📋 Tender Overview
This document presents the results of the study entitled Analysis of the structure, dynamics and composition of the health workforce in Costa Rica, in the context of the COVID-19 pandemic. At the end of the nineties of the last century and the beginning of the first decade of this century, similar studies were carried out that made it possible to have a clear picture of the situation of human resources in the country and to identify the main trends and challenges. Since then, a similar investigation had not been carried out to date, which is why the Health Systems and Services Area of the Pan American Health Organization (PAHO/WHO) in Costa Rica, in coordination with the Directorate of Health Services of the Ministry of Health, agreed to carry out this research.
The purpose of this study is to contribute to the knowledge and debate on the situation of the health workforce in Costa Rica, the challenges faced by the country in this field and to advance in the formulation of a policy and planning of Human Resources in Health (RHUS) at the sectoral level. This type of analysis became particularly relevant in the context of the COVID-19 pandemic, which produced an unexpected increase in the demand for health professionals (especially nurses, general practitioners and specialists, among others); also, because it supports the containment of the emergency and its aftermath, as well as aspects related to the health and safety of the health workforce. The latter makes evident, once again, the urgent need to better understand the situation of the health workforce and the challenges for the short and medium term.
The objectives of this research were the following:
a) To carry out an analysis of the health workforce, at the national level, in the context of the COVID-19 pandemic, taking into account its structure, composition and dynamics, both in the public and private sectors.
(b) To analyse the availability and characteristics of the information on the country's health workforce brought together by the National System of Human Resources in Health (SINARHUS), as well as to formulate recommendations that contribute to strengthening it;
(c) Identify the main challenges facing the country in relation to the management of the health workforce;
The research was carried out in four stages that are detailed below: conceptualization, characterization, collection and systematization of statistical data and, finally, semi-structured interviews and systematization of challenges. In the first stage, a conceptualization of the issue of the health workforce and the public health workforce was carried out, including the field of professional practice of these workers and their contribution to the health goals of a country. Also, the concept of human resources in health and the space in which these workers interact with other social actors, with different interests and power, were reviewed. Finally, reference is made to the structuring processes of human resources in health that condition both supply and demand, namely, education and work.
In a second stage of the study, a work was carried out to characterize the organization of the National Health System and the Health Sector of Costa Rica, with special reference to the institutions that make them up and, in the case of the Public Health Sector, the way in which the public supply of health services is organized. Particularly important in this regard is the recognition of the structuring of health services networks in the public sector. A similar effort, although much more limited due to the lack of information, was made in the case of the private health sector.
A third stage of research work focused on the collection and systematization of statistical data on the health workforce in Costa Rica, based on two sources of information: the National Institute of Statistics and Census (INEC) and SINARHUS. Based on the data provided by these two entities, a characterization and analysis of the health workforce in the Public Sector was made, in relation to aspects such as:
Structure and composition of the health workforce. Data related to health professionals and technicians were systematized, according to occupational group, main employers, forms of contracting, geographical location, among others.
Dynamics of the health workforce. An analysis of the dynamics of the health workforce was made, with special reference to recent years, its main trends and challenges.
Training of the health workforce. With respect to the training entities of human resources in health, aspects such as: main training entities, type of careers by training entity, lists by occupational group and condition (graduates, active), among others, were seen.
Finally, in the fourth and final stage of this research, two activities were carried out. First, semi-structured interviews were conducted with some authorities and officials of the Health Sector (see Annex 1) and some professional associations, to obtain their perspective of the situation of the country's health workforce, with special reference to the context of the COVID-19 pandemic. Secondly, a work was done to systematize the main challenges faced by the management of human resources in health, in the face of the transformations that the field of health has been experiencing at the technological, epidemiological and management levels of health services; as well as those that the country's health personnel and services will face, as a result of the COVID-19 pandemic.
The results of this study are organized into the following chapters and sections. In the second chapter, the theoretical-conceptual elements related to the health workforce are presented. The third chapter presents the structure of the sector and the National Health System of Costa Rica, with special reference to the case of the largest public institution that provides health services to the population, the Costa Rican Social Security Fund (CCSS).
