Dussault Gilles, Dubois Carl-Ardy
World Bank Institute, Washington, DC, USA.
Hum Resour Health. 2003 Apr 14;1(1):1. doi: 10.1186/1478-4491-1-1.
In the last few years, increasing attention has been paid to the development of health policies. But side by side with the presumed benefits of policy, many analysts share the opinion that a major drawback of health policies is their failure to make room for issues of human resources. Current approaches in human resources suggest a number of weaknesses: a reactive, ad hoc attitude towards problems of human resources; dispersal of accountability within human resources management (HRM); a limited notion of personnel administration that fails to encompass all aspects of HRM; and finally the short-term perspective of HRM.There are three broad arguments for modernizing the ways in which human resources for health are managed:bullet; the central role of the workforce in the health sector;bullet; the various challenges thrown up by health system reforms;bullet; the need to anticipate the effect on the health workforce (and consequently on service provision) arising from various macroscopic social trends impinging on health systems.The absence of appropriate human resources policies is responsible, in many countries, for a chronic imbalance with multifaceted effects on the health workforce: quantitative mismatch, qualitative disparity, unequal distribution and a lack of coordination between HRM actions and health policy needs.Four proposals have been put forward to modernize how the policy process is conducted in the development of human resources for health (HRH):bullet; to move beyond the traditional approach of personnel administration to a more global concept of HRM;bullet; to give more weight to the integrated, interdependent and systemic nature of the different components of HRM when preparing and implementing policy;bullet; to foster a more proactive attitude among human resources (HR) policy-makers and managers;bullet; to promote the full commitment of all professionals and sectors in all phases of the process.The development of explicit human resources policies is a crucial link in health policies and is needed both to address the imbalances of the health workforce and to foster implementation of the health services reforms.
在过去几年中,卫生政策的发展受到了越来越多的关注。但在政策带来预期益处的同时,许多分析人士一致认为,卫生政策的一个主要缺陷是未能为人力资源问题留出空间。当前的人力资源管理方法存在一些弱点:对人力资源问题采取被动、临时的态度;人力资源管理(HRM)中的问责分散;人事管理概念有限,未能涵盖人力资源管理的所有方面;最后是人力资源管理的短期视角。
劳动力在卫生部门的核心作用;
卫生系统改革带来的各种挑战;
需要预见影响卫生系统的各种宏观社会趋势对卫生人力(进而对服务提供)产生的影响。
在许多国家,缺乏适当的人力资源政策导致了长期失衡,对卫生人力产生了多方面影响:数量不匹配、质量差异、分布不均以及人力资源管理行动与卫生政策需求之间缺乏协调。
为了使卫生人力资源(HRH)开发中的政策制定过程现代化,提出了四项建议:
从传统的人事管理方法转向更全面的人力资源管理概念;
在制定和实施政策时,更加重视人力资源管理不同组成部分的综合、相互依存和系统性;
培养人力资源(HR)政策制定者和管理者更积极主动的态度;
促进所有专业人员和部门在该过程的各个阶段充分投入。
制定明确的人力资源政策是卫生政策的关键环节,对于解决卫生人力的失衡问题以及推动卫生服务改革的实施都至关重要。