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Seminario del Observatorio Cuba 2002

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Desarrollo y Fortalecimiento de la Gestión de los Recursos Humanos en el Sector Salud

Desafíos y Problemas de la Gestión de Recursos Humanos de Salud en las Reformas Sectoriales

Los procesos de reforma de los sistemas de salud han impactado sobre los sistemas laborales, pero a la vez, los trabajadores del sector salud han influido sobre las reformas proyectadas. Se analiza aquí la interrelación entre los procesos principales de cambios del sistema de salud y sus repercusiones en la fuerza de trabajo. Se concluye en la necesidad de acompasar ambos procesos a fin de viabilizar los cambios con la participación de quienes proveen los servicios

Gestão de Recursos Humanos e Reformas do Setor Público: Tendências e Pressupostos de uma Nova Abordagem

Os processos de reforma negligenciaram a importância da gestão de recursos humanos, por dois motivos básicos. Primeiro, devido a que os reformistas puseram forte ênfase na necessidade de diminuir o tamanho do aparato de Estado; segundo, por terem feito do combate à burocracia um dos objetivos principais do novo estilo de administração pública que propunham. Por conseguinte, os reformistas adotaram uma abordagem da gestão de recursos humanos essencialmente negativista, não tendo dedicado atenção a seu indispensável ordenamento jurídico e tampouco à sua complexidade política.

Regulación de Recursos Humanos de Salud en Chile

La provisión de servicios de salud constituye un sector económico intensivo en recursos humanos, por lo que la regulación de su formación y desarrollo son cruciales para avanzar simultáneamente en la eficiencia y calidad de la atención de salud que reciben los usuarios. El tema de la regulación de los recursos humanos en salud presenta altos niveles de complejidad debido a que el universo analítico relevante se compone de tres espacios de regulación (de la formación, del ejercicio y de las relaciones laborales), de una gran cantidad y diversidad de trabajadores y profesionales.

A REGULAÇÃO DOS RECURSOS HUMANOS EM SAÚDE E A REFORMA DO SETOR SAÚDE EM PAÍSES DA AMÉRICA LATINA

A Reforma dos Sistemas de saude na Regiao das Americas preconizou a focalização da ação do estado em aspectos de regulação do sistema como o controle de custos, a promoção da eficiência no uso dos recursos, a descentralização dos processos de decisão, o estímulo à privatização da provisão, entre outros. Noutras palavras, o estado deveria fortalecer e ampliar seu papel de agente regulador das atividades setoriais (capacidade em grande parte dos casos muito reduzida em função da proeminência das funções de prestação direta características do modelo anteriormente vigente).

OIT (ORGANIZACION INTERNACIONAL DEL TRABAJO) " Reunión paritaria sobre las condiciones de empleo y de trabajo en el marco de las reformas del sector de la salud"

SISTEMAS DE PAGO Y PRÁCTICA MÉDICA: Teoría y evidencia empíricas

En esta revisión se presentan los principales sistemas y formas de pago médico (puras y mixtas) en los países desarrollados y América Latina, con una discusión de la manera como afectan el comportamiento médico. La teoría de la agencia es utilizada para examinar la selección contractual entre organizaciones proveedoras de servicios de salud (principal) y los médicos (agente). Las evidencias empíricas originadas, fundamentan las discusiones sobre las diversas formas de pago y incentivos, y las posibles alteraciones que causan en la práctica médica.

Produtividade e Desempenho dos Recursos Humanos nos Servicos de Saúde

A produtividade dos serviços de saúde, longe de significar um fato pontual, está na agenda de discussão das reformas do setor, embutida no rol de transformações políticas e sociais que colocam em cena a cidadania e a hegemonia das transformações do mundo.Nos serviços de saúde o conceito de produto pode ser um conceito pouco definido. A atividade em saúde comporta diversificados processos de trabalho, que incluem ações que podem delimitar uma maior padronização e outras de difícil padronização. O benefício a ser alcançado é a saúde que pode ser atribuído ao serviço prestado, porém de difícil mensuração (como por exemplo, a assistência médica) e generalização.

Competencia laboral: Manual de conceptos, métodos y aplicaciones en el sector salud

Este manual intenta constituirse en una herramienta versátil para la programación y la ejecución de programas y proyectos educativos que utilicen el enfoque de competencias, tanto en el ámbito del personal activo en los servicios de salud como para las institucionesque se ocupan de la formación técnica y profesional para el sector. Asimisno, apunta al esclarecimiento y actualización conceptual del enfoque de competencia laboral, y de sus múltiples acepciones y aplicaciones

Desempeño en Equipos de Salud - Manual

Este manual presenta el análisis de desempeño como una propuesta integral de desarrollo institucional formulada a partir de la perspectiva de los recursos humanos. Ha sido utilizado en varios países de la Región y pretende contribuir al cambio del trabajo en los servicios de salud, teniendo como objetivo la salud para todos.

Developing and Strengthening Human Resources Management in the Health Sector

HR AND NEW APPROACHES TO PUBLIC SECTOR MANAGEMENT: IMPROVING HRM CAPACITY

Human Resources in the Health Sector: Guidelines for Appraisal and Strategic Development

The scope of these guidelines goes beyond appraisal and suggests approaches to address strategic issues. In order for the process behind this step to be understandable, the document presents: basic factual information on human resources in the health sector; a framework for analysis of HRD needs; a checklist of questions which relate the information collected on HRD to the different dimensions of the analytical framework;a discussion of how to tailor sector assistance to identified priorities.

Decentralization and Human Resources: Implications and Impact

Decentralization of political and administrative power, combined with a civil service reform, are increasingly prevalent components of health sector reform. The wider implications of decentralization for human resources development are, however, poorly researched and inadequately understood. Four important human resource issues are found to emerge as a part of the process of transferring power to lower management levels. They are the adequacy of available information on human resources, the complexity of transferring staff, the impact of professional associations, unions and registration bodies on the design and implementation of management structures and jobs, and the morale and motivation of health workers.

HUMAN RESOURCE MANAGEMENT AND PUBLIC SECTOR REFORMS: TRENDS AND ORIGINS OF A NEW APPROACH

Public sector reforms underemphasized the importance of human resource management, because, a) the reformers made strong emphasis on the need to reduce the size of the government apparatus; and, b) because they made war on state bureaucracy. The analysis shows that after two decades of reformist experiments, measures of correction are being taken in several countries to restore the importance of human resource management as public policy. But, in many places governments have lost their ability to regulate and govern owing to the combined effect of downsizing and underestimation of the human resource planning function.

Labour market adjustment in health systems

The process of labour adjustment will generally be initiated whenever an administrative unit has either too few or too many workers to carry out its mandate. Adjustment can be in either two these forms when health systems are reformed or reform can lead to a situation in which more of some types of workers and fewer of other types are required. The paper focuses on ontegrating human resources planning, including labour adjustment, with broader strategic plans for health systems

Skill mix in the health care workforce: reviewing the evidence.

This paper reflects the basis on which skill mix should be examinedidentifying the care needs of a specific patient population and using these to determine the required skills of staff. It is therefore not possible to prescribe in detail a universal ideal mix of health personnel. For the mix of nursing staff, the evidence suggests that increased use of less qualified staff will not be effective in all situations, although in some cases increased use of care assistants has led to greater organizational effectiveness. Evidence on the doctornurse overlap indicates that there is unrealized scope in many systems for extending the use of nursing staff. The effectiveness of different skill mixes across other groups of health workers and professions, and the associated issue of developing new roles remain relatively unexplored.

ILO (International Labour Office). 1998. Joint Meeting on Terms of Employment and Working Conditions in Health Sector Reforms

Human resources : the political and policy context

Health leaders, managers and others do not well enough understand the strategic importance of HR to strengthening health system capacity. It seems to be still perceived by some as being at the soft and fluffy end of the spectrum in health (other than perhaps some formal and continuing education programmes), instead of something that is as essential to a strong health system as sound health financing, and which requires a similarly rigorous approach. There is little evidence that enough key players understand the key role of strategic HR approaches in achieving sustainable organizational change. While there are case histories of innovation and system change experiences using HR strategies, there is little evidence in the literature.

When staff is underpaid: dealing with the individual coping strategies of health personnel

Health sector workers respond to inadequate salaries and working conditions by developing various individual coping strategiessome, but not all, of which are of a predatory nature. The paper reviews what is known about these practices and their potential consequences (competition for time, brain drain and conflicts of interest). The effectiveness of many of these piecemeal reactions, particularly attempts to prohibit personnel from developing individual coping strategies, has been disappointing. Governments will need to recognize the dimension of the phenomenon and systematically assess the consequences of policy initiatives on the situation and behaviour of the individuals that make up their workforce.