OVERVIEW: RESOURCE REQUIREMENT TOOL (RRT) FOR HUMAN RESOURCES FOR HEALTH Overview of the RRT functionalities July 13, 2009 1.

OVERVIEW: RESOURCE REQUIREMENT TOOL (RRT) FOR HUMAN RESOURCES FOR HEALTH Overview of the RRT functionalities July 13, 2009

1

GHWA Financing Task Force (FTF) Alberto Carrasquilla,

Former Minister of Finance, Colombia

Sanjeev Gupta, Senior Advisor, International Monetary Fund

Eyitayo Lambo, Former Minister of Health, Nigeria

Mamadou Lamine Loum, Former Prime Minister, Senegal

K. Srinath Reddy, Head of the India Public Health Foundation

Rick Rowden, ActionAid

Julian Schweitzer, World Bank

Netsanet Walelign, UNICEF

Hong Wang, Abt Associates Inc.

Ex-officio members

Discussion Topics

RRT overview

Description of RRT components Employment component

Pre-service training component

Affordability component

3

Purpose of the tool

Estimate/project cost to (i) hire and (ii) train planned HRH

Analyze affordability of the HRH plan

Conduct “what if” analyses of (i) policies; (ii) plans; (iii) assumptions

Produce specific information for advocacy

Monitor implementation of HRH plan

Provide input into human resource information systems (HRIS) design related to costs and financing

44

RRT audience and users

Ministries of Health

Ministries of Education

Ministries of Finance

Development partners

Advocacy Groups

5

RRT structure: three components

ABILITY TO

FUND

RESOURCE REQUIREMENT TOOL

1

2

3

• How much would it cost to hire, retain and deploy HRH?

• Estimates public sector HRH employment and HRM costs

• Accounts for private sector employment

• How much would it cost to train HRH?

• Estimates resource requirements for public sector HRH pre-service training

• Accounts for private sector PST capacity

• Can it be afforded?• Estimates gap

between required and available resources for government HRH plans

6

Discussion Topics

RRT overview

Description of RRT components Employment component

Pre-service training component

Affordability component

7

Employment component: Inputs (1/2) Basic Country information

Employment-specific information

Public sector HRH (by cadre and by geographic areas)

Resources dedicated to public sector HRH by cadre, by geographic area

Salary and benefits

Deployment cash and non-cash bonuses

Performance-related cash and non-cash bonuses

Assumed productivity improvements due to performance-based financing

In-service training costs

HR Management (HRM) staff and related costs

Private sector HRH, accounting for “moonlighting”

ABILITY TO

FUND

Country HRH Scale

up Plans

RESOURCE REQUIREMENT TOOL

1

2

3

8

Employment component: Scenarios (1/2)

Scenarios:

Vary the number of projected pubic sector HRH

Vary resources for public sector HRH by cadre by geographic area

Salary and benefits

Deployment cash and non-cash bonuses

Performance-related cash and non-cash bonuses

Vary potential performance savings

In-service training costs

Vary resources dedicated to HRM HRM salaries and benefits

HRM recurrent costs

HRM capital investments

ABILITY TO

FUND

Country HRH Scale

up Plans

RESOURCE REQUIREMENT TOOL

1

2

3

9

Discussion Topics

RRT overview

RRT description Employment component

Pre-service training component

Affordability component

10

PST component: Inputs (1/2)

ABILITY TO

FUND

Country HRH Scale

up Plans

RESOURCE REQUIREMENT TOOL

1

2

3

Inputs are listed by 1) ministry and 2) by type of cadre that is trained

Names of public training institutions and years of training for this cadre

Total students in the university HRH graduates in the current year (by region

urban/rural) and total HRH graduates Total capacity for HRH students per graduating

year Number of years to reach capacity HRH student average drop out rate Weighted average variable cost per HRH student Weighted average fixed cost per HRH student Total capital costs

11

Scenarios that can be created for pre-service training

ABILITY TO

FUND

Country HRH Scale

up Plans

RESOURCE REQUIREMENT TOOL

1

2

3

Scenarios:

Vary

HRH attrition rate

HRH rate of re-entry into the sector

Costs of education

Capital investment requirements

Expected revenues

Private competition for grads

12

Discussion Topics

RRT overview

RRT description Employment component

Pre-service training component

Affordability component

13

Likely Affordability: Inputs

ABILITY TO

FUND

Country HRH Scale

up Plans

RESOURCE REQUIREMENT TOOL

1

2

3

Inputs: Total GDP/GNI Share of GDP/GNI captured by government

Share of public spending allocated to health

Share of health spending for HRH Share of public spending on education

Share of education spending on HRH pre-service training via MOE

Donor funds committed/expected for HRH employment or training

Revenues from public universities

14

Likely Affordability: Scenarios

ABILITY TO

FUND

Country HRH Scale

up Plans

RESOURCE REQUIREMENT TOOL

1

2

3

Scenarios:

Vary:

Growth of GDP

Government capture of GDP

Government allocations for health and education

Health allocation for HRH

Education allocation for HRH

Donor commitments for HRH

15

Based on gaps countries can adjust HRH plans

ABILITY TO

FUND

Inputs Scenarios

Outp

uts

Inputs Scenarios

Outp

ut

s

Inputs Scenarios

Outputs

Country HRH Scale

up Plans

RESOURCE REQUIREMENT TOOL

1

2

3

Feedback

16

ABILITY TO

FUND

Country HRH Scale

up Plans

RESOURCE REQUIREMENT TOOL

1

2

3

ABILITY TO

FUND

Country HRH Scale

up Plans

RESOURCE REQUIREMENT TOOL

1

2

3

17

Countries can monitor implementation of plans over time

ABILITY TO

FUND

Country HRH Scale

up Plans

RESOURCE REQUIREMENT TOOL

1

2

3

YEAR 1

YEAR 2

YEAR 3

17

• Gaps that can be used for advocacy or for reconsideration of HRH plans

0

5000000

10000000

15000000

20000000

25000000

2009 2010 2011 2012 2013 2014 2015

Needed resources

Available gov't resources

Gap

Year

Do

llar

s

1818

Sample Outputs: West African Country RRT application

18

Questions?

19

What RRT is not…

RRT not JUST a costing tool:

It estimates projected resource requirements including costs and expenditures and compares resource requirements to availability

RRT not a tool for projecting and planning HRH numbers (i.e., number of HRH is taken as input)

It can inform HRH planning when used interactively

RRT lets users vary number of HRH as feedback to planners who may choose to change planned levels of HRH

20

What RRT is not…

RRT not a conceptual framework

Builds on ideas from conceptual frameworks and literature on HRH financing

Practical tool ready for use by MOHs

BUT it can be complimented with two papers by the Financing Task Force: 1) Economic and Financing Issues in Scaling Up HRH and What Countries Can Do Now Paper

RRT not a demand forecast for public sector HRH

BUT it is provides a model for estimating private sector demand

RRT does not replicate exiting tools, but builds on them

Content based on WBG Costing Tool (March 2007) and WHO Costing Tool (2002)

Design based on GAVI FSP, Malaria costing tool, etc

21

Sample output: Employment costs

42635081 5287 5505 5780 6069 6372 6691

2008 2009 2010 2011 2012 2013 2014 2015

Year

22

Do

llar

s f

or

HR

H E

mp

loym

en

t

HRH Employment Cost (Dollars in thousands)

22

84104 118 131

145159

17318824

2424

2525

2525

26

2008 2009 2010 2011 2012 2013 2014 2015

Planned additional HRH in PST

Current level of HRH in PST

Do

llar

s i

n T

ho

usa

nd

s

Year

Costs for Scaling HRH Pre-Service Training

Sample Outputs: Pre-Service Training Costs

2323