Competency Gaps in Human Resource Management in the Health Sector An Exploratory Study in Ethiopia, Kenya, Tanzania, and Uganda, 2009

Abstract

The human resource (HR) crisis in health is widely acknowledged. Most countries in sub-Saharan Africa have clearly identified the HR challenges they face, and many have developed an HR strategy for addressing the challenges. Progress in achieving the goals of these strategies depends not only on increasing resources but on managers who are able to lead and manage teams at all levels of the health system to transform HR strategies, plans, and recommendations into a comprehensive, harmonized approach that is effectively implemented and sustained. At present, most government HR functions remain fragmented and, within the health sector, these functions are often either the responsibility of clinicians who direct health facilities and who have little or no preparation in human resource management or the responsibility of “personnel administrators” who have been trained to handle routine civil service policies and procedures. Despite rising attention to the acute shortage of health care workers, little attention has been paid to the role of those who have human resource management responsibilities and whose job is to transform health workers into a productive, motivated, and supported workforce capable of improving health and saving lives. There is an urgent need to professionalize this role and develop a cadre of well-trained HR managers, especially in large public sector and private sector health institutions. This would include expanding both the number of HR managers and the organizational view of their role, as well as updating their skills. These changes would enable HR managers to be more effective in leading and implementing positive solutions that in turn would improve the performance and retention of staff. While many others working in health also have a role to play in supporting the health workforce, including health managers in general, this report focuses on professionals with a specific responsibility in human resource management (HRM). HR management is defined as the integrated use of procedures, policies, and practices to recruit, maintain, and develop employees to strengthen the capacity of an organization to meet its goals. For the purpose of this study, HRM includes six broad components: personnel policy, performance management, training, HR data systems, HR strategy development, and general leadership and management. An HR manager’s role involves one or all of these components. However, as the responsibility for HRM in health is more often assigned to managers with other roles, most of the study respondents are managers with dual roles, both clinical and managerial.