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