Human Resources for Health in Maternal, Neonatal and - HRH ...

Health system standards are explicit statements of expected quality and can be categorised
according to their technical and administrative features (QAP 2009). At the input level HRH
performance standards such as administrative policies, rules and regulations and
qualifications are labelled as administrative standards. Among the list of technical standards
are job descriptions and specifications, or detailed descriptions of what is required of a
product or service. An example of this in an HRH context might be the performance
requirements and quality standards required in maternal health services such as that they are
staffed 24hrs a day.
Table 26 Taxonomy of Health System Standards
System Components
Categories
Administrative
Technical
INPUT
Administrative policies
Rules and regulations
Job descriptions
Specifications
Qualifications
PROCESS Standard operating procedures Algorithms
Clinical pathways
Clinical practice guidelines
guidelines
Procedures
Protocols
Standing orders
OUTCOME Expected results Health outcomes
At the process level standard operating procedures such as the payroll or grievance
procedures can be considered administrative standards while a protocol on the management
of patient care is technical. The measurement of the characteristics of these standards at the
input and process levels can help shed light on outputs in terms of productivity and quality of
care. This is where indicators play an important role in quality improvement, health worker
accountability and linking inputs and interventions to outcomes.
An example of the use of standards in performance evaluation is Jhpeigo‘s Standards-Based
Management and Recognition (SBM-R) tool, a practical management approach for
improving the performance and quality of health services (2005). Jhpiego has adapted SBM-
R to a process for defining and achieving high-quality midwifery education in Afghanistan.
The Ministry of Public Health, Jhpiego and partners developed 59 educational standards and
supported the establishment of a Midwifery Education Accreditation Board. The schools used
the explicitly detailed standards to evaluate their performance, define their needs and mark
their progress. The Board oversees external evaluations and formal accreditation. Thus far, 13
of Afghanistan‘s 21 midwifery schools have achieved accreditation, and the remainder are
continuing their process of performance improvement and anticipate accreditation soon.
HRH performance indicators
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