health and education in FCAS  What are the most important common challenges?  What are the differences?  Where could there be greater collaboration between the two sectors? (programme design, research, etc)  What specific help do donors and governments want?

Editor's Notes

  • #8: Shortage of health workers in Africa in 2013 = 4.2M (GHWA strategy) Conversely, there will be a projected shortage of 18 million health workers to achieve the Sustainable Development Goals, mostly in low- and lower-middle income countries. Source: High-Level Commission on Health Employment and Economic Growth http://www.who.int/hrh/com-heeg/com-heeg-meeting-chair/en/
  • #11: Since 2010, all major donors have published frameworks for programming in FCAS. This is in response to research that emphasises the feedback loops between inclusive political settlements, core state capacity, and legitimacy in forming a social contract that is the basis of sustainable development.   Donors reason that development projects need to be sensitive to how interventions shape the broader statebuilding and conflict dynamics within which they operate.   DFID increased spending in FCAS to 30% of UK ODA by 2014-15, representing an 86% increase since 2010. In November 2015 HMG made a commitement to allocate 50% of all DFID’S spending to fragile states and regions.   This commitment, combined with the reduction in number of DFID priority countries from 43 to 28 following the 2011 Bilateral Aid Review, and commitment to spend 0.7% GNI on ODA have led to a significant absolute increase in DFID’s expenditure on FCAS .   Range of scenarios of FCAS Hummanitarian assistance eg. for IDPs Reconstruction phase Development phase Transition from one to another  Add something about staff in gaps in eduction and health
  • #12: Since 2010, all major donors have published frameworks for programming in FCAS. This is in response to research that emphasises the feedback loops between inclusive political settlements, core state capacity, and legitimacy in forming a social contract that is the basis of sustainable development.   Donors reason that development projects need to be sensitive to how interventions shape the broader statebuilding and conflict dynamics within which they operate.   DFID increased spending in FCAS to 30% of UK ODA by 2014-15, representing an 86% increase since 2010. In November 2015 HMG made a commitement to allocate 50% of all DFID’S spending to fragile states and regions.   This commitment, combined with the reduction in number of DFID priority countries from 43 to 28 following the 2011 Bilateral Aid Review, and commitment to spend 0.7% GNI on ODA have led to a significant absolute increase in DFID’s expenditure on FCAS .   Range of scenarios of FCAS Hummanitarian assistance eg. for IDPs Reconstruction phase Development phase Transition from one to another  Add something about staff in gaps in eduction and health