WORLD HEALTH ORGANIZATION
ORGANISATION MONDIALE DE LA SANT~
REGIONAL O.FFICE FOR
THE WESTERN PACIFIC
BUREAU REGIONAL DU PACIFIQUE OCCIDENTAL
REGIONAL COMMI'.rl'EE
WPR/RC20/8 1 September 1969 ORIGINAL: ENGLISH
Twentieth Session Manila 2.3-.30 September 1969 Provisional agenda item 15
TRAINING OF NATIONAL HFALTH PERSONNEL 1 INTRODUCTION Inclusion of the topic "Training of National Health Personnel" on the agenda of the twentieth session of the Regional Committee arose from resolution WHA21.20 the following item: " (c) to suggest to the regional committees, at their meetings 1
of the Twenty-first World Health Assembly which
requested the Direotor-General to act on a series of measures, including
in 1969, that they undertake an analysis of the problems of
training profeSSional and auxiliary health personnel." It is intended that the views and conclusions of regional committees on particular problems of training applicable to their own regions will serve to guide the Executive Board at its forty-fifth session and the Twenty-third World Health Assembly in making appropriate provisions for the Organization to assist further the training of national health personnel. 2
BACKGROUND The lack of trained medical and paramedioal personnel in many
countries has long been reoognized as a major obstacle to the development of health services. In this aonnexion, the Fifteenth World Health !Assembly in •••
~xt of resolution WHA21.20 is appended.
WPR/RC20/8 page 2 Assembly in 1962, in considering the subject of the United Nations Development Decade endorsed the recommendations of the ExeQutive Board that governments should "concentrate on the education and training of professional and auxiliary staff for strengthening their health services, with specific measurable targets for expanding each category of staff, depending on pre-determined needs for each" (resolution WHA15.57).1 Despite considerable efforts by many governments in
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this direction
and although WHO for its part has continued to give education and training activities a very high priority in its overall programme, progress in the training progranmes of national health personnel has been slow and not very satisfactory due to a variety of factors.
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COLLECTION OF MSIC INOORMATION
Recognizing that it will not be feasible at this stage for each country to carry out a detailed and comprehensive study on ,the training of national health personnel, it is proposed that countries now be asked to provide basic information using simple uniform guidelines. The collection of such data will enable an individual assessment and review to be made as well as a comparable study of the findings both from regional and inter-regional viewpoints. It is thus suggested that relevant information under the following headings might be provided:
3.1 National health plan Does such a plan exist, and if so, is it within the context of an overall social and economic development plan? 3.2 Health manpower plan and projections Is there a health manpower component of the national health plan? . !
What are its essential details?
13.3 Categories ~andbook of Resolutions and Decisions, lOth ed.,
436-437.
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wPR/RC20/8 page 3
Categories of existing health personnel (professional and auxiliary) Ca) (b) (c) Cd) (e)
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Duties, functions and responsibilities of each category Number currently in the service Numbers trained each year Estimate of numbers required over the next five years (by year) Education and training of each category (i) (ii) (iii) (iv) admission requirements; curriculum content and design; duration of training; training facilities and resources for each category number of schools, enrolment, number of graduates per year, faculty, budget, ministry responsible for training (health, education), field training facilities, (v) (vi) etc.; work opportunities for each category; continuing and post-basic education arrangements.
3.4 Outline of plans for training of new categories of health personnel 4
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PROBLEMS OF TRAINING As well as submitting basic information on existing categories
of health personnel and training activities, it would be helpful if countries could elaborate on specific problems encountered in their training programmes and how these are being solved or tack-led.. Some problems commonly met are: 4.1 Lack of a national health plan based on a realistic appraisal of health needs, demands and resources A national health plan should define health policy, describe the pattern of health services. project the health manpower necessary to implement the plan and outline the functions of each category of health personnel and the training each should receive. /4.2 Relevance •••
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4.2 Relev ance of train ing prPgrammes to natio nal needs Unfor tunate ly in many coun tries, there exist s a lack of flexi bility in train1 ng programmes and a conti nuati on of the more tr8di tiona l type of train1 ng not parti cular ly relev ant to the socia l, econom ic and healt h situa tions of the count ry.
4.3 The relat ively unsat isfac tory state of gener al or basic educa tion in many devel oping oount ries This is a fundamental problem which healt h admin 1strat ions canno t influe nce direc tly, but which in turn influe nces the requir emen ts for admis sion, the level of train ing, the curric ulum. durat ion of cours es, etc.
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4.4 Short age of quali fied teach ing staff This is a wides pread problem aggra vated by lack of teach er train ing facil ities , the "brai n drain " and often the lack of inducement to keep facul ty members in their own count ries. Concerning the train ing of auxil iarie s, the quest ion is frequ ently raise d wheth er they shoul d be traine d by other auxil iaries or by profe ssion al staff . 4.4 Numbers and stand ard of traine es It is often a problem to decid e wheth er train1 ng programmes shoul d be geare d to the produ ction of a few well- quali fied perso nnel or to the produ ction of more perso nnel but of a lower categ ory and possi bly of a lower stand ard. These quest ions also invol ve the durat ion of train1 ng of each categ ory of healt h perso nnel. 4.5 Curri cula and cours e conte nts While it is gener ally agree d that cours es shoul d be desig ned to meet natio nal needs , it 1s not easy to achie ve this ideal . Healt h admin 1strat ions as the event ual employers of train ees must be involv ed in the plann ing and desig ning of vario us cours es and steps must be taken to relat e profe ssion al and auxil iary educa tion and train ing to /the natio nal •••
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the national health plan. determine a national ascertained.
Operational research may be conducted to of health services that will help a country
s~rategy
to design curricula geared to meet the needs and demands that have been
4.6 Methods of teaching -
the~retical or classroom teaching verSus practical and field training
Many institutions have difficulty in keeping up-to-date with teaching methods, the use of audio-visual aids, training manuals, field training activities, etc. Language problems regarding the translation of manuals and teaching material are encountered, particularly in courses for auxiliary personnel where the texts of manuals and books are not freely available in the local language.
4.7 Integration of training courses There are many advantages in integrating training courses of various categories of health personnel. In this way, health workers
become aware of each other's duties, responsibilities and problems and this facilitates their working as a team rather than as individuals. It is often difficult to integrate courses and success in this direction will depend much upon co-operation and collaboration between training institutions as well as individual 4.8 Continuing education A common problem facing health administrations is how to keep their personnel, already in the service, abreast of new developments, methods and policies. Refresher courses, workshops, seminars are commonly used to assist in this direction. instl~ctors.
4.9 Promotion of auxiliaries The question is often asked whether it is desirable to promote schemes under which auxiliary health personnel can acquire higher /qualifications
WPR!RC20/8 page 6 qualifioations and more extensive training so as to pennit'their promotion to higher oategories. The educational level of the auxiliary In situations where is an important factor in oonsidering this matter. 'persons, some difficulties may arise. 4.10 Job satisfaotion This is an important subject to which health administrations as employers must give attention to see that there is a satisfactory scheme of employment which takes into account adequate compensation, security of tenure, meritorious increase, hardship pay, and other incentives designed to upgrade the morale of health workers thus preventing the rapid turnover of staff and possibly limiting the "brain drain".
health auxiliaries are gradually replaced by more highly-qualified
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wPR/RC20/8 page 7 RESOLUTION OF THE WORLD HEALTH ASSllMBLY 'IWENTY-FmsT WORLD HEAL'IH ASSEMBLY
WHA2l.20 22 May 1968
TRAINING OF NATIONAL HEAL'IH PERSONNEL
T.he Twenty-first World Health Assembly, Considering that the World Health Organization is called upon in accordance with its Constitution to assist governments in strengthening their health services and to promote teaohing and training in the health, medical and related professions; Appreciating the efforts being made by all countries, particularly the developing countries, to speed up their economic and social development, including the improvement of their health situation; Being convinced that in order to improve the health situation in all countries it is necessary to intensify efforts to develop and utilize human resources, and particularly to train national staff, taking into account the development plans in each country and its present and longterm needs for qualified health staff at all levels; and
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Recalling resolution 2083(XX) of the General Assembly of the United Nations, dated 20 December 1965, which refers to "measures calculated to intensify concerted action by the United Nations and the specialized agencies with regard to the training of national personnel for the
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economic and social development of the developing countries" and "invites ••• the specialized agencies ••• to bear these problems in mind when they review future programmes of action", 1. RECOMMENDS Member States to give increasing attention to the train-
ing of profeSSional and auxiliary health personnel; 2. REQUESTS the Director-General: (a) to continue to give high priority to programmes of assistance to Member States in the training of professional and auxiliary health personnel; / (b)
to continue
WPR/RC20/8 page 8 (b)
to continue to collaborate with the United Nations and the
speoialized agencies in the utilization and development of human resources; (c) to suggest to the regional committees, at their meetings in 1969, that they undertake an analysis of the probl~ms of
training professional and auxiliary health personnel; (d) to make provision for a general evaluation during the forty-fifth session of the Executive Board of the experience aocumulated by the World Health Organization, taking into aocount the oonclusions reached by the regional oommittees; and
(e)
to submit to the Twenty-third World Health Assembly furth~r
a report on any conorete measures that the World Health Organization might appropriately take to assist the training of national health personnel at all leveJ,s.
Sixteenth plenary meeting, 22 May 1968 A21/VR/16
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