Tool will help developing countries deploy their healthcare workers in the most optimal manner
Chronic shortages of healthcare workers (HCWs) represent one of the biggest barriers to development and improvements in health outcomes for people living in developing countries. In Mozambique where life expectancy is only 50 years, HCW shortages are particularly pronounced. Fewer than 1,500 doctors serve a population of 25.2 million, with only 89 HCWs per 100,000 people – a ratio significantly below the World Health Organization’s recommendation for the minimum number of HCWs that are needed for a country to adequately meet the health needs of its population.
In another example of Georgia’s impressive global reach and the value of real collaboration, the Centers for Disease Control and Prevention (CDC) and the Public Health Informatics Institute (PHII) at The Task Force for Global Health, in collaboration with researchers and students affiliated with Georgia Tech’s Center for Health and Humanitarian Systems, have developed an innovative tool to help Mozambique improve the allocation of HCWs and ensure more consistent healthcare services for its population. Called the Workforce Allocation Optimization Tool, the Excel-based system considers different indicators and key factors such as budget constraints and provincial-level demand to assign HCWs to locations around the country. Provinces with high levels of disease such as HIV receive priority for HCWs in order to ensure that the health workforce can be scaled up to address health needs in those locations. CDC is currently testing the tool and plans to pilot it in Mozambique during the next allocation period for new HCWs.
CDC’s Division of Global HIV/AIDS initially asked PHII to analyze the current state of health workforce business processes in Mozambique as part of CDC’s efforts to scale up HIV services in Mozambique. PHII staff worked with JHPIEGO, a Baltimore-based global health organization, and the Ministry of Health (MOH) in Mozambique to learn from health officials around the country about how they allocated doctors, nurses, laboratory technicians, and other staff. The team’s analysis revealed that the decision-making process was inconsistent and resulted in uneven allocation of HCWs around the country. Out of their analysis emerged the recommendation for a data-driven, evidence-based system that would allocate HCWs in the most optimal manner.
The PHII team led by Vivian Singletary and Juneka Rembert worked with a Georgia Tech team that included students Emily Gooding, Colleen Goottee, and Monica Villarreal who were advised by Professors Pinar Keskinocak and Julie Swann, to develop the workforce allocation tool. PHII also collaborated with CDC, JHPIEGO, and the MOH to ensure the tool met Mozambique’s requirements and needs. An Excel-based system was ultimately chosen to ensure that the tool could be used effectively even if only basic computer equipment was available. For the Georgia Tech students, developing the tool provided a valuable educational opportunity to apply skills in industrial and systems engineering while addressing a particular global health issue.
To address the significant issue of HCW turnover in Mozambique, the workforce allocation tool takes into consideration HCW preferences for particular location assignments. The aim is to maximize their satisfaction with their assignments, which should help reduce turnover and ultimately ensure more consistency in the delivery of healthcare services, especially in rural areas where health services often are not available.
It is anticipated that better allocation of HCWs should help address gaps in health services across the country and eventually improve health outcomes for the population. HCW shortages will continue to be an issue in the scale-up of HIV services in Mozambique, but there should be fewer gaps in services after the country deploys the workforce allocation tool.
Mozambique’s adoption of the workforce allocation tool demonstrates a commitment to the use of data and objective criteria for allocating HCWs, an approach that more developing countries are recognizing as vital for stronger health systems. Tanzania and Malawi have already expressed interest in using the tool for their own HCW allocation processes. PHII plans to demonstrate the tool to Ministries of Health in these countries later this year.
The collaboration among CDC, PHII, Georgia Tech students and researchers, JHPIEGO, and the Mozambique MOH, that yielded the workforce allocation tool demonstrates the value of collective action in addressing an intractable global health problem. The Atlanta area is rich with innovative organizations that are working together to make critical and worthy contributions to global health. But these collaborations tend to be project-specific and typically end due to discontinuation of funding. For Atlanta and Georgia to become the “Global Health Capital” – a distinction that we can own – we need to build a coalition that harnesses the power of our collective and synergistic actions. Under such a coalition, it will be possible to facilitate and promote more regular and systematic collaborations among Georgia’s global health organizations. In future blogs, we will continue to explore the value of such a coalition and highlight more success stories about real collaborations in global health.