KIT Institute designs and implements a technical assistance approach to strengthen health workforce planning and ensure the right health workers are in the right place.

Evidence-informed decision-making

There is a shortage of health workers in many low-and middle-income countries (LMIC). The workers that are available are often not well distributed – with a concentration of workers in urban areas. 

Health workforce planning aims to make sure the right health workers are in the right place. In many countries not enough information is available and there is a poor participation of stakeholders in health workforce planning or human resources for health (HRH) planning. 

As part of this project, KIT provided technical assistance to the ministries of health at the state, province and district levels in Nigeria, Chad, Mali, Niger and DRC to strengthen health workforce planning processes.  To improve the evidence based decision making, the project conducted secondary data analysis, health workforce facility surveys,  workload indicator staffing needs assessments and qualitative interviews. This evidence was used in data for decision making dialogues at decentralized level to develop HRH strategic plan and action plans. In the last project technical assistance was provided to support the implementation of the plans including linking to the grant making process of Global Fund at country level. 

Country-based results

The project was evaluated positively by independent evaluator ITAD. The short terms results, by country, are: 

Nigeria

In Nigeria the activities have raised awareness on the importance of human resources for health (HRH) systems, and to have filled a critical gap in terms of HRH data and strategic direction.

One State level respondent noted that Jigawa State’s last HRH policy was from back in 2010, and that they were keen to have an up to date evidence based approach to identifying training gaps. The development of the Jigawa state health workforce strategic plan (2023-2027) (the first state HRH strategic plan) was seen as an important achievement, together with an implementation framework. 

Information generation and data use was perceived as a key success of this work in informing decision-making, facilitated by ongoing trainings on the use of the National Health Workforce Registry. These data were said to have enabled a more strategic approach to staff deployment:

Chad

In Chad stakeholders involved in KIT’s technical assistance activities agreed that it was relevant to Chad’s health system, and some degree of local ownership and support was observed at national and local levels.

In particular, respondents reported that the activities  

1) Increased awareness of human resources for health, including awareness at national level of the need to implement an HRH information system.

2) Improved the quality and availability of HRH data.

3) Positively influenced staff allocation. For example, respondents reported observing an increase in the recruitment of local staff, who are expected to be more willing to work in rural areas, improving workload as a result. KIT has also supported improvements in the distribution of midwives across facilities.

4) Increased awareness of the need to increase health worker recruitment, which is also reflected in a broader national-level agenda to increase health worker availability at sub-national levels.

Niger

In Niger, stakeholders perceived that KIT increased national-level awareness of HRH challenges within district, with national level stakeholders, by engaging them in the district action plan. Government stakeholders perceived an increase in the HRH capacity of government staff for HRH planning. This included improvement in data collection and analysis skills, and awareness of how data can be used to support staff allocation. Skills were also said to have been strengthened in workload planning and identification of strategies to support deployment and retention. 

The activities were argued to have the potential to improve the allocation of HRH resources, by identifying effective strategies to encourage staff to relocate, especially to rural areas.  KIT identified potential for improvements in the distribution of tasks at the facility level, for example through midwives coaching and supervising other staff.

DRC

In DRC there was a strong emphasis on secondary data analysis of health workforce registry data, like identifying duplicate health workers within the database. Video tutorials were developed so that ministry of health staff can learn how to use the HRH data base and conduct analysis and interpretation of the data.

Although the stakeholders noted that some programme participants initially found newly introduced HRH concepts difficult to comprehend, there was perceived to be a positive engagement from both national and provincial stakeholders overall.  

Furthermore, as a result of KIT’s support, through the increased data cleaning skills, the provincial staff felt that they could recognise, and update, duplicate data entries, which resulted in a more accurate register of HRH staff. This increased accuracy meant that stakeholders could then develop a relevant HRH plan.

Mali

In Mali the technical assistance was positively received and had a number of positive effects, such as increasing the capacity of regional government stakeholders to engage in HRH analysis and engage in problem solving around HRH topics. 

For instance, some of the stakeholders at the district level reported that some of the interventions have already started being implemented, such as the renovation of on-call housing, the purchasing of motorcycles, or the formalisation of recruitment processes. There were also reportedly increasing attempts to clarify the position of voluntary workers who did not have contracts.

Furthermore, the district level reported that as a result of the Action Plan, they now collect relevant HRH data regularly in order to support evidence-based decision making.