Contents of Webinar Series
Background
The Asia Pacific Action Alliance on Human Resources for Health (AAAH)
In 2005, AAAH, a regional partnership mechanism, was launched by 10 founding member countries in response to international recognition of the need for global and regional action to strengthen country capacity for human resource for health (HRH) planning and management. The AAAH is part of a larger movement to enhance HRH development as articulated in Kampala Declaration and the Agenda for Global Action. The AAAH membership is gradually expanded. From 2005 to the present, membership has increased to 18 countries; 9 from the South East Asia (SEA) region including Bangladesh, Bhutan, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka and Thailand, and 9 from the Western Pacific Region (WPR): Cambodia, China, Fiji, Lao PDR, Mongolia, Papua New Guinea, Philippines, Samoa and Vietnam. AAAH coordinates with partners to strengthen joint effort in advocating the HRH, provides technical support and augments country-level HRH development through regional collaboration. It aims to ensure sustained commitments addressing HRH needs through research, and contribution to policy development.
The conference is a main platform that AAAH has organized for learning and sharing knowledge related to HRH and strengthening HRH capacities among the member countries, HRH experts, and international agencies. The conference was held every year between 2006 and 2012, and then every 2 years since 2014. With regard to the AAAH work plan in 2014-2016 and 2016-2018 based on the 9th and 10th AAAH conference’s conclusion in 2016 and 2018, member countries have identified three priority areas for regional collaboration on a) accreditation of health professional training institutes, b) HRH unit and coordinating function, and c) national health workforce account (NHWA) that are in line with the milestones in the year 2020 of the Global Strategy on HRH: Workforce 2030.
In addition to these milestones, AAAH members have also identified common priorities for HRH to be achieved by 2030 which include a) equality of access to health workers, b) halving dependency on foreign trained health workforce, and c) completing rate of health professional graduates. Rural retention strategies and assessment were also emphasized to help strengthen health systems in order to achieve universal health coverage (UHC).
In 2020, AAAH planned to organize the 11th AAAH conference in the theme “Accelerate Progress towards Achievement of 2020 and actions for 2030 Milestones of Global Strategy on HRH” in Myanmar in August 2020. However, because of the COVID-19 pandemic globally and its impacts on public health and health care workers (HCWs) who are work frontline and are the high-risk group to expose COVID-19, AAAH needs to address this important global HRH issues timely. Therefore, the AAAH conference of this year will change the theme toward HCWS in response to COVID-19. The platform of AAAH conference also will revise the format from an in-person conference as usual into a series of webinar to ensure safety of all attendees while AAAH members still widely share their experiences with HRH experts and international agencies. The series of webinar will be useful to open widely discussion and sharing experiences among HCWs globally that have faced with this health crisis. It will also help strengthen HCWs capacity to battle COVID-19 safely and to help AAAH members and other countries formulate evidence-based health policies in response to COVID-19 pandemic under their national contexts effectively.
COVID-19 situation
Based on WHO’s situation report[1], on 31 December 2019, the WHO China Country Office was informed of pneumonia cases of unknown etiology detected in Wuhan City, Hubei Province of China. Less than a week the number of pneumonia cases of unknown etiology had increased in Wuhan City. In January 2020, a new type of coronavirus (novel coronavirus: 2019-nCoV) was identified as a causal agent of these pneumonia cases and the outbreak is associated with exposures in one seafood market in Wuhan City. Because of rapid confirmed cases and deaths from this novel virus in China and many countries, WHO declared the 2019nCoV outbreak a public health emergency of international concern[2] and named this novel virus as “coronavirus disease 2019 (COVID-19)” on 11 February 2020.[3]
Since January until currently, the number of total confirmed cases and total deaths are rapidly increasing globally, especially in Americas and Europe. Although AAAH members’ countries have less number of COVID-19 cases and deaths, the trend of infected cases and deaths are rising in many countries, such as India, Indonesia, and Philippines while many countries can flat the curve of this virus transmission, such as China and Thailand. Although the number of the COVID-19 cases decrease in some countries, HRH resiliency for future outbreaks or resurgence is needed to focus.
Governments of all countries take this health crisis to be their priority to save lives of their people by reducing COVID-19 transmission. Many preventive and control measures are used, such as mandated quarantine, social distancing, and isolation of infected populations since COVID-19 is beginning to spread, stopping mass gatherings, closure of educational institutes or places of work where infection has been identified, etc. It is still difficult to prevent and control this disease. It also add negative impacts on health systems, economic, and physical, psychological, and social effects on people.
There are many challenges of this emerging disease that the countries have faced. Medication to treat the disease and vaccines are under development but may take a year or more to be able to effective and safety use in human). The virus is easily and rapidly transmissed from infected person to other person before the onset of symptoms and there are a large number of asymptomatic cases of COVID-19.[4] It is overwhelming for HCWs to provide cares for patients for a long period of time. Some cases have severe respiratory signs and symptoms that require patients to be admit in intensive care units, but health care facilities have a limited number of beds in ICU and HCWs who can provide care for critical ill patients. To control the transmission, the number of health care facilities to quarantine the suspected cases and confirmed cases, medical devices, such as ventilators and personal protective equipment (PPE) are also limited. Health care services for non-communicable diseases (NCD) are also essential because there are evidence that NCD patients increase the susceptibility to COVID-19 and about 60-90 % of mortality COVID-19 cases had NCD comorbidities.[5] Temporary closure of outpatient health facilities in some hospitals due to COVID-19 situation is also a challenge for NCD and other essential care.
[1] https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200121-sitrep-1-2019-ncov.pdf?sfvrsn=20a99c10_4
[2] https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200130-sitrep-10-ncov.pdf?sfvrsn=d0b2e480_2
[3] https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200211-sitrep-22-ncov.pdf?sfvrsn=fb6d49b1_2
[4] https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200402-sitrep-73-covid-19.pdf?sfvrsn=5ae25bc7_6
[5] https://ijme.in/wp-content/uploads/2020/04/Non-communicable-disease-management-in-vulnerable-pgs103-105.pdf
Health Care Workers in Response to COVID-19
HCWs are recognized as the frontline workers to play an essential role in detecting the suspected cases and providing care for COVID-19 patients.[1] However, WHO reported that as of 8 April 2020, 22,073 cases of COVID-19 among HCWs from 52 countries had been infected.[2] It is accounted for 1.63% of the total number of confirmed cases globally (1,353,361 cases). However, WHO illustrated that there is no systematic reporting of HCWs COVID-19 infection6, so that the number of reports tend to under-represent the number of COVID-19 HCW infections nationally and globally.
Evidence or studies on risk factors and impacts on HCWs in response to COVID-19 are also limited. The editorial of Lancet reported global shortage of PPE for HCWs is a key concern while the COVID-19 pandemic accelerates. WHO reported that HCWs are exposed to hazards that put them at risk of infection.[3] Hazards include pathogen exposure, long working hours, psychological distress, fatigue, occupational burnout, stigma, and physical and psychological violence.5
WHO announced Health worker rights, roles and responsibilities5 and recommended a high level of infection prevention and control (IPC) and occupational health and safety to protect HCW from infection, all of which are urgently required. Principles of IPC strategies associated with health care for suspected COVID-19 5 are:
- Ensuring triage, early recognition, and source control (isolating patients with suspected COVID-19);
- Applying standard precautions for all patients;
- Implementing empiric additional precautions (droplet and contact and, whenever applicable, airborne precautions) for suspected cases of COVID-19;
- Implementing administrative controls; and
- Using environmental and engineering controls.
The Frontline Health Workers Coalition[4] also provided policy recommendations to protect and support frontline health workers in low-and middle income countries during COVID-19 pandemic, including
- National and regional health workforce planning;
- Occupational safety—health, testing, treatment, wellbeing;
- Surge capacity;
- Better data on the number of health worker infections and deaths, medical supplies, and PPE availability;
- Education, health workforce pipeline, e-learning for health care students and HCWs;
- Addressing gender-related inequalities/barriers of HCWs;
- Addressing stigma, attacks and harassment; and
- Policy changes and investments on new, long-term funding for HCWs as part of COVID-19 response.
In addition to impacts on in-service HCWs, policies in response to COVID-19, including lockdown, social distancing, and school closure, affect to health professional training and education directly, especially teaching and learning modalities. Most of health profession educational institutes still provide teaching and learning activities in classrooms or laboratories than online approaches. The core essence of health professional education is also clinical practice with patients either in hospital and community settings. Therefore, the COVID-19 pandemic is a main obstacle for continuing pre-service HCWs’ education. To maintain competencies and on-time graduation of health professional students, teaching and evaluation methods need to adapt from in-person to online platforms though these are quite difficult to minimize clinical practices with patients in healthcare facilities. These challenges may require institution and instructional reforms. In addition to focused attention to modifying teaching and learning modalities to maintain in service training delivery (virtual, digital, etc.) to maintain current health workforce stay up to date.
[1] https://apps.who.int/iris/bitstream/handle/10665/331510/WHO-2019-nCov-HCWadvice-2020.2-eng.pdf?sequence=1&isAllowed=y
[2] https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200411-sitrep-82-covid-19.pdf?sfvrsn=74a5d15_2
[3] https://www.thelancet.com/action/showPdf?pii=S0140-6736%2820%2930644-9
[4] https://www.frontlinehealthworkers.org/sites/fhw/files/fhwc_covid-19_recommendations.pdf
Theme
Addressing Health Care Workers’ Challenges in Response to COVID-19: sharing experiences and drawing countries’ lessons
Objectives
General objectives
As inputs for the 11th AAAH conference, a series of webinar will be convened prior to the conference as follows:
- To share national and global experiences in planning and implementing to mobilize the surge capacity of HCWs who are responsible for public health actions and clinical services in response to COVID-19 pandemic, identify challenges and recommend effective solutions;
- To share national and global experiences on measures which reduce occupation hazards and violence from COVID-19 infection and mortality in HCWs; to discuss and promote approaches that ensure HCW’s mental health, well-being and resilience; to discuss data systems which capture morbidity and mortality from COVID-19 in HCWs; and to identify challenges and recommend effective solutions; and
- To share national experiences on pre-service health professional training in the context of school closures due to COVID-19 pandemic and HCW in-service and graduate training for effective response to public health emergencies, identify challenges and recommend effective solutions.
Webinar 1: Mobilizing surge capacity of health care workers in response to COVID-19 pandemic
Episode 1: Mobilizing surge capacity for public health actions, which include field epidemiologists, public health workforce for case identification, contact tracing, quarantine, risk communication and community engagement, leverage of private sectors, identify innovation strategies (if any), challenges and recommend effective solutions;
Episode 2: Mobilizing surge capacity for diagnostic and clinical management which include physicians, nurses and midwifes, pharmacists, laboratory technicians. What additional measures are introduced such as package of financial, non-financial incentive including social recognition packages, identify challenges and recommend effective solutions;
Episode 3: Sustaining non-COVID-19 essential health services and maintaining quality of care (such as non-communicable diseases, accident and emergencies, and other medical urgencies) by HCWs in the context of COVID-19 response.
Webinar 2: Occupational risk protection of health care workers
Episode 1: Country experiences from the WHO three Regions (EMR, SEAR and WPR) on measures to ensure occupational safety of HCWs against infection and mortality, financing for treatment cost of HCWs affected from COVID infection; COVID insurance coverage, additional hardship incentives and allowance, and adequacy of personal protective gears;
Episode 2: Country experiences from the WHO three Regions (EMR, SEAR and WPR) on impact of COVID on health care workers’ mental health, stressful work environment, and government’s psychosocial support, including violence against health care workers (if any), and HCW resilience.
Webinar 3: National experiences on pre-service health professional training in the context of school closures due to COVID-19 pandemic and HCW in-service and graduate training for effective response to public health emergencies
Episode 1: Country experiences from the WHO three Regions (EMR, SEAR and WPR) on innovations, challenges and effective solutions on pre-service HCW training such as online training and clinical practicum (a. medical and b. nursing and midwifery) in the context of school closures;
Episode 2: Review country experiences from the WHO three Regions (EMR, SEAR and WPR) on investment on HCW pre-service, in-service and post-graduate training related to public health competencies; in relation to clinical versus. This lesson will guide future direction of skill mix essential for effective response to public health emergencies.
The 11st AAAH Webinar Series 2020
“Addressing Health Care Workers’ Challenges in Response to COVID-19:
sharing experiences and drawing countries’ lessons”
Webinar 1: Mobilizing surge capacity of health care workers in response to COVID-19 pandemic
- Episode 1: Mobilizing surge capacity for public health actions, which include field epidemiologists, public health workforce for case identification, contact tracing, quarantine, risk communication and community engagement, leverage of private sectors, identify innovation strategies (if any), challenges and recommend effective solutions.
Link to registration (Closed on 12 August 2020): https://us02web.zoom.us/webinar/register/3015965125477/WN_mDaIWC58Rg6iAq99yAe81w
Host: WHO South-East Asia Region
Co-host: USAID and Assian Development Bank
Date and time: 14 August 2020; 18.00-19:45h Bangkok time (UTC+7)
Main issues (background):
Health workers (HWs) are at the forefront of the COVID-19 response. They not only play a critical role in delivering COVID-19 related care but also in preventing the transmission of the virus and in delivering routine essential health services.
Most countries in Eastern Mediterranean, South-East Asia and Western Pacific regions already face an overall shortage of health workers, along with skill-mix imbalances, geographical maldistribution and a short supply of clinical specialists.
Rapid increases in the workload due to COVID-19 related demand for services has further exacerbated the shortages. In addition, countries have had to plan and create the surge capacity for the health workforce to meet the growing COVID-19 public health needs such as case identification, contact tracing, quarantine and isolation and risk communication among others.
The emerging health workforce situation poses a challenge for the COVID-19 response that needs to be addressed. Countries in the three regions have been implementing policy actions and initiatives to address the health workforce needs. This webinar presents an opportunity to share some good practices on health workforce policy, planning, management and training.
Objectives:
- Recognize the current public health workforce challenges for the COVID-19 response and efforts undertaken to address them;
- Share good practices and lessons learnt on improving public health workforce surge capacity to respond to COVID-19 pandemic;
- Identify policy options and actions needed to strengthen the public health workforce, to create a resilient health system and to respond to COVID-19.
Potential moderator / speakers / commentary
Introductory Remarks
Manoj Jhalani
Director, Department of Health Systems Development
World Health Organization South-East Asia Regional Office
India
Mr. Manoj Jhalani is the Director, Health Systems Development, WHO, Regional Office for South-East Asia, New Delhi. He has been a member of the Indian Administrative Service. Between March 2012 to November 2019, he served in the Ministry of Health and Family Welfare, Government of India as Joint Secretary (Policy) and later as Mission Director, National Health Mission (NHM) while holding the post of Additional Secretary and Special Secretary to the Govt. of India. Between 1987 to 2012, he served at sub-district, district and state levels in planning, designing and implementing policies and programmes in the social sectors in the state of Madhya Pradesh, India. He did MBA in Public Service from The University of Birmingham, United Kingdom and B. Tech from the Indian Institute of Technology (IIT), Kanpur. Several awards and accomplishments to his credit including the UNIATF award for his contribution towards addressing NCD challenge in India.
Moderator
Wanda Jaskiewicz
HRH2030 Project Director
Chemonics International
USA
Wanda Jaskiewicz leads the global USAID Human Resources for Health in 2030 (HRH2030) Program at Chemonics. She has more than 20 years of experience in international health and development with a focus on human resources for health, HIV/AIDS, family planning, reproductive health, and maternal and child health. She has worked in more than 25 countries, providing strategic leadership to global and national initiatives to strengthen the health workforce. Ms. Jaskiewicz has supported the development of effective human resource management systems to produce, recruit, and retain competent health workers for increased access to quality health services. She has also created evidence-based tools to assist ministries of health in developing workforce incentive packages as well as measuring and improving health worker performance. Ms. Jaskiewicz holds an M.P.H. from the Tulane University School of Public Health and Tropical Medicine and a B.A. in biology from Dartmouth College.
Speakers
Assad Hafeez
Vice Chancellor
Health Services Academy University, Islamabad
Pakistan
Rajan Khobragade
Principal Secretary Department of Health, Kerala State
India
Yik Ying Teo
Dean (Saw Swee Hock School of Public Health)
National University of Singapore
Singapore
Prof Yik-Ying Teo, or commonly known as YY, is the second Dean of the Saw Swee Hock School of Public Health at the National University of Singapore. Trained as a mathematician at Imperial College and completed his MSc and DPhil at Oxford in statistical genetics, YY returned to Singapore in 2010 after working for four years as a Lecturer in Oxford and concurrently a researcher at the Wellcome Trust Centre for Human Genetics. Prior to his Deanship, he was the Founding Director for the Centre for Health Services and Policy Research, and also the Director for the Center for Infectious Disease Epidemiology and Research. He is presently a member on the Council of Scientists for the International Human Frontier Science Program, as well as a member governing board member of the Regional Centre for Tropical Medicine and Public Health Network for Southeast Asia.
Commentary
Gabriel Leung
Dean of Medicine
The University of Hong Kong
Hong Kong (SAR)
Gabriel Leung is the fortieth Dean of Medicine (2013-), inaugural Helen and Francis Zimmern Professor in Population Health and holds the Chair of Public Health Medicine at the University of Hong Kong (HKU). He was the last Head of Community Medicine (2012-3) at the University as well as Hong Kong's first Under Secretary for Food and Health (2008-11) and fifth Director of the Chief Executive's Office (2011-2) in government.
Closing Remarks
Patrick Osewe
Chief of Health Sector Group
Asian Development Bank
Philippines
Dr. Patrick L. Osewe is the Chief of the Health Sector Group at the Asian Development Bank (ADB). He provides leadership on policy, technical, and operational matters. In close collaboration with the Sector Committee, he leads the application of evidence based and innovative approaches to address priority and emerging health issues in Asia and the Pacific. Since the outbreak of the coronavirus disease (COVID-19), Patrick has provided leadership and guidance in the implementation of ADB’s $20 billion commitment to respond to COVID-19. His work related to COVID-19 includes convening global partners to reach consensus and prioritize investments, mobilizing leading private sector firms to support a range of response activities, and collaborating with International Air Transport Association, International Civil Aviation Organization, airlines, and hotels to safely restore travel and tourism industries based on available evidence.
Audiences:
- National and subnational health policy-makers responsible for developing and implementing health workforce plans for COVID-19 response
- International organizations, professional associations, and research institutions working in the field of health systems and more specifically in the area of human resources for health
Agenda
| Time | Programme | Remarks |
|
17:30-17:50 |
0. Preparatory session Welcomes speakers, checks connections and presentations, final housekeeping arrangements |
This session will not be broadcast. |
|
17:50-18:00 |
Session goes live and waits for the participants to log in | Title slide on |
|
18:00-18:10 |
1. Setting the scene Mr Manoj Jhalani, Director Health Systems Development, WHO South-East Asia Region |
Title slide off |
|
18:10-18:13 |
2.Moderator Wanda Jaskiewicz, Director of the USAID/HRH2030 project (Suggested from USAID/HRH2030) |
Title slide off |
|
18:13-18:25 |
3.Speaker 1 Topic: Dr Assad Hafeez, Vice Chancellor, Health Services Academy University, Islamabad, Pakistan |
Screen shared by speaker
(backup by the secretariat if needed) |
|
18:25-18:37 |
4.Speaker 2 Topic: Dr Rajan Khobragade, Principal Secretary Department of Health, Kerala State, India |
Screen shared by speaker
(backup by the secretariat if needed) |
|
18:37-18:49 |
5.Speaker 3 Topic: Professor Yik-Ying Teo, Dean of the Saw Swee Hock School of Public Health at the National University of Singapore |
Screen shared by speaker
(backup by the secretariat if needed) |
|
18:49-19:00 |
6.Commentary Prof Gabriel Leung, Dean of Medicine and Chair of Public Health Medicine at the University of Hong Kong, Hong Kong |
Screen shared by speaker
(backup by the secretariat if needed) |
|
19:00-19:35 |
7. Moderated Q&A Wanda Jaskiewicz, Director of the USAID/HRH2030 project (Suggested from USAID/HRH2030) |
|
|
19:35-19:45 |
8. Summary and next steps Dr. Patrick Osewe, Chief of the Health Sector Group, Asian Development Bank (Suggested from ADB) |
Slide off |
Key questions: (to guide the presentations)
- Policy level: What policy actions has your country taken to meet the growing demand for public health workers for the COVID-19 response? How does the country plan to address the surge capacity for public health workers? What policy initiatives have been implemented to ensure safety and motivation of health workers?
- Organizational & management level: What interventions have been out in place at the facility level to optimize the effective use of the limited public health workforce?
- Individual level: What interventions have been taken to repurpose and upskill health workers to respond to COVID-19 and deliver public health actions?
Outcome/Deliverable:
- Participants learn good practices and identify policy options on increasing surge capacity of public health workers
- Produce a policy brief (short) on this session (or joint brief with Webinar 1 Episode 2). Hire a senior consultant to do this.
- Webinar is widely distributed through social media (IHPP takes the lead on this with support from SEARO, HRH2030 and ADB, who will also distribute it across their networks)
- Publication of a paper
- Write a bloq about the webinar
Logistics
- Presentations: For speakers and commentary,
- Please prepare your presentations based on the key questions (maximum 10 slides in total) and kindly share with us at least 1 day before the webinar’s date.
- Please share your slides from your end for easy transitioning of slides, while we’ll prepare your presentations handy in case you have technical issues (such as low bandwidth).
- Zoom (May be changed): For speakers and commentary,
- Please use the panelist invitation link separately sent to you to log in as a “panelist”, so that you can share your screen and also see the list of participants and questions. If you haven’t received the invitation, please let us know.
- Questions will be taken up by zoom Q&A feature; moderator of session will moderate the questions and request speakers to respond to relevant questions. We’d appreciate your spot-on, concise answers, to accommodate maximum number of questions.
- Please feel free to contact Ms. Boonyarak Chanprasobpol (boonyarak@ihpp.thaigov.net, +66-81-897-7719) for technical/connectivity issues before and during the webinar.