July 1st is World Doctor’s Day — an opportunity in the year to appreciate some of the heroes of our public health system. It’s also the perfect time to reflect on some of the things India’s public health system needs to do better in order to adequately support the heroic efforts of its workforce.
So here’s a quick roundup of some of the key challenges in providing support to health workers in the public health system:
- Planning: Inadequate HR professionals and policies in the public health system, and in particular recruitment based on vacancies rather than actual requirements, leads to poor planning for human resource allocation. Tedious and gender-biased recruitment processes also don’t help with hiring the best talent available.
- Migration: Due to poor facilities, support and opportunities, qualified rural health workers tend to migrate to urban areas, leaving rural facilities inadequately staffed.
- Capacity Building: Narrowly conceived in capacity building of health workers is also hamstrung by the small number of institutions providing it, trainers with limited tools and skills for the job, insufficient budgets and poor post-training monitoring. Without a complete system in place to continuously build capacity, from capacity building needs assessment before to handholding support afterwards, existing health workers can’t fulfil their potential.
- Performance Management: Vague and outdated recruitment notices and processes leave the qualified personnel who have been hired with an unclear role to perform. Traditional methods of appraisals and promotions result in higher attrition. Accountability suffers due to poor monitoring.
But the outlook is not all gloomy: governments and non-government organisations are innovating to improve the work environment and conditions for health workers. Clear health policies and coordinating bodies, strategic use of technology, better capacity-building and incentives for health workers, especially in rural areas, and better performance management systems which actively engage with staff to solve problems, would all contribute to improving the situation.