Health Workforce Planning For Low-Income Countries – Democratic People’s Republic Of Korea

Importance of National Workforce Planning

The current assignment focuses upon the health workforce planning for low income countries as specified by World Health Organization (WHO). In the current assignment, the Democratic People’s Republic of Korea has been taken into consideration. The study here focuses upon the importance of national workforce planning. It aims at delivering a workforce which is deployed in the right numbers at the right places. A number of reasons could be provided over here for supporting the effective implementation of the national health workforce. There is an increase in the aged care population, which points towards increased complexity in the delivery of health and support care services (World Health Organization, 2016). Hence, planning an effective health workforce can help in the distribution of the right resources at the right time, in the right places.

Additionally, a change within the social attitudes affects the manner in which the care is delivered.  It is also very important to train the workforce on using a person centred approach which places satisfaction and well being of patients at the centre. The current study focuses upon the availability of health and support care services in the marginalized countries with poor economy. In the current study, a workforce planning has been done based upon the overall data collected for the region.

In the current study, the Democratic People’s Republic of Korea has been chosen. The Democratic People’s Republic of Korea or North Korea is an authoritarian state led by Kim and family. It is known to be one of the most repressed authoritarian countries of the world. The citizens of North Korea do not have the right to change their government and are subjected to rigid controls over many aspects including denial to the freedom of speech, assembly, association, religion, movement and worker rights. As mentioned by Beck, Singer, Buche, Manderscheid and Buerhaus (2018), amidst the political disharmony the health requirements of the North Korean citizens are seriously compromised. Additionally, the ones who have come across the borders are subjected to greater scrutiny in availing the healthcare services. The prisoners or the detainees are constantly reported to violence and torture. As commented by Murphy, Birch, Mackenzie, Rigby and Langley (2017), the prisoners or the refugees were even denied medical care. As reported by Crettenden et al.  (2014), the poor sanitation made the health disparities even wider. In many cases access to healthcare services were largely dependent upon loyalty to the government. In this respect, the people specifically living in the marginalized areas or across the border were expected to provide the government with all relevant and important information against any suspicious activities. In the context of any group or community found to possess anti-national sentiments or unwilling to get subjugated by the demands of the government, they were subjected to unequal access to health and support care services. Therefore, based upon the political unrest and the poor economy of the region it has been placed in the priority areas under the health and support care policies of the World healthcare organization.

Environmental Conditions of the Region through the STEEP Model

In order to conduct an environmental scan of the health and support care workforce of North Korea an effective framework could be followed over here such as the STEEP model which could be broken down into various components such as- social, technological, economic, environmental and political factors. A comprehensive evaluation of all these factors helps in understanding the preparedness of the health workforce of the country.   These have been represented in a table below as:

Factors Save Time On Research and Writing Hire a Pro to Write You a 100% Plagiarism-Free Paper. Get My Paper	Effects
Social	· The political unrest of the country prevents the healthcare professionals from travelling there. · The social unrest results in inequitable distribution of healthcare resources.
Technological	· The poor and not so friendly relations of North  Korea with other neighbouring countries affects the  process of exchange of  information on  latest technologies · The lack of expertise in the healthcare professionals regarding the handling and management of the latest technologies can affect the quality of the support and healthcare services.
Economic	· The unstable political conditions also  affects the creation and availability  of job opportunities which results in poor  economy · The lack of support from the government affects the quality of the health and support services delivered.
Environmental	· Unsustainable  human activities also results in poor economy and poor health conditions
Political factors	· Global  wars and terrorism  also affects the creation and the development of  effective  health care policies

Table: STEEP Environmental scan for the health workforce of North Korea

(Source: Author)

The above analysis provides a comprehensive overview of the overall environmental conditions of the region, which have a considerable effect over the healthcare policies. For example, the political unrest in the region prevents the healthcare professionals from travelling into North Korea which results in unequal distribution of healthcare services. As mentioned by Lopes, Almeida and Almada-Lobo (2015), the disputed relation of the country with other neighbouring regions also closes the door for the exchange of information on technological advancements and technological resources.  In the lack of help and support  from the adjacent regions  the  healthcare services of North Korea  are  placed within confined limits , which  also prevents exchange of  human  resources and overall quality  enhancement of  the healthcare services.

The data profile of the health workforce could be presented on the basis of stats and figures.   For instance, the health workforce distribution of the North Korea region has been discussed over here with reference to per 1000 population. The health workforce have been divided into nine categories and their availability per thousand of the population have been represented below in a tabular format

Category  wis  human resources	Availability per 1000 of the population
Physicians	27
Nursing and midwifery professional	43.2
Dentistry personnel	0.4
Pharmaceutical  personnel	0.6
Laboratory  health workers	0.1
Environment and public health workers	0.2
Community and traditional  health workers	0.3
Other health workers	0.05
Health management and support workers	11.8

In the above table, the statistical distribution of the healthcare workers per 1000 residents in North Korea has been discussed. The healthcare workforce have been divided into  nine different categories such as – physicians, nursing midwifery professional, dentistry personnel, pharmaceutical personnel, laboratory health workers, environmental and public health workers, community and traditional healthcare workers, other healthcare workers and health management and support  workers. The  highest number were recorded for nursing and midwifery professionals with 43.2 nurses for  per 100 of the population, 27 physicians  per 1000 of the population followed  by 11.8 for  health management  and support  workers (euro.who.int, 2018). In this regard, consecutively lower number was recorded for dentists, pharmaceutical professionals, laboratory and other health workers (Yamalik, Ensaldo?Carrasco, Cavalle & Kell, 2014). Therefore, depending upon less availability of healthcare professionals the overall health situation of North Korea is compromised. Therefore, the government should provide sufficient help and encouragement to the training and absorption of more healthcare professionals to cope up with the issues of   unequal distribution.

Challenges in Effective Planning of the Health Workforce

There are a number of critical issues faced in effective planning of the health workforce which could be further divided into internal and external factors. The internal factor refers to problems in effective recruitment and retention of the workforce, poor geographical distribution of the skilled set of workers, the mismatches of skills with the recent technological interventions and challenges. As mentioned by Lopes, Almeida and Almada-Lobo (2015), North Korea is a closed economy which along with the political unrest challenges the exchange of effective human resources.  As argued by Addicott, Maguire, Honeyman and Jabbal (2015), due to the political unrest and the sceptical and intolerant attitude towards   refugees and foreigners the healthcare professionals do not want to visit the region. The lack of reconciliation of North Korea with the neighbouring counties also affects the exchange of technology and interventions. These further results in the healthcare professionals lacking   sufficient knowledge of the new interventions and technologies, compromising the quality of the health and support care services.

Additionally, the poor distribution of the skilled set of workers also affects the overall quality of the services.  It  could  be further reflected upon from the above  presented chart   where  it had been clearly  depicted that the distribution of  allied  healthcare workforce  in North  Korea is of poor quality which further aggravates the  problem  of unequal distribution  of healthcare services (Kepley & Streeter, 2018). The political unrest and being in odd terms with the neighbouring counties prevents the access to monetary help in times of need or emergency. This had lead to North Korea becoming one black hole of suffering where people are deprived of the fundamental rights such as healthcare.

A number of strategies could be used for an effective workforce planning. Some of these could be discussed in a number of stages such as data, strategies, planning and evaluation.  In the first step an effective analysis of the current health care workforce is required which also helps in evaluating the needs for the future. Based upon the requirements of the future, effective workforce training or planning is required. The planning stage is important as it helps in filling the workforce gaps by focussing upon the needs versus the skills (Tobing, 2017).  As mentioned by De Bruecker, Van den Bergh, Beliën and  Demeulemeester (2015), the planning stage is based upon enrichment of the present set of workforce by exposing them to proper technological interventions. The evaluation is the ability to monitor the effectiveness of the plan, which is fully dependent upon the measurement standards applied.

Additionally, for the effective implementation of the healthcare workforce plan sufficient support and participation is required from the federal government, as well as the local and community health care centres (Mossialos et al., 2015). In order to develop an effective workforce conducting an internal audit is beneficial. This could be done in the form of a survey where sufficient data regarding the skills possessed by the employees are analysed.  For this sufficient cooperation from the national healthcare agencies are required. The data gathered from the internal audit helps in identification of the strengths and weaknesses of the workforce which could be used for developing an appropriate training plan (Martsolf, Mason, Sloan, Sullivan & Villarruel, 2017). The strategies which could be implemented over here are undertaking national audits on a regular basis and planning budget accordingly for bringing about changes within the healthcare infrastructure so that they could be delivered at nominal prices to the marginalized section of the society.

Conclusion  

The current study focuses upon the aspect of health workforce planning. In the present study,   the region of North Korea had been taken into  consideration as it fall within  one of the low income countries which further affects the quality of  the healthcare services. The low economy in this case could be related to poor living conditions and less availability of effective job opportunities. This could be due to the political unrest prevailing in North Korea where the Government follows   strict authoritarian practice over the basic living fundamental rights of people.

Therefore, the ones do not raise their concern against the repressive government are often given stricter punishments such as  depriving them of  the basic fundamental rights such as  right  to health and support services.  Additionally, the political and economical unrest also affects the technological resources of the country based upon which the healthcare services are delivered (Kroezen, Buchan, Dussault, Glinos & Wismar, 2016). Hence, it is important to develop an effective health workforce planning in order to ensure proper distribution of the healthcare resources between the citizens.

References 

Addicott, R., Maguire, D., Honeyman, M., & Jabbal, J. (2015). Workforce planning in the NHS. King’s Fund.

Beck, A. J., Singer, P. M., Buche, J., Manderscheid, R. W., & Buerhaus, P. (2018). Improving data for behavioral health workforce planning: development of a minimum data set. American journal of preventive medicine, 54(6), S192-S198.

Crettenden, I. F., McCarty, M. V., Fenech, B. J., Heywood, T., Taitz, M. C., & Tudman, S. (2014). How evidence-based workforce planning in Australia is informing policy development in the retention and distribution of the health workforce. Human resources for health, 12(1), 7.

De Bruecker, P., Van den Bergh, J., Beliën, J., & Demeulemeester, E. (2015). Workforce planning incorporating skills: State of the art. European Journal of Operational Research, 243(1), 1-16.

euro.who.int (2018), euro.who.int , retrieved on 4 May 2018, from https://www.euro.who.int/__data/assets/pdf_file/0019/101476/E93762

Kepley, H. O., & Streeter, R. A. (2018). Closing behavioral health workforce gaps: a HRSA program expanding direct mental health service access in underserved areas.

Kroezen, M., Buchan, J., Dussault, G., Glinos, I., & Wismar, M. (2016). How can structured cooperation between countries address health workforce challenges related to highly specialized health care? Improving access to services through voluntary cooperation in the EU. Policy Brief, 20.

Lopes, M. A., Almeida, Á. S., & Almada-Lobo, B. (2015). Handling healthcare workforce planning with care: where do we stand?. Human resources for health, 13(1), 38.

Martsolf, G., Mason, D. J., Sloan, J., Sullivan, C. G., & Villarruel, A. M. (2017). Nurse-Designed Care Models.

Miller, F. A., Bytautas, J., & Feng, P. (2018). Opportunities for Engaging Canadian Health Systems in Addressing the Challenge of Climate Change.

Mossialos, E., Courtin, E., Naci, H., Benrimoj, S., Bouvy, M., Farris, K., … & Sketris, I. (2015). From “retailers” to health care providers: transforming the role of community pharmacists in chronic disease management. Health Policy, 119(5), 628-639.

Murphy, G. T., Birch, S., Mackenzie, A., Rigby, J., & Langley, J. (2017). An Integrated Needs-Based Approach to Health Service and Health Workforce Planning: Applications for Pandemic Influenza. Healthcare Policy, 13(1), 28-42.

Tobing, D. S. K. (2017). The impact of asean economic community on workforce: Human resources planning.

World Health Organization (2016), WHO country cooperation strategy at a glance: Democratic People’s Republic of Korea.

Yamalik, N., Ensaldo?Carrasco, E., Cavalle, E., & Kell, K. (2014). Oral health workforce planning part 2: figures, determinants and trends in a sample of World Dental Federation member countries. International dental journal, 64(3), 117-126.