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Evaluation of the Decade For Strengthening Human Resources for Health (2015-2024) in the WHO South-East Asian Region

Bangladesh, Bhutan, DPRK, Indonesia, India, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, Timor-Leste
April 2023 – Jan 2024

South East Asia faces some of the largest shortages of health workers globally. KIT Institute and Universitas Padjadjaran conducted an evaluation of the initiatives conducted in the South East Asian region over the last ten years to improve countries’ health workforce. The learnings of the evaluation will be used by both the WHO and countries to understand what worked well and what could be improved, and support their efforts to address the region’s dramatic health worker shortages.

Regional meeting in Sri Lanka
Regional meeting in Sri Lanka

In 2013, The World Health Organization estimated that the South-East Asian Region (SEAR) faced the largest shortages in health workers globally—needing an additional 6.9 million workers. Of this 6.9 million, the largest shortfalls were among nurses and midwives. The WHO also projected that demand for health workers in the region would rise from six million in 2013 to 12.2 million by 2030, based on their estimates.

Decade for strengthening Human Resources for Health

Recognising the regional Human Resources for Health (HRH) problems and the importance of HRH to health systems strengthening, the WHO’s South East Asian regional office selected human resources for health (HRH) as a flagship priority in 2014. This commitment then evolved into the ‘Decade of HRH Strengthening (2015-2024)’: a ten-year agenda of HRH strengthening launched at a regional meeting in Bhutan. This agenda would be a guiding framework for the region’s member states to improve and strengthen their health workforce.

In view of the end of the Decade, WHO’s South East Asian regional office sought an evaluation of HRH-related achievements in the region since its launch of the decade and the associated contribution of the WHO. In partnership, KIT Institute and Universitas Padjadjaran conducted a formative evaluation to respond to the regional office’s needs.

Learning from the last ten years

KIT Institute and Universitas Padjadjaran (UNPAD) conducted a formative evaluation, guided by a Theory of Change (ToC), to learn from the achievements of the last ten years, and identify remaining issues for health workforce strengthening in the region.

The evaluation used a mixed methods approach, including: a desk review, presentations of country achievements from health ministries, and qualitative interviews at regional and country level. The evaluation selected five countries in the region as case studies: Indonesia, India, Bangladesh, Bhutan and Timor-Leste.

The results have been summarised in an evaluation report that will be discussed at a forthcoming WHO Regional Committee meeting, and feed into the regional office’s next strategy cycle.