Wise Governance to Enhance Market Performance for Health Workforce in Africa
Ineffective stewardship and poor governance of the health workforce undermine the performance of health systems and prevent them from realizing their full potential. Absence of mechanisms to orchestrate the efforts of actors and restrain behaviors might drive market failures and produce perverse incentives that result in duplication, waste, inefficiency, poor quality, inequities, misconduct and several other issues that undermine health outcomes. Fostering effective stewardship and promoting good governance generates value for all stakeholders, Assigning health workforce functions to well-resourced, empowered actors with respective mechanisms to hold them accountable would help in realizing the full potential of a country’s health workforce.
Governance is paramount for
1) setting the right direction,
2) steering the ecosystem in the identified direction
3) engaging stakeholders while protecting their rights.
To set the right policy direction, several determinants could be put into consideration including public health needs, burden of disease, availability of services, employment opportunities, potential remuneration and career growth.
Several policy interventions and governance mechanisms could be leveraged to steer and regulate HWF markets and mitigate market distortions and failures. Actors like providers of education and training services, professionals, and employers could be influenced. The areas of influence could be the number and distribution; service quality and allocation of financial resources. There are several levers to influence the ecosystem and shape the health workforce market structure and dynamics, for example: developing national plans for HWF; setting standards and guidelines spelling out the norms and quality levels for the profession; offering subsidies and financial incentives; licensing, registration, accreditation and inspection; certification and ratification of certificates and certificate providers; and enforcement of disciplinary actions. Moreover, governments affect markets by acting inside them through owning and managing educational and training service providers, and by employing professionals. The governing structures are enacted through different regulations and institutional actors entrusted and empowered to realize their mandates in addition to being held accountable for outcomes.
Governance is critical to market performance for the HWF. It defines the institutional architecture and checks and balances essential to advance Human Resources for Health. Governance and stewardship spearheaded by government must be at the center of countries’ strategies to advance their health workforce markets. This highlights the need to create governance frameworks, structures and processes to orchestrate the efforts of health workforce stakeholders, foster coordination and strengthen accountability. Moreover, there is need to build capacities on how to use policy levers and shape the right institutional architecture to enhance the performance of health workforces.
Governance is paramount for
1) setting the right direction,
2) steering the ecosystem in the identified direction
3) engaging stakeholders while protecting their rights.
To set the right policy direction, several determinants could be put into consideration including public health needs, burden of disease, availability of services, employment opportunities, potential remuneration and career growth.
Several policy interventions and governance mechanisms could be leveraged to steer and regulate HWF markets and mitigate market distortions and failures. Actors like providers of education and training services, professionals, and employers could be influenced. The areas of influence could be the number and distribution; service quality and allocation of financial resources. There are several levers to influence the ecosystem and shape the health workforce market structure and dynamics, for example: developing national plans for HWF; setting standards and guidelines spelling out the norms and quality levels for the profession; offering subsidies and financial incentives; licensing, registration, accreditation and inspection; certification and ratification of certificates and certificate providers; and enforcement of disciplinary actions. Moreover, governments affect markets by acting inside them through owning and managing educational and training service providers, and by employing professionals. The governing structures are enacted through different regulations and institutional actors entrusted and empowered to realize their mandates in addition to being held accountable for outcomes.
Governance is critical to market performance for the HWF. It defines the institutional architecture and checks and balances essential to advance Human Resources for Health. Governance and stewardship spearheaded by government must be at the center of countries’ strategies to advance their health workforce markets. This highlights the need to create governance frameworks, structures and processes to orchestrate the efforts of health workforce stakeholders, foster coordination and strengthen accountability. Moreover, there is need to build capacities on how to use policy levers and shape the right institutional architecture to enhance the performance of health workforces.