Harvard Humanitarian Initiative

Co-Leaders:

Seble Frehywot, Assistant Research Professor of Health Policy & Global Health, George Washington University

Hani Mowafi, Assistant Professor and Co-Director of the Section of Public Health and International Health Department of Emergency Medicine at Boston University School of Medicine and Fellow, Harvard Humanitarian Initiative

Participants:

Julian Lambert; Rajesh Panjabi; Karen Hein; Ross Anthony; Adam Richards; Langdon Greenhalgh; Iain Logan; Brian Sorensen; Marisa Herran; Mubashar Sheikh; Linda Doull; Tobias Stillman; Donna Campbell; Nan Buzard; Earl Wall; Mary Pack; Carmen Huckel Schneider; Mey Akashah; Hilarie Cranmer; Mohamed Jama; Brooke Stearns Lawson; Marla Haims; David Lange; Marvin Birnbaum

State of the Art:

Previous working groups on human resources in humanitarian health have outlined many of the key areas that represent challenges for recruitment, training, and retention of qualified staff for international humanitarian health projects. Some of these have included:

• the over-reliance on professional degrees as surrogates for accreditation of specific expertise;
• expanded responsibility of health professionals without adequate support;
• lack of clear professional path, training guidelines, and opportunities for career advancement;
• difficulty in retaining workers in complex and austere environments;
• lack of adequate support from/to local health care establishment in order to build resiliency and institutional memory of best practices; and
• insufficient focus on and funding for human resources initiatives within the donor community.

This working group has decided to focus on the strategy of "task shifting" to address the immediate health professional shortage. The task shifting approach has recently been embraced by the World Health Organization to address the shortage of workers in the global HIV/AIDS pandemic. This working group seeks to determine whether some of these approaches may be applied to the shortage of health workers in complex humanitarian emergencies.

Objectives:

• Summarize current literature on core competencies of humanitarian health staff;
• Categorize the main functions performed by health-sector professionals in the complex humanitarian emergency context;
• Identify a process by which these functions may be broken down into discrete health tasks for which less highly trained staff may be trained;
• Target the main facilitators for and barriers to re-allocation of these tasks;
• Explore what sort of regulatory framework and/or quality assessment mechanism needs to be in place to ensure that such re-allocation is done adequately and safely; and
• Identify other key working groups whose work may overlap in content and whose goals parallel our own in order to ensure that a broad consensus on how to move forward in further development of HRH in humanitarian work.

Potential Deliverables:

• Findings from a survey on task reallocation best practices within humanitarian health NGOs;
• Identification of programs in human resource-poor settings that may serve as templates or offer best practices; and
• Identification of awareness-raising strategies among the donor community on the need for expanded HR capacity in humanitarian health programs.

Advance Reading:

• Coping with Health Worker Shortages
• Do lay health workers improve healthcare delivery and healthcare outcomes?
  
• Evaluation of Joint Emergency Health Nutrition and HIV/AIDS Programme in Uganda
• HHC 2007 Final Report
• Humanitarian Stakes
• Non-physician Clinicians In 47 Sub-Saharan African Countries
  
• Solving Health Worker Shortages
• Task shifting for antiretroviral treatment delivery in sub-Saharan Africa: not a panacea
  
• Task Shifting the Solution for Healthcare Worker Shortages
  
• WHO First Global Conference on Task Shifting
• WHO Task Shifting Recommendations
• Health Workforce Advocacy Initiative response to the G8 2008 Hokkaido Summit's health workforce commitments