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AN ANALYSIS OF GAVI, THE GLOBAL FUND AND WORLD BANK SUPPORT FOR HUMAN RESOURCES

Tuesday, 28th of February 2012

These World Bank authors ask the obvious question: since the Bank, GAVI and GF all fund health services strengthening, usually to the same countries, why could they not do so in a more coordinated way?

Abstract below; full text is free to journal subscribers.

Good reading.

BD

Health Policy Plan. (2012) doi: 10.1093/heapol/czs012 First published online: February 13, 2012

 

 

• AN ANALYSIS OF GAVI, THE GLOBAL FUND AND WORLD BANK SUPPORT FOR HUMAN RESOURCES FOR HEALTH IN DEVELOPING COUNTRIES

1. 1.   Marko Vujicic¹,^*,
2. 2.   Stephanie E Weber²,
3. 3.   Irina A Nikolic³,
4. 4.   Rifat Atun⁴ and
5. 5.   Ranjana Kumar⁵

+ Author Affiliations

1. 1.    ¹Senior Economist, Human Development Network, The World Bank, Washington DC, USA, ²Consultant, The World Bank & Doctoral Candidate, School of Public Health, University of California, Berkeley, CA, USA, ³Health Specialist, Human Development Network, The World Bank, Washington DC, USA, ⁴Director, Strategy, Performance & Evaluation Cluster, The Global Fund to Fight AIDS, Tuberculosis and Malaria, Vernier-Geneva, Switzerland and ⁵Program Manager South East Asia, Program Delivery Team, Global Alliance for Vaccines and Immunisation Secretariat, Geneva, Switzerland
2. ↵*Corresponding author. Senior Economist, Human Development Network, The World Bank, 1818 H St NW, Washington DC 20433, USA. Tel: +1-202-473-6464. Fax: +1-202-522-3489. E-mail: vujicic74@gmail.com

       Accepted December 14, 2011.

Abstract

Shortages, geographic imbalances and poor performance of health workers pose major challenges for improving health service delivery in developing countries. In response, multilateral agencies have increasingly recognized the need to invest in human resources for health (HRH) to assist countries in achieving their health system goals. In this paper we analyse the HRH-related activities of three agencies: the Global Alliance for Vaccines and Immunisation (GAVI); the Global Fund for Aids, Tuberculosis, and Malaria (the Global Fund); and the World Bank. First, we reviewed the type of HRH-related activities that are eligible for financing within each agency. Second, we reviewed the HRH-related activities that each agency is actually financing. Third, we reviewed the literature to understand the impact that GAVI, Global Fund and World Bank investments in HRH have had on the health workforce in developing countries. Our analysis found that by far the most common activity supported across all agencies is short-term, in-service training. There is relatively little investment in expanding pre-service training capacity, despite large health worker shortages in developing countries. We also found that the majority of GAVI and the Global Fund grants finance health worker remuneration, largely through supplemental allowances, with little information available on how payment rates are determined, how the potential negative consequences are mitigated, and how payments are to be sustained at the end of the grant period. Based on the analysis, we argue there is an opportunity for improved co-ordination between the three agencies at the country level in supporting HRH-related activities. Existing initiatives, such as the International Health Partnership and the Health Systems Funding Platform, could present viable and timely vehicles for the three agencies to implement this improved co-ordination.