Public sector reform and demand for human resources for health (HRH)

<p>Abstract</p> <p>This article considers some of the effects of health sector reform on human resources for health (HRH) in developing countries and countries in transition by examining the effect of fiscal reform and the introduction of decentralisation and market mechanisms to t...

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Main Author: Lethbridge Jane
Format: Article
Language:English
Published: BMC 2004-11-01
Series:Human Resources for Health
Online Access:http://www.human-resources-health.com/content/2/1/15
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author Lethbridge Jane
author_facet Lethbridge Jane
author_sort Lethbridge Jane
collection DOAJ
description <p>Abstract</p> <p>This article considers some of the effects of health sector reform on human resources for health (HRH) in developing countries and countries in transition by examining the effect of fiscal reform and the introduction of decentralisation and market mechanisms to the health sector.</p> <p>Fiscal reform results in pressure to measure the staff outputs of the health sector. Financial decentralisation often leads to hospitals becoming "corporatised" institutions, operating with business principles but remaining in the public sector. The introduction of market mechanisms often involves the formation of an internal market within the health sector and market testing of different functions with the private sector. This has immediate implications for the employment of health workers in the public sector, because the public sector may reduce its workforce if services are purchased from other sectors or may introduce more short-term and temporary employment contracts.</p> <p>Decentralisation of budgets and administrative functions can affect the health sector, often in negative ways, by reducing resources available and confusing lines of accountability for health workers. Governance and regulation of health care, when delivered by both public and private providers, require new systems of regulation.</p> <p>The increase in private sector provision has led health workers to move to the private sector. For those remaining in the public sector, there are often worsening working conditions, a lack of employment security and dismantling of collective bargaining agreements.</p> <p>Human resource development is gradually being recognised as crucial to future reforms and the formulation of health policy. New information systems at local and regional level will be needed to collect data on human resources. New employment arrangements, strengthening organisational culture, training and continuing education will also be needed.</p>
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spelling doaj.art-8bdb60652a8b4ec79637c4dad93813922022-12-22T01:07:58ZengBMCHuman Resources for Health1478-44912004-11-01211510.1186/1478-4491-2-15Public sector reform and demand for human resources for health (HRH)Lethbridge Jane<p>Abstract</p> <p>This article considers some of the effects of health sector reform on human resources for health (HRH) in developing countries and countries in transition by examining the effect of fiscal reform and the introduction of decentralisation and market mechanisms to the health sector.</p> <p>Fiscal reform results in pressure to measure the staff outputs of the health sector. Financial decentralisation often leads to hospitals becoming "corporatised" institutions, operating with business principles but remaining in the public sector. The introduction of market mechanisms often involves the formation of an internal market within the health sector and market testing of different functions with the private sector. This has immediate implications for the employment of health workers in the public sector, because the public sector may reduce its workforce if services are purchased from other sectors or may introduce more short-term and temporary employment contracts.</p> <p>Decentralisation of budgets and administrative functions can affect the health sector, often in negative ways, by reducing resources available and confusing lines of accountability for health workers. Governance and regulation of health care, when delivered by both public and private providers, require new systems of regulation.</p> <p>The increase in private sector provision has led health workers to move to the private sector. For those remaining in the public sector, there are often worsening working conditions, a lack of employment security and dismantling of collective bargaining agreements.</p> <p>Human resource development is gradually being recognised as crucial to future reforms and the formulation of health policy. New information systems at local and regional level will be needed to collect data on human resources. New employment arrangements, strengthening organisational culture, training and continuing education will also be needed.</p>http://www.human-resources-health.com/content/2/1/15
spellingShingle Lethbridge Jane
Public sector reform and demand for human resources for health (HRH)
Human Resources for Health
title Public sector reform and demand for human resources for health (HRH)
title_full Public sector reform and demand for human resources for health (HRH)
title_fullStr Public sector reform and demand for human resources for health (HRH)
title_full_unstemmed Public sector reform and demand for human resources for health (HRH)
title_short Public sector reform and demand for human resources for health (HRH)
title_sort public sector reform and demand for human resources for health hrh
url http://www.human-resources-health.com/content/2/1/15
work_keys_str_mv AT lethbridgejane publicsectorreformanddemandforhumanresourcesforhealthhrh