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HRH in the context of health systems in the Caribbean Rasul Baghirov, Advisor, Health Systems & Services Office of Caribbean Programme Coordination.

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Presentation on theme: "HRH in the context of health systems in the Caribbean Rasul Baghirov, Advisor, Health Systems & Services Office of Caribbean Programme Coordination."— Presentation transcript:

1 HRH in the context of health systems in the Caribbean Rasul Baghirov, Advisor, Health Systems & Services Office of Caribbean Programme Coordination

2 Health systems in the Caribbean: Functional Overview Financing: shrinking fiscal space, unemployment, limited space for reforms Provision of services: escalating health costs, driven by medicines/ technologies HRH: continuous out-migration of health workforce (esp. nurses) and of population (declining fertility) Health information systems: mostly informal collaboration between public and private sectors; attempts to implement easy solutions – software Governance: weak regulation, especially of the private sector; low compliance with rules when exist; uneven quality

3 Office of Caribbean Programme Coordination Health systems in the Caribbean: Challenges Fragmented Health Systems – 3 in 1 – mostly for the poor/middle quintile – public sector; mostly for upper- middle – private sector (OOP; PHI); mostly for the rich – off-shore tertiary care; Erosion of solidarity – intra-country and inter-country – implication for insuring health; Increasingly isolationistic national health policies, which affect not only travelers but also residents (those without passports).

4 Office of Caribbean Programme Coordination HRH in the context of health systems More or less regulation? Bigger or smaller private sector? Passive or active purchasing of health services: how to remunerate health professionals? What is the Objective: Equity? Efficiency? Quality? Who is to be made happier? Where to begin? Do money follow ideas, or ideas follow the money?

5 Office of Caribbean Programme Coordination HRH Milestones = System thinking What is an Objective of a Milestone? (or Who is to be made happier?) What resources and processes needed? (or Who will pay and get it implemented?) Do future benefits justify costs? (or What about opportunity costs? Cost-benefit analysis?) How proposed changes will affect other parts of health systems? (or What about unintended consequences?)


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