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Washington, DC, October 19-21, 2010

The purpose of this meeting is to bring together a small group of experts who have experience in data management and analysis, as well as in the application of evidence to HRH planning, with the objective of exploring a Regional process and system for HRH data collection, management and analysis. A Regional framework and process will help the countries of the Region to more effectively gather sufficient HRH data to produce valid, quality evidence on which to base decisions and to track the effects of health system policies.




The countries of the Americas have aligned their HRH policies with their health objectives to provide universal coverage with a renewal of primary health care. These policies have been focused in five priority need areas or challenges, highlighted by the Toronto Call to Action: policies and planning, distribution, education, workforce management, and management of migration.

Countries of the Americas Region have made great strides in linking the workforce policies as an integral factor to achieving the national health goals. Moving the policies to strategies has posed greater challenges. Decision makers often have not known, or have known very little about, the current situation of their workforces. Thus, strategic planning does not address targeted priorities as effectively as needed. Moreover capacities for monitoring trends or measuring effects of those policies are weak or non-existent.

Supported by PAHO technical cooperation, countries have engaged in establishing a core data set so as to better understand the landscape of the human resources, with regard to stocks, flows, and production, and to be able to take more informed decisions.

In addition, the countries agreed to a set of indicators, or 20 goals, as priority objectives toward which to plan their strategies for overcoming the five challenges and attaining an effective health workforce that will be well trained, well-distributed, and motivated to delivery quality care based on a primary health care model.

It has become evident that the countries of the Region need some sort of standardized process for collecting data, assessing indicators, and establishing processes for monitoring and evaluation. A guide that could be used throughout the Region as a common framework for building evidence, monitoring progress, and evaluating trends and comparisons would provide:

  • A definition of a basic set of data that should be most useful in analyzing the workforce and making decisions
  • A Regional taxonomy and guidelines for the collection, reporting, and monitoring of data to allow comparisons among countries and sub-regions.
  • Access to a database either that would connect with the national HRH database or, when one does not exist, will provide a platform through which the national data might be stored.

Currently the Region is re-positioning its Observatories at the national, sub-regional, and Regional levels to more directly address the gathering and use of quality and valid data, the assessment and monitoring of indicators, and the contribution of research so as to provide substantial and dependable information on which decision-makers may form policies and develop strategies, and then track the results of those plans.

To this end, the Regional advisors join with networks of demographers, statisticians, and researchers to provide technical support, leadership, and expertise to the Regional Observatories for Human Resources in Health in the Americas.


The countries of the Americans Region will have a framework through which they can gather a sufficient set of core HRH data, use that data to assess needs in workforce development, and use that information to target initiatives, evaluate/ monitor progress, and identify needed research areas. In addition, the countries will use an information system to disseminate data through the sub-regional website nodes and a Regional Observatory websites.


  • Define an initial Core Data Set for Americas Region
    • Professions in three areas of health: Service Delivery, and Management and Education
    • Definitions/ Glossary of those Professions
    • Variables that will constitute core data on those Professions (such as numbers, age, gender, linguistic abilities, years of service, FTE).
  • Identify key sources and "collectability" of data from those sources
  • Propose guidelines for validation and quality assurance of data
  • Identify best practice framework for a process of collection, management, analysis, and dissemination that can be outlined for the countries.
  • Discuss a "backend" database for observatory (regional and sub-regional levels) that can be used by the country managers to collect, enter, manage and information
  • Reach consensus on some key indicators that the Observatory should make available for users so that they have access to key workforce information (such as stocks and flows, education, migration, distribution, productivity, access, competencies, and relation of workforce indicators to health systems indicators and population health outcomes)


  • Shared understanding of common information needs, access to data, and information management processes across the countries of the Region
  • Outline and Elements of a Guide that may be used in the countries to standardize HRH data gathering and management
  • Begin the cooperation and sharing of ideas and recommendations among a network of HRH experts
  • Agreement on an initial set of core data on HRH, basic definitions of key occupational categories, main sources of information, and collection processes


 Meeting Agenda

Tuesday, 19 October 2010

8:30am Opening remarks Charles Godue
9:00am Introductions All
9:30am New Direction of the Observatory Hernán Sepúlveda
10:00am Context of HRH data in the Americas and Outline of Topics to be Discussed Allison Foster
11:15am COFFEE BREAK  
11:30am Professions: Management
Selection of Professions to Include in Core Data
1:00pm LUNCH  
2:00pm Taxonomy of Professions
Review professions and clarify the parameters that will define those for selected professions for mapping (Refer to ILO, Latin American Demographic Center, WHO-FIC, etc)
4:00pm Continue with Taxonomy All
5:00pm CLOSE  

Wednesday, 20 October 2010

8:30am Review of Previous Days Discussions Charles Godue
9:00am Production: Data Elements for Core Data Set to Measure, Assess, and Monitor Production of Health Workforce All
11:15am COFFEE BREAK  
11:00am Integration with the Health Indicators
Statistical Unit will Share their work in Health Statistics
Patricia Ruiz, Health Surveillance, Disease Prevention and Control
12:00pm Process for Collection
  • Sources
  • "Collectability"
  • Process of Moving Information from Sources to Analysis
  • Quality Assurance
  • Validation
  • Approval
  • Sharing of Analysis
1:00pm LUNCH  
2:00pm Process for Collection
(Continue Discussion)
3:45pm Indicators for HRH in the Americas
What information on numbers, relationships, and ratios are most important for users of the Observatories? How is this information best presented?
6:15pm CLOSE  
6:15pm Optional social event:For those who want to join for dinner, meet in the Virginia Avenue lobby of the State Plaza and we will join for dinner.  

Thursday, 21 Octuber 2010

8:30am Review of Previous Days Discussions Allison Foster
9:30am Managing Technologies for Databases
Best Practices and Options for the Observatory
11:00am COFFEE BREAK  
11:15am Final Summary of Consensus on Topics
  • Questions and Comments
12:30am Next Steps Charles Godue
1:00pm CLOSE  


 List of Participants

  • Rick Cameron, Principal, Cameron Health Strategies, Ltd, Halifax, Nova Scotia, Canada
  • Sabado Girardi, Gerente, Secretaria de Estado de Saúde de Minas Gerais, y Investigador, Núcleo de Educação em Saúde Coletiva (NESCON), Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brasil
  • Neeru Gupta, Demographer, Health Workforce Information and Governance Department, Human Resources for Health, World Health Organization (WHO), Geneva, Switzerland
  • Gustavo Nigenda, Investigador en Ciencias Médicas E Director de Innovación en Servicios y Sistemas de Salud, Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública (INSP), Cuernavaca, México
  • Edward Salsberg, Director, National Center for Health Workforce Studies, U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), Bureau of Professions, Rockville, Maryland, USA
  • Members of the PAHO HRH Unit: Hernán Sepulveda, Allison Annette Foster, and Charles Godue, PAHO, Washington, DC
  • Members of the Health Surveillance, Disease Prevention and Control Unit: Oscar Mujica, Antonio Escamilla and Patricia Ruiz, PAHO, Washington, DC

 Working Documents

 Background Documents