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Founded in 2002, CHAI has helped governments expand access to healthcare, with an initial focus on AIDS treatment
What we strive for…A world in which all individuals have equitable access high-quality health care, enabling them to live healthy and productive lives with dignity and equal opportunity.
What we do…We support the rapid expansion of access to high quality, essential healthcare for all who need it by improving the organization of commodity markets and by enabling the effective delivery of health services and efficient management of health systems.
How we work… We help governments to optimize the use of available resources to maximize health outcomes.
Problem … CHAI’s Response …
Pediatric HIV/AIDS
Malaria
Health Systems
Human Resources for Health
Value for Money
• Expand ACT access in the private sector, improve diagnosis, and lay groundwork for elimination
• Transitioning scale-up responsibility, focus on infants and quality, and prove models to prevent infection
• Be a hand-in-hand partner in 2-3 countries to plan and implement comprehensive system strengthening
• 50% of HIV+ children die before the age of two, yet systems continue to focus on treating older children
• There is a $20B gap in next 5 years from what’s available and needed to keep HIV treatment programs going
• 50% of external aid is “off budget” from national plans; resources are not optimized to strengthen health systems
• Malaria kills 1 million children annually because diagnosis and treatment are not reaching patients
• Africa has 11% of the world’s population, 24% of its disease burden, but just 3% of its healthcare workers
• Lower commodity prices, improve efficiency of spending, and better align donor funds with national costs
• Improve capacity, deployment and productivity of health workers to help bridge the human resource gap
As the AIDS and global health landscape has evolved, so has CHAI and its approach to pressing global health issues
CHAI Zambia HRH follows the government’s leadership to design and implement national HRH programs
Support government in analyzing and diagnosing HRH bottlenecks / barriers
Holistic approach to addressing the HRH crisisWork with MoH to develop pragmatic, integrated, and
comprehensive solutionsSupport data-driven planning and decision making
Help to mobilize resources needed
Finance the cost of implementationAssist governments raise large-scale, ongoing funding
internally and externallyRationalize the use existing funds – by redeploying or lowering
costs
Provide light touch operational support to implement MoH-driven interventions
Coordinated and sustainable implementation of HRH interventionsFollow MoH leadership to un-stick bottlenecks and kick start new initiatives to drive changeIntegrate core functional systems for ongoing oversight
CHAI Zambia HRH takes a holistic approach to HRH with a view across the lifespan of the health workforce
CHAI HRH Program Objectives
Partner closely with MoH to: System-Level Outcome Health Outputs
Increase the number of qualified healthcare workers
Accelerate production of healthcare workers
Strengthen skills of health workforce
Increase number of patients seen and treated
Provide higher quality of care
Optimize the distribution of healthcare workers
Improve absorption of healthcare workers into the workforce
Improve distribution of health workforce
Increase number of patients seen and treated
Improve patient access to primary healthcare
Maximize the productivity and utility of formal and informal healthcare workers
Optimize use of existing health workforce
Formalize skills of informal workforce
Increase number of patients seen and treated
Provide higher quality of careImprove patient access to primary healthcare
To implement a comprehensive HRH strategy, MoH has helped CHAI understand the partner landscape across the HRH spectrum
Increase the number of qualified healthcare workers
Optimize the distribution of healthcare workers
Maximize the productivity and utility of healthcare workers
• MoH: DHRA, DPP, DCCDS, DTSS• MoFNP• MoE• MoSTVT• MoWS• Cabinet Office• Senate (for UNZA programs)• General Nursing Council• Health Professionals Council of
Zambia• Other regulatory bodies
(Pharmaceutical Regulatory Authority, etc.)
• TEVETA• Health worker unions (ZUNO, etc.)• Public and Private Health Training
Institutions• Health facilities (clinical practice)• Faith-based Organizations (CHAZ)• Civil Society Organizations• Implementing Partners• Cooperating Partners
• MoH: DHRA, DPP• MoFNP• Public Service Management
Division• General Nursing Council• Health Professionals Council of
Zambia• Health facilities• Faith-based Organizations
(CHAZ)• Civil Society Organization• Implementing Partners• Cooperating Partners
• MoH: DHRA, DPP, DCCDS, DTSS, DPHR
• MoFNP• Public Service Management
Division• Cabinet Office• General Nursing Council• Health Professionals Council of
Zambia• Health worker unions• Public and Private Health
Training Institutions• Health facilities• Faith-based Organizations
(CHAZ)• Civil Society Organization• Implementing Partners• Cooperating Partners
Case Study: National Training Operation Plan (NTOP) Achieving HRH expansion through training scale-up
As training capacity is a significant bottleneck to expanding the health workforce, how will Zambia achieve it’s target to scale-up training output by 70%+ across 39 training institutions (TIs)?
Partner with MoH and regulatory bodies to conduct assessment of the 39 TIs to determine resource requirements Lacked infrastructure and tutors and clinical instructors
Expert interviews for feedback on quality standards
Support MoH to produce and disseminate a 5-year costed scale-up plan Put scale-up infrastructure systems requirements in-place Help implement strategies to address the gaps: D/E tutor
and Clinical Instructor Program design
Funding commitment of $26 million from GRZ, partners and Global fund
Support government in analyzing and diagnosing HRH bottlenecks / barriers
Provide light touch operational support to implement MoH-driven interventions
Help to mobilize resources needed
Approach
Case Study: National Training Operation Plan (NTOP) Partner collaboration in training scale-up
Underlying the NTOP is coordination and collaboration with various partners
CHAI Zambia HRH:Lessons Learned
National leadership is paramount
HRH approach must strengthen national HR systems, address key government priorities, be aligned with national health strategic plans
Although a partnership dynamic is established at the outset, the government assumes ownership of process, methodology, data, results and next steps
End product is the government’s to use at its discretion
Quantitative analysis informs resource allocation and priority-setting decisions
Methodology and data collection process involves MoH and all relevant stakeholders
• Consensus and buy-in established at the outset
Avoid large expenditures on HRH interventions that lack clear understanding of which interventions will have the greatest impact on addressing shortage of workers
CHAI Zambia HRH:Lessons Learned Continued
Coordinated support by multiple stakeholders can inform better decisions, allow for improved resource mobilization, and avoid potential bottlenecks
National planning / strategies should be complemented with continued on-the-ground support to ensure implementation follow-through and sustained results
Supporting MoH to identify and rapidly remove barriers to implementation and breakdown bottlenecks can often unlock resources and build momentum for further progress
• Optimize use of resources across partners
• Avoid doing what others are already doing well
Clear means to transition responsibility and funding for the proposed approach to the government and/or other organizations