Strengthening Jordan’s Human Resources for Health Observatory for Reliable Health Workforce Data

Strengthening Jordan’s Human Resources for Health Observatory for Reliable Health Workforce Data

 Audio interview with Dr. Al Hadidi (in Arabic)

In Jordan, HRH2030 works with the High Health Council (HHC) to strengthen the council’s capacity to govern the health workforce. A critical piece of this work is collaborating with the HHC to bolster the National Human Resources for Health (HRH) Observatory. The National HRH Observatory is meant to serve as a primary source of reliable HRH data to inform policy development and decision-making. HRH2030 is supporting the observatory to become a national resource for HRH data and information for policymakers, researchers, health care leaders, and other stakeholders.

HRH2030 recently conducted an assessment of the National HRH Observatory’s current contributions to HRH decision-making, gaps in these contributions, and resources needed to address these gaps. The overall findings of the assessment revealed that many factors have hindered the observatory’s efforts to become Jordan’s national HRH data arm. These include lack of strategic vision and clear lines of authority, inactive governance structures, inadequate human and non-human resources, and limited capacity to manage core functions. Based on its assessment, HRH2030 recommends restructuring the observatory by revisiting its functions, diversifying the membership of the observatory’s National HRH Policy Coordination Forum, and developing an automated reporting system for data collection to be able to more closely monitor movement within the health workforce. These changes will lead to more strategic HRH direction for the country and support institutional and financial sustainability of the observatory. HRH2030 will work with the observatory to achieve these goals.

This interview with former National HRH Observatory Director and current HRH2030 Governance Component Lead Dr. Raghad Al Hadidi (pictured above with HRH2030 Jordan Project Director Edward Chappy) highlights the observatory’s history, role, and assessment findings.

What is the role of the National HRH Observatory?

The National HRH Observatory is a cooperative initiative among all stakeholders responsible for human resources for health data collection, analysis, and distribution for both the public and private sectors. It is considered a tool for designing evidence-based health policies and providing data for decision-making.

What were the observatory’s main accomplishments during the past few years?

The National HRH Observatory started operating in 2008. One of its first efforts was a survey of all related stakeholders to analyze the status of HRH in Jordan. The survey findings revealed HRH priorities and challenges facing the health workforce in Jordan. Moreover, the observatory was listed in the national agenda and the executive development program covering the years 2011 to 2013. A national event was held bringing together all national HRH stakeholders, including policymakers and decision-makers. Based on the recommendations made during the event, the Prime Minister formed a national coordination policy forum comprised of representatives from all national HRH stakeholders. Following that step, a field working group of data collectors was formed. This group collected data annually to feed into the observatory’s annual reports. The observatory launched its own website, linking to the HHC website, after that.

On July 16, 2009, the National HRH Observatory was officially launched, followed by development of a country profile on human resources for health in 2010. The observatory has produced its annual report since 2009. This report is considered a policy-making tool as it revealed the distribution of health workers at both the national and governorate levels. It uncovers the level of equity in the distribution process, the number of health workers, and the number of health students in both public and private universities. The observatory also produced leaflets, conducted HRH-related studies, and developed policy briefs that were used for driving health policies.

How does the observatory collect data and share it to inform decision-making? How could this process be improved?

The national observatory’s data collection process is usually done through the field working group, which collects data at the governorate level from the public and private sectors and at the central level from all health institutions. As for sharing the data, it is done through the observatory’s annual report, which is linked from the HHC website and printed and disseminated among HRH related stakeholders if budget allowed.

What are some decisions that were based on the observatory’s data?

Decisions based on the observatory data are split into two parts. The first relates to stock analysis; for example, identifying equitable distribution of health workers between governorates, between levels of the healthcare provision (primary and secondary) and within the level itself (primary versus comprehensive health care centers). The second relates to production. When we talk about producing health workers, we can make decisions related to the number of students admitted to and graduated from health programs in public and private universities in the previous year to align with the labor market needs. Decisions can also be related to the percentages of university admissions based on gender and specialty.

I mentioned that the national observatory provides data on the number of students admitted to health programs. We recently had an issue related to nurses in Jordan. There is high demand for female nurses in hospitals and health centers, but there is a shortage of female nurses. The observatory flagged this shortage and a policy was issued to increase the number of female students admitted to nursing programs in public and private universities. Universities started admitting more female applicants than their male counterparts to bridge the gap in the labor market needs.

What do you view as the observatory’s biggest challenges?

There are two types of challenges facing the observatory: financial challenges that are related to lack of financial resources allocated for the observatory and non-financial challenges. The latter includes lack of human resources like IT staff, lack of a central computerized system to analyze the collected data, lack of a marketing and advocacy plan, and weakness in utilizing the observatory’s data in the decision-making and policymaking process.

There are often data discrepancies between different jobs and sectors. Considering its role as a national entity that collects data from different sectors, how does the observatory coordinate across sectors to link and harmonize the data?

The observatory has been facing the data discrepancy problem since its establishment. Many efforts were paid to overcome this challenge, including forming a national working group that includes all HRH data-related stakeholders. Also, in the 2016 HRH Annual Report, the HRH operational definitions were standardized, and an inclusion criteria was developed for certain professions. For example, when we talk about doctors, we agreed to exclude the non-practicing doctors, doctors working abroad, and the retired ones. Identifying the target groups and definitions have contributed to enhancing the data quality. In the 2016 report, the observatory also unified the data collection methodology with the Ministry of Health, which decreased the level of data discrepancy between the data collected by the observatory and the data collected by the ministry.

Through your current position as a governance component lead at HRH2030, how do you believe the Jordan activity can support the observatory to achieve its objectives and strengthen its role as a reliable HRH data source?

HRH2030 has the financial and technical capacity to support the observatory’s objectives and strengthen its role. This can be done through enhancing public and private sector databases, particularly those available through the country’s medical, pharmaceutical, dental, and nursing and midwifery associations. Those databases [currently] lack accuracy and advanced information related to the health workforce.

HRH2030 can also help the observatory create a central computerized system that links HRH data in the High Health Council’s central database with data available at the Ministry of Health directorates, which are spread across the country’s governorates. HRH2030 can also help develop a strategy to promote data use for decision-making and policymaking, in addition to providing on-the-job data collection trainings to HHC staff.