Registration for the event is €75 (with lunch included on both days and an informal reception at the end of day 1) and a fee of €40 is being applied for registered students. To avail of the student rate, please register directly with Geraldine  Quinn (geraldine.quinn@ucd.ie) rather than via the portal on the site.

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Key points at a glance

KEY ISSUES

• Renew commitment to health as a core aspect of development and a cross cutting issue across all themes and sectors, including hunger.
• Maintain the current focus on HIV and major communicable diseases and maternal and child health, building on Irish Aid’s achievements and comparative strengths in its contribution towards achieving the MDGs.
• Strengthen national health systems with particular attention to the health workforce, and promote a community systems strengthening approach to health and development.
• Strengthen support and engagement with key global health partnerships where Ireland can make an effective contribution to health outcomes through influence and leadership on policy and practice.  
• Ensure development programmes and projects are inclusive and gender-sensitive, equitable and accessible to people disadvantaged by poverty, disabilities and stigma.

WAYS OF WORKING

• Focus on the poorest and most marginalised in countries through support for organisations working at community level, including NGOs and national institutions.
• Collaborate and partner with Irish organisations and institutions that are aligned with Irish Aid’s objectives, including Higher Education Institutions, NGOs, the private sector and networking organisations such as the Irish Forum for Global Health.
• Build on existing collaborations with the HSE and Department of Health to achieve greater coherence towards development goals and help mobilise new resources and skilled personnel to produce greater impact from development budgets.
• Increase attention to evidence-based aid, measurement of development results and demonstration of value for money, and make greater use of research capacity in Ireland to support internal measurement and evaluation processes.
• Integrate health as an indicator of performance across other development sectors - all interventions to address key issues such as hunger, poverty and climate change should be able to demonstrate effectiveness on basic social indicators of well-being.

Consultation documents

A number of relevant background documents were available in preparation for the consultation and are all online on the Irish Aid website at: http://www.irishaid.gov.ie/whitepaper/publications.htm In particular we would like to highlight the following:

1. White paper Consultation Review Paper Summary: http://www.irishaid.gov.ie/whitepaper/assets/IA-Summary%20Paper_web.pdf
2. Irish Aid White Paper 2006 Summary http://www.irishaid.gov.ie/whitepaper/assets/Whitepaper.pdf
3. White paper Consultation Review Paper: http://www.irishaid.gov.ie/whitepaper/assets/IA-Consultation%20Paper_FINAL.pdf
4. IRELAND AND AFRICA: Our Partnership With a Changing Continent: http://www.irishaid.gov.ie/whitepaper/assets/strategy_paper_eng.pdf

Stepping down after five years as Executive Director of the Global Fund to Fight AIDS, TB and Malaria, Michel Kazatchkine shares his parting views:  Full letter online here:

“As I leave the Global Fund, I wish in this open letter to share a number of reflections based on the unique perspective that is afforded the Executive Director. My hope is that these observations will contribute to ongoing discussions about the Fund’s future direction as it marks its tenth anniversary and undergoes a challenging process of transition under new leadership”.

His letter goes on to elaborate on five things he wishes to emphasise as he steps down:

1. The Global Fund has been highly effective in its primary role as a financing institution

2. Global Fund financing has allowed countries to achieve unprecedented results and impact in the fight against the three diseases

3. The Global Fund has shown that it is a highly effective mechanism for translating public health and human rights principles into action

4. Partnerships require a lot of attention and work but are the only way to ensure long-term success and sustainability

5. The leadership of the Global Fund needs to carefully assess and strike a balance between competing tensions that are inherent to the Fund’s model

Author Affiliations:Dept. of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland

Option 1- Scientific / Empirical Research Findings Presented as – Oral Presentation

Background:

Planning for human resources for health (HRH) requires good knowledge of their distribution and skill mix. Lack of a comprehensive national and reliable HRH database in Uganda limits the knowledge on HRH gaps.

Aims:

To determine the geographical and skill mix distribution of qualified health workers in Uganda; identify the current efforts to improve the quality of available information on staff distribution; determine the level of integration of existing data on staff distribution; and identify the successes and challenges of producing high quality information on staff distribution.

Methods:

Interviews of database managers and review of documents and HRH databases

Results:

Health system sub-components are not obliged to report HRH data to a common database. There are four parallel HRH databases, with no common format, linkage or sharing of data. Data are rarely audited and of poor quality. Only 56% of approved government posts have qualified staff compared to 35% in faith-based units. Median staffing with qualified staff is 55% in the central, urbanised region and 42% in the rural western region, and 36% in the lowest level facilities compared to 88% in national hospitals.

Key achievements include the establishment of a Human Resource Information System (HRIS) at the MOH, and web-based and centralised HMIS in faith-based bureaus. Challenges include lack of a policy on comprehensive national HRH databases, high staff turnover and lack of IT infrastructure and technical capacity at lower levels.

Discussion:

Lack of a policy on national electronic databases limits the willingness to invest in the development of a comprehensive high quality national HRH database. However, the existence of centralised electronic HRH databases in the four main sub-systems is an opportunity that can be exploited to establish a comprehensive national database. We recommend joint investment, harmonisation of formats and linkage of databases in the four sub-systems.

Author Affiliations:University of Oslo

Option 2- lessons from the field; project and programme evaluations; and syntheses or analyses Presented as – Oral Presentation

Issues:

When realizing HMIS as computer hardware, software, communication infrastructure and operational personnel, it is hard to avoid falling into vendor entrapments and other, often-hidden, dependencies. Implementations of complex ICT architectures have a politics, a sociology and a geography which changes in response to new trends, innovations, opportunities and challenges. For example, “Cloud computing” has (like open source, open standards before it) been offered as holding keys to mitigating some of the risks of strengthening national HMIS in developing countries.

Description:

We consider implementation of a national HMIS in four different African national settings, two in a “production” stage and the other two at advanced stages of rollout. Each has taken different approaches to the geographic architecture of the system. The first is implemented in a distributed manner, with semi-autonomous systems operating at the district level and interoperating with a system at national level. The other three have taken advantage of mobile internet connectivity to offer a single centralized system at the national level, accessible to facilities and districts via the web. But they have each chosen different geo-locations of the servers (and hence data): (i) Internally in the ministry of health, (ii) within a local national internet service provider data centre and (iii) using a “cloud computing” provider. Each is receiving technical support from the University of Oslo. All are struggling with a skills deficit for operating the system.

Lessons learned:

Choices about geo-location and centralization of HMIS bring particular risks and requirements regarding the location and the nature of skills required to sustain the system. Further, location of data outside of MOH exposes an urgent (and existing) need to develop policy regarding access to data. Resolution of these two can be understood in terms of the dependencies created.

Author Affiliations:The National Human Resources for Health Observatory-Sudan, HRD, FMOH, Sudan

Option 2- Lessons from the field; project and programme evaluations; and syntheses or analyses Presented as – Oral Presentation

Issues:

Human resources for health (HRH) are critical for health systems and health care. However, lack of evidence is hampering HRH development in several countries. Health workforce observatories have been introduced to address evidence and multi-stakeholder coordination for HRH. The Sudan National HRH Observatory (NHRHO) was established in 2006 as part of a regional initiative.

Description:

NHRHO establishment was based on ownership and participation of over 15 HRH stakeholders in the country. The observatory's underpinning philosophy is that health workforce is the most valuable asset for the health system; hence it should be highly prioritized. The observatory visions to figure out as a comprehensive, sustainable and dynamic human resource information system (HRIS) and policy forum serving the development of health system and improvement of population health in Sudan and beyond. NHRHO missions to continuously generate and provide evidence and convene stakeholders to inform and support policy and decision-making in HRH. The goal of the observatory is to monitor trends in patterns of the health workforce to generate reliable and instant data, information and evidence needed for human resource development.

Lessons learned:

During its short existence, NHRHO has demonstrated a model in initiating, leading and facilitating HRH reforms for health system strengthening. NHRHO established a vivid stakeholder forum meeting regularly to discuss HRH issues. It also developed a comprehensive data-base on national health workforce based on two national surveys. The observatory created a web-based data system for easy access to health workforce data and information for policy and decision-makers, various stakeholders and researchers. Through conducting a nationwide exercise HRH research priorities and agenda for Sudan were identified, explored and now being researched. Recently, NHRHO spearheaded the production of a comprehensive HRH strategic plan for Sudan, the first of its kind.

Next steps:

Prospects for NHRHO work involve consolidating and sustaining stakeholder forum, extending electronic databases to decentralised levels, scaling up advocacy and addressing capacity gaps for HRH development and fostering invocative solutions to health workforce issues.

Authors: Melo S.¹ , McAuliffe E.¹ , Bradley S.¹, Honorati M.² , Mollel H.², Lwilla F.², Moshin S.³, Madede T.³, CambeI.⁴, Mbofana F.⁴

Author Affiliations: 1Centre for Global Health, Trinity College Dublin, Ireland, 2IIfakara Health Institute – Tanzania, 3Eduardo Mondlane University, Mozambique, 4National Health Institute – Mozambique

Option 1- Scientific / Empirical Research Findings Presented as - Poster

STEM will take place in selected districts in Tanzania and Mozambique and has a total duration of 36 months (April 2011 – March 2014). The overall objective of STEM is to strengthen the Human Resource Management (HRM) function at district and health facility level, by increasing the capacity of managers to support and supervise their staff. The specific objectives of the project are a) to improve the working environment by targeting managers and their approach to HRM and b) to provide a structure and skill set to put HRM policies into practice. The target groups of STEM are the District Health Management Teams (DHMT) and facility managers in selected districts in each country. The final beneficiaries will be the DHMT and facility managers; health care workers in facilities within target districts; rural populations within target districts; policy makers at national level; and researchers at country and regional level. It is estimated that STEM will allow the development of a model of effective district health management by putting in place an evaluated HRM education programme and evidence of good practice that can be scaled up and inform policy and strengthening HRH. Finally, it is expected that STEM will facilitate a coalition between civil society organizations (CSO) and research institutions to improve knowledge of HRH issues and provide an evidence-based platform to influence policy. The main activities of STEM will include: the development of action learning HRM programme for DHMT; pilot work with a small sample of managers; baseline data collection of primary and secondary outcome measures; implementation of a finalised programme; and an evaluation including analysis of post intervention data collection, an ongoing process evaluation and an economic cost-benefit analysis.