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400843 Health Care Workforce Situation in Bangladesh Assessment 2 Analytical Report Answer

Unit Details
Unit Code: 400843
Unit Name: Health Workforce Planning
Credit Points: 10
Unit Level: 7

2.4.2 Workforce performance report

Weight: 60%

Type of Collaboration: Individual

Submission: Via Turnitin on unit vUWS site.

Format:

Length: 2500 words

Curriculum Mode: Report

Rationale

The purpose of this assignment is to prepare a national health workforce plan for one country in the category of low and lower-middle income countries, as defined by WHO. These countries in particular have been identified in the latest report by WHO (WHO, 2016) as having a shortfall in health workers of some 18 million by 2030.

Task

The WHO has a system of classification of countries by region and income which is described in Annex 1 of the World Health Statistics Report, 2015. (WHO, 2015) (p.160-161). Use the table showing countries on in the low and lower-middle income categories to select the country you will use to develop the health workforce plan. This report also provides a range of statistics on the health workforce by country.

The assignment will be scaffolded so that tutorials will support the development of the National Health Work- force Plan on key topics relevant to the development of the workforce plan, including preparing an Environmental Scan, analysing the national health workforce data set, identifying critical issues and developing strategies to address the issues identified. The National Workforce Plan should be a five year plan.

1. Prepare a Table of Contents for the National Health Workforce Plan using report format.

2. Draft the Introduction for the Workforce Plan, including documentation of the rationale for selection of the country.

3. Prepare the Environmental Scan for the health workforce of the selected country using national and international health workforce references including policy and planning documents, and any relevant health workforce plans.

4. Prepare a data profile of the health workforce by category using WHO data and other data sources. Develop the workforce profile using tables and graphs and supporting explanatory text.

5. Based on the previous steps and relevant literature, identify critical issues to be addressed in the workforce plan.

6. Use the set of ten recommendations developed in the WHO 2016 report Working for health and growth: investing in the health workforce 4 as a framework to develop strategies relevant to implement the workforce plan (WHO, 2016, p.11-12).

Criteria

You will be assessed according to the following criteria:

– Ability to introduce the topic and findings in a well summarised Executive Summary.

– Understanding of the process of the development of a health workforce plan.

– Preparation of an Environmental Scan,

– Capacity to analyse workforce profile data including the use of charts and tables to support the analysis and presentation.

– Critical analysis and synthesis of the relevant literature to support issues identification and strategies development.

– Academic writing skills, use of report format and APA.

Resources:

Graphic material is an essential way of presenting health workforce data. Topics will be discussed at supporting tutorials. Use the Hints document on vUWS to identify the relevant sections for report format. WHO has established Regional Observatories on Human Resources in Health Systems, which includes an Africa Health Workforce Observatory. These regional observatories may include relevant material for the development of the National Health Workforce Plan.

Answer

Assessment 2 Analytical Report

Workforce performance report

Executive Summary

It has been seen that there would be a lack of health care workforce at the lower income countries in the near future. There is a connection between the income level of the country and the improvement of the health care sector. The main objective of this paper is to evaluate that connection on the perspective of the health care workforce situation in a particular country. The chosen country in this context is Bangladesh.  In order to evaluate this in a proper way, environmental analysis is done. Apart from that, the conclusion is drawn from the factors discussed in the paper.

Introduction

With the improvement of the health care system, there is a need for the improvised health care strategy. The health workforce plan is one of the components of the advanced health care strategy. The main aim of the health workforce plan is to ensure that all the people from the different parts of the country in Australia is getting the right amount of health care services.  The target of the health workforce plan is needed to be pointed at the achievement of the health care objectives, commitments and obligations (Ahmed &Shirahada, 2019). Apart from that the health care workforce should include a policy to maintaining the health care system in a proper way. The main objective of this paper is to understand the different perspective of the health care system along with the workforce in health care. 

It has been seen that the income of the country plays a significant role in the development of the health care workforce. WHO has categorised different countries on the basis of the income.  As for example, one of the country in the higher income group is Australia.  It has been seen that the health care sector of Australia is improved and is accessible to all people in the country. On the other hand, the lower middle-income group one of the countries is India, and it has been seen that certain improvement is needed to be done in the health care sector of this country (World Health Organisation, 2019). One of the countries in the lower income group is Bangladesh, and there is a necessity for the major improvement of the health care sector and the workforce for this country (Cross et al., 2016). The justification of choosing Bangladesh for this discussion is that according to WHO, there will be a shortfall of 18 million health workers in this country by 2030. In this context, it is necessary to evaluate the proper workforce plan for this county in the health care sector.

Introduction to workforce plan and rationale for selection of the country

The selected country in this discussion is Bangladesh. Bangladesh belongs to the lower income group category. This income group category reflects the economic condition of the country.  It has been seen if the average income of the citizens in a country is low, it is natural that the investment in maintaining health care would be low (Ahmed et al., 2018). This indicates the limited accessibility in the health care facility. Apart from that, a person from this country has to go to the other country in order to get better treatment.

In this situation, the proper health care workforce plan is needed to be developed so that the proper health care services can be provided to the people and the citizens of the country with limited accessibility.

It has been seen there is a shortage of the health care workforce in Bangladesh. The number of physicians is only 0.03% per 10,000 population, and the number of nurses is 1.07% per 10,000 population (Ahmed et al., 2018). Apart from that, there is a shortage of sanctioned health care workers in the country.

The main focus regarding the health care of Bangladesh is the improvement of the health care situation in urban areas and the condition of the tertiary hospitals. It has been seen that 70% of people live in rural areas in the country. There are certain challenges for the improvement of the healthcare system in Bangladesh. Some of these problems are the improvement of the weak management and centralisation of the health care system. Apart from that, it has been seen that only 28% of the people in this country get facilities from the government regarding medical treatment and medicines (Bogren et al., 2018). The rest of the percentage is deprived of getting minimum health care services. 

In this context, it has been found out that there would be a lack of health care professionals in Bangladesh by 2030 that will make the situation worse. It has been seen that in the country like Bangladesh from the lower income group, the average income of the individuals is less. In this case, the investment in the health care sector is not properly implemented. Regarding this, it can be said that there is a need for the evaluation of the health care workforce for the organisation. 

In order to understand the planning of the workforce in the health care sector, there is a need for the evaluation of environmental factors in the organisation. In order to do this, the environment can be performed on the basis of the situation.

Environmental Scan:

The analysis for the environment in the development of the health care workforce in Bangladesh, the internal and external environment of the situation is needed to be developed in a proper way.

Knowledge and understanding of internal environment:

Organisationalstructure:

There is no specific organisation that can define the health care sector in Bangladesh. It can be described as the specific sector that needs improvement or further development for providing proper services to the people. The health care sector in Bangladesh is operated through both government and private health care providing organisation. The government of Bangladesh is responsible for providing health care services at a certain limit to the non-privileged people. However, there is a need for the proper documentation as proof of the financial condition of the people in order to avail the service. It has been seen that 70% of people are under privilege and are capable of availing the advantage of the health care services from the government. However, it has been seen that only 28% of people can avail these services (World Health Statistics 2015, 2019). This indicates that proper monitoring of the services regarding the distribution of health care is not followed in a proper way. This also indicates there is a lack of the workforce for the health care sector. There are government hospitals in the rural areas of Bangladesh. However, there is a lack of medical facilities, and the treatments can be done to a limited level.

Current Workforce:

It has been seen there is a shortage of the health care workforce in Bangladesh. The number of physicians is only 0.03% per 10,000 population, and the number of nurses is 1.07% per 10,000 population (World Health Statistics 2015, 2019). Apart from that, there is a shortage of sanctioned health care workers in the country. This increases a significant number of incidents like the increase of maternal mortality rate. Apart from that, it has been seen that due to the lack of health workers, some of the unprofessional people are handling the medical cases that are leading the situation to the worse condition. 

In order to improve the current workforce, certain measures are taken by the government of Bangladesh. In order to improve the overall system, the government has initiated the scheme HRH strategy under Human Resource Development Unit of Ministry of Health & Family Welfare, Bangladesh Secretariat (MOHFW).  This scheme has helped the government to increase the number of health care workers (Ahsan et al. 2017). Under this scheme, the government has initiated the training to the graduates in order to handle the medical situation. Apart from that, the government of this country is thinking about increasing the number of medical students by increasing the number of medical colleges. These initiatives are resulting in a positive outcome for the organisation. 

Analysis of the current workforce data:

Distribution of health care workforce

Figure: Distribution of health care workforce

Source: (World Health Organisation, 2019)

From the statistics, the overall distribution of the health care workers for the different sectors is mentioned. It has been seen that most of the health care workers are indulged in patient monitoring and the support system. This indicates that most of the health care workers are serving in health care organisations and hospitals. However, other important sectors like health care awareness and disease and epidemic outbreak surveillance, there is less number of health workers. This indicates the lack of distribution in the health care workers in a proper way. Apart from that, it has been seen that only 10% of people are taking health education, which implies that less number of people are becoming health care professionals.

Financial analysis:

Health Expenditure by source

Figure 1: Health Expenditure by source

Source: (Islam, Ahsan & Biswas, 2015)

From the above diagram, it has been seen that the expenditure for getting the proper health care service primarily contributed by the citizen of the country. It has been seen that 63% of expenditure are from the household out-of-the-pocket payment that indicates that the people are paying their medical bills and they are not getting extra facility or subsidiary from the government (World Health Statistics, 2019). The expenditure in the health care sector is recycled for the improvement of the health care system. In this context, it has been seen that the income of the people is low in Bangladesh, and that is affecting the investment in the health care sector. The government funding for the improvement of the health care sector is only 23.09% (Islam, Ahsan & Biswas, 2015). Apart from that, the country is getting aid from the rest of the world, which is 8.35% of total expenditure (World Health Statistics, 2019).

It has been seen as the major investment is made by the people of the country in the health care sector, there is a lack in the expenditure as the average income of the people in low in this context. Apart from that, the fund provided by the government and the other national and international organisation is low compared to the required fund. 

Distribution of health care facilities

Figure 2: Distribution of health care facilities

Source: (World Health Statistics, 2019)

Apart from that, it has been seen there is a gap for the investment in the health care sector and the expenditure for the health care services at the different parts of Bangladesh.  The highest percentage of investment in medical health care and the expenditure occurs in Dhaka, which is the capital of the country. The second highest place in this context is held by Chittagong, another notable city of Bangladesh. However, if the evaluation of the other places can be done, it can be seen that the rural areas like Rangpur, Barisal, Sylhet have less investment in the medical and health care sectors. This indicates that there is a lack of medical awareness in rural areas. Apart from that, the spending power of the people in these areas is less due to the low economic condition.

A potential source of risks:

There are certain sources of risks which can be identified in this context. It has been seen due to the lack of proper health workers. There are numbers of unprofessional people trying to help others in serious medical condition that is leading to the loss of life (Shawon et al. 2018).  In this situation, the government is thinking to train the potential people about taking primary care in serious medical issues.

Apart from that, in case if the proper investment occurs in the health care system, there is a possibility that health care services can be misused. The government can make grants for giving proper training to the students and the potential people in health care management. However, there is a chance that the proper monitoring of the process may not be done. In that case, there is a chance the future health workers are not getting the proper training, and that will affect the overall system.

External Environment scan

In order to understand the external analysis, the PESTLE analysis can be conducted.

Political/ legal:

The political factors are important in order to understand the scope for the improvement of the health care workforce. In this context, it can be said that the laws and regulations also play an important role in the development of the workforce. However, there is no such rules and regulations for the other paramedical workforces, though they have to go through the proper training. Apart from that political factors is an influencer for the development of health care. It has been seen that due to the political turbulence in Bangladesh, the improvement of the overall situation and the development of the workforce are affected negatively (Yap, 2018). There are certain rules needed to be followed by the doctors and nurses for providing the health care services to the patients in Bangladesh.

Economic:

The economic condition of Bangladesh is in the lower income group (World Health Organisation, 2019). This indicates that the average income of the people in this country is lower than the other countries in the world. That indicates the poor economic condition of the country. This economic condition is restricting investment in the health care system of the country. Apart from that, it becomes a constraint for the development of the proper health workforce in Bangladesh.

Social:

Most of the people in Bangladesh live in rural areas (World Health Organisation, 2019). It has been seen that there are limited facilities in the rural areas. Most of the areas are not well connected with the city. Apart from that, there are less medical facility and the lack of health care professionals in those areas.

Technological:

The use of advanced technologies in health care can be seen at some of the reputed hospitals in Bangladesh. It has been seen that most of the hospitals and regional health care centres in Bangladesh are lacking form primary health care services (World Health Organisation, 2019).

Environmental:

The environmental issues are needed to be concerned in this situation. It has been seen that the health care professionals in Bangladesh are trying to adopt sustainability in the management of the health care system.

Data profile of the health workforce by category

Types of the health care workforceNumber
Doctors91,000
Nurses15415
Dentists10,100
Midwives16559
Medical Technologist9249
Health Visitors5411
Registered vetsNo data available

Table: Workforce data profile

Source: (Worldbank, 2018)

Interestingly, it has been seen that the numbers are not satisfactory in terms of the health care workforce required for the country. Apart from that, the number of registered vets is not available that indicates the lack of monitoring the medical workforce in a proper way.

Identification of critical issues to be addressed in the workforce plan

  • Lack of the medical workforce in the country: There is a lack of medical work force in the country that includes insufficient number of doctors. This causes the lack of treatment for most of the people.
  • Lack of proper investment in the improvement of the health care sector as the country is in a lower income group: The investment for the improvement of the health care sector is not enough as the buying capacity and the income for the most of the people in Bangladesh is low.
  • The lack of a trained medical professional: There is a lack of trained medical professionals that causes serious condition in the rural area. The people from rural area do not get proper medical help when it is needed.
  • Inadequate numbers of regional hospitals in rural places: In the emergency medical conditions, people from the rural place can not avail proper medical treatment from the regional hospitals. In that case they have to come to the city to get properly treated.

Strategies relevant to implement the workforce plan

Certain development of the medical workforce can be done so that the improvement of the overall situation can be achieved. In this context, the following recommendations can be made:

  1. Creation of the proper job posts: The job posts can be created for the medical professionals so that the people and the students can get interested to enroll in health care professional sector (World Health Organisation, 2019).
  2. Gender equity: Maintaining the gender equity in the workforce can make the women come to the health care sectors. Apart from that, this will also help to increase the workforce.
  3. Giving proper education and training: Giving proper education and training will help the students and the people undertaking the health care courses to understand the need for the health care workforce in a proper way.
  4. Use of the technology: The use of technology for training the workforce can be implemented. This will make learning interactive in nature. Apart from that, this will enhance the quality of learning.
  5. Partnership and collaboration: The course materials can be developed with the collaboration of international health care organizations.  This will enhance the overall quality of the training.
  6. International migration: It is recommended to safeguard international migrant rights by establishing policy framework to acknowledge international qualification degrees of health care professionals. This will optimize skill use and increase the benefits from health workforce migration. 
  7. Data information and accountability:To properly approach the problem of scarcity of health care professionals in Bangladesh, it is recommended to undertake robust research for analyzing the health labor markets. By using harmonized methods and metrics accountability, action and evidence can be strengthened.
  8. Health Service Delivery and Organization: Bangladesh should reform its service models that are concentrated on hospital care and focus more on prevention of diseases. It is recommended to focus more on unserved areas and establish efficient provision of “high-quality, affordable, integrated, community-based, people-centred primary and ambulatory care” (World Health Organisation, 2019). 
  9. Crises and Humanitarian Settings: It is recommended to ensure investments in core capacity development as well as skill development of national and international healthcare professional in humanitarian settings. Bangladesh should development capacity of its workforce for detecting and responding to its public health risk. 
  10. Financing And Fiscal Space: It is recommended to consider a financial reform and raise huge amounts of funding from public and privet domestic and international sources. Bangladesh should focus on securing sustainable health financing. 

Conclusion

It has been seen that through the proper development of the workforce the overall improvement of the health care sector in Bangladesh can be achieved. Apart from that, there is a need to take certain steps in order to improve the workforce in the health care sector.

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