Leading Voices: Meet Shelemo Shawula

September 07, 2018

Leading Voices: Meet Shelemo Shawula

Improving Human Resources through Better Management Tools and Approaches

Dr. Shelemo Shawula, Senior Human Resources Management (HRM) Advisor for the Improved HRM Capacity component of the USAID-funded and Jhpiego-led Strengthening Human Resources for Health (HRH) Project in Ethiopia, led countrywide regional teams of HRM officers in improving the capacity of HR managers and their staff at all levels of the health sector. Through his strong leadership and management of the HRM component, the project surpassed targets and set the stage for further commitments and investments in HRH. MSH recently supported an assessment of HRM achievements under the project. Dr. Shawula discusses his work with the project and MSH’s work in Ethiopia.

Hello Shelemo, what is it that drives you?

The passion to improve the health status of Ethiopians, the daily challenges that I face due to the complex nature of human resource management (HRM), and the limited attention and support from health sector leaders. My focus is that I always strive to do something and do it well.

How did you get to where you are today?

I am a doctor of medicine and received a master of public health from Addis Ababa University (Ethiopia) and the University of Leeds (United Kingdom), respectively. In the past 19 years, I’ve worked as a clinician, as well as managing and leading health organizations and public health programs. As a young medical director for a large referral hospital in Ethiopia, I faced HRM-related challenges, including poor performance, and quality of care. That is the main reason I went into public health to seek management and leadership skills and address these challenges.

Today, I continue to work on strengthening HR planning and management in the broader health sector context for organizational and programmatic effectiveness that creates access to quality health care and public health services as well as improved performance and productivity of the health sector workforce.

Why did the HRH Project want to conduct the assessment of HRM achievements and why was doing so important?

The aim was to understand, consolidate, and document the key achievements, barriers, and enabling factors for strengthening HRM in Ethiopia’s public health sector. MSH is an implementing partner of the Strengthening HRH Project in Ethiopia. The review also contributes to the overall program documentation and learning agenda and determines the most promising practices to guide future HRM programming in similar settings.

What are the most important key points from the assessment?

A comprehensive participatory HRM capacity assessment with a multidisciplinary team of experts from the organization was a good entry point to develop jointly agreed upon actions and setting the stage for successful implementation. Putting the government (Federal Ministry of Health [FMOH] at national and sub-national levels and its stakeholders, such as the Ministry of Civil Service and their regional offices) in the driver’s seat was key to project effectiveness. The project was able to successfully advocate for and involve these stakeholders during HRM in-service curriculum development, national HRH strategic plan development, restructuring the health sector functions to create dedicated HR units at sub-regional levels, and increasing the number of HR positions at all levels.

Who will benefit most from this assessment and how?

Implementing partners of the HRH project, Ministry of Health, and other stakeholders interested in strengthening HRH in the country.

What do you hope this assessment will accomplish?

It will be disseminated and utilized as a reference document for the HR Directorate at national and regional levels.

It’s been five years since the HRH Ethiopia Project first launched. What impact have we made in our work?

Using the MSH-developed HRM Capacity Assessment Tool for Health Organizations, we have identified a need to address the lack of HR structures; low HR staffing levels; and limited knowledge, skills, attitude, and practices of existing HR staff across the health sector. Through advocacy, technical, and financial inputs, we now have more than 1,300 additional HR positions at various levels in the health sector, and helped to fill more than 95% of the newly created and existing vacant HR positions. The minimum qualifications for the HR positions have been revised to meet the dynamic needs of health sector human resources. To equip HR managers and staff, a standardized HRH management in-service training was provided to more than 2,700 HR staff from the FMOH, regional health bureaus (RHBs); district and facility levels received additional HRM training.

In addition to the improved HRM capacity, we have also improved the understanding, availability, and utilization of HRM policy and procedure documents and established HRH stakeholders’ fora at national and regional levels to improve collaboration and partnership for health sector HR. With thorough planning, the recruitment and distribution of health workers have been improved. Lastly, through our work, we have elevated the importance that HRM plays as a key function in the health sector.

What are HRH Ethiopia’s biggest achievements?

Creating and filling more than 1,300 additional permanent, government-salaried HR positions at all levels of the health system. A standardized HRH management in-service training curriculum was the first of its kind in the country. The HRH Project baseline survey showed that none of the HR staff interviewed received any training in HRM in the past. Guided by the curriculum, more than 2,700 HR staff were trained to develop competence as HR staff. This training has not only contributed to their knowledge, skills, and attitudes but also improved the image of HR functions as a key component of health sector performance and the value HR staff have in the sector. When you only provide training, coaching, and mentoring, many of the staff can still end up unemployed. Increasing the number of permanent positions is a foundation for sustainable HRM capacity in the country, where HR positions will continue to be present beyond the project. Improved HRM capacity has significantly improved recruitment, orientation, deployment, and retention practices over the project period and contributed to doubling the number of the health workforce from 106,000 during the HRH Project baseline survey to more than 200,000 by the end of the project.

What accomplishments during your time with the project are you most proud of?

In 2012, I worked with the FMOH’s HR Directorate and developed two important documents: the Employee Handbook (Staff Orientation Manual) that was later adopted/adapted by the RHBs, and restructuring and improving the HRM Unit at the FMOH by applying workload indicators of staffing need. The request came from Dr. Amir Aman, who was a state minister back then and is currently the minister of health. I was alone at that time (no other MSH staff was onboard the HRH Project yet) and I was able to produce documents within the requested time frame. I established a solid ground and reputation as an individual and an MSHer. This relationship became the foundation of our work, enabling us to eventually improve HR governance structures and staffing, HRH management in-service training, as well as initiate a motivation and retention study, and more.

What can we do better?

Improve our tools and techniques to strengthening forecasting and projections (models) for medium-term and long-term HRM in resource-limited settings, like Ethiopia. Link strategic HRM with improved financing, including advocacy, planning, mobilization, and efficient utilization of financial resources to attain HRH goals and universal health coverage.

What do you think makes MSH different?

MSH has the capability and commitment to strengthen health systems, HRH being one. MSH also has a lot of tools such as the HRM Capacity Assessment and the Management and Organizational Sustainability Tool (MOST) readily available for use to improve health systems performance.

Is MSH’s work done in Ethiopia?

Not yet. As MSHers, we have achieved a lot, but the need is still greater. In HRH, we have just started to build a very good reputation in health sector HR in Ethiopia. If resources allow us, we have a great deal to do, in partnership with the FMOH, RHBs, and decentralized district governance systems.

Finish this sentence: Health is ___

Health is a basic human right, and health workers are the drivers.

This story was made possible by the generous support of the American people through the US Agency for International Development (USAID) under cooperative agreement AID-663-A-12-00008. The contents are the responsibility of Jhpiego and its partner Management Sciences for Health (MSH) and do not necessarily reflect the views of USAID or the United States Government.