Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2012 2013 2014 2015 2016 2017

Details for Mechanism ID: 11972
Country/Region: Dominican Republic
Year: 2012
Main Partner: IntraHealth International, Inc.
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: USAID
Total Funding: $0

The MOH employs approximately 57,000 health and administrative workers. Additional health staffs are employed by the Dominican Armed Forces (DAF), the Social Security Institute (IDSS) and the Teachers Health Insurance System (SEMMA), and the private for-profit and non-profit Sectors. The GODR estimates that 6 percent of its 57,000 workers are in the process of retiring (some are over 80 years old) and the government doesnt know where another six to seven percent of its employees are. In addition, a comparison of different MOH payrolls showed that 40% of all health workers appear on at least four payrolls and another 30% on at least three. This may explain the significant staff shortages found in remote or rural health services. Conversely, health facilities in and around the major cities have staff surpluses. A recent study on use of staff time in hospitals found that doctors who are contracted and paid for six hours of services, in fact only provide two hours. USAID/DR provides support to the MOH to develop a HR system needed to manage its workforce to perform effectively. This work includes developing new legislation to create a public health career and health worker career paths. This legislation was developed, with the support of the Ministries of Public Administration and of Public Health, and was discussed in a forum attended by representatives from 87 organizations, including members of Congress. This addresses the health sectors human resources as a means to ensure good governance. The law approved by the Senate is awaiting approval by Congress. In addition, Capacity Plus provides TA to develop HR policies, HR structures at all levels, position descriptions for staff at each hospital level and the corresponding salary scales.

Funding for Health Systems Strengthening (OHSS): $0

During 2013 CAPACITY Plus will continue to reinforce the importance of country-led implementation, provide TA and other support to the MOH to implement the new Public Health Career Law, and support the MOH to develop the HR departments needed at the central level and in least in three regions. It will also support the MOH to increase transparency in the payroll system, unify the different payrolls and implement a Human Resource System that will include the elemental HR functions, such as position descriptions, salary scales, supervision and evaluation, training plans and promotions to ensure health worker retention, transparency and accountability. All of this will translate into better access to care and improved health outcomes.

The CAPACITY PLUS local office will also train the HR staff at the various levels, so they will have the necessary tools and knowledge to implement the Human Resource System.

Subpartners Total: $0
Secretaria de Estado de Salud Publica: NA