HR Case Study 2: Staropol District Health Office Looks at the Human Resource Implications of its New Responsibilities

Igor Ivanovich Stratonov, District Health Officer, Staropol District Health Office, and his management team-Maria Stepanovna Kopchuk, Chief of Family Planning Services; Galina Victorovna Zarivskaja, Chief of Maternal and Child Health Services; Roman Petrovich Malarenko, Immunization Officer; Andrei Andrejevich Larchenko, Training Coordinator; and Irina Dmitrijevna Gorlova, Chief Accountant, sat around a long table in the staff conference room. District Officer Stratonov started the meeting. "Welcome, colleagues," said Igor Ivanovich. "As you know, rumors have been flying for months about changes in the management structure of health services in our region. In meetings last week at the Regional Office, we were officially informed of two major changes for management of our district health program:

All staff working at the district level will become district employees and will no longer be employees of the Regional Office. They will be managed through the District Health Office, which will be responsible for determining staffing levels, hiring and firing, skill development, and performance management.

The Regional Office will provide each District Health Office with a set amount of annual funding. We will have to prepare an annual budget, submit it to the Regional Office for approval, and be accountable for managing our finances."

The room began to buzz as the team reacted to this news. Galina Victorovna responded first. "It seems to me that it is the human resource implications that we should be concerned with. If we are going to be responsible for managing all the staff in our district, then we better know who those workers are, their job titles, responsibilities, skills, and salaries. Does the Regional Office have that data?"

"You have made a good point," said Igor Ivanovich. "We should focus today on the human resource implications of these changes. Unfortunately, the Regional Office doesn't have good data on district-level staff. We will have to gather that ourselves. These data will help us assess our staffing, skill, and funding needs."

"Facility managers have already been telling us that we have too many skilled staff in some service delivery sites and not enough in others," said Roman Petrovich. "We will have to transfer some staff will from one facility to another."

"Staff morale and productivity are already at an all-time low, with the rumors that have been going around about these changes," said Irina Dmitrijevna. "Some managers have been having trouble providing consistent coverage, because people aren't coming to work."

"Once we have identified our staff and their skill levels and location, we will have to manage them, too," commented Maria Stepanovna. "The Regional Office's performance management system does not have clear policies and guidelines for performance review. Many of our staff have been grumbling for years about the random nature of promotions and salary raises. Maybe we should look at this as an opportunity to develop a better performance management system. But who should take on that responsibility?"

"I am the only person in the district who has been handling our human resource responsibilities to date," said Andrei Andrejevich. "I have been responsible for documenting our in-service training needs and coordinating with regional staff to make sure that training is done. And I have other responsibilities. I think we will need to have a full-time Human Resource Coordinator. He or she will have to act as a liaison with the Regional Office and civil service representatives at all government levels. This person will also have to work with others to write job descriptions, train supervisors and staff in the new system, and manage the hiring and firing process."

"We will have to hire someone new or identify someone on our staff already who would like to take on these responsibilities," said Igor Ivanovich. "This will have to be a senior position."

"What about salary levels? Will we be able to set them at the district level?" asked Galina Victorovna.

"No," answered Igor Ivanovich. "The civil service, advised by the Regional Office, will still be in charge of salary policy and levels."

"What about the human resource implications of the financial management side of these changes?" said Irina Dmitrijevna. "We will have to create new positions, with new skills, to handle our increased responsibilities. Is the Regional Office going to help us determine our needs? Will any Regional Office staff be transferred to our level?"

"Several District Officers brought up this concern during our meetings last week," said Igor Ivanovich. "Nothing has been decided yet. Staff who are working in the capital will probably resist any efforts to transfer them to the districts. But there was talk of the Regional Office providing training for district-level staff in preparing budgets. We will have to work with them to determine our financial management skill requirements."

"I suggest that we form a Human Resource Advisory Committee," Galina Victorovna said. "I would like to be on it. I think we should be sure to include a union representative, too, who can be our liaison with the workers' union. The team could be charged with assessing our human resource system needs, gathering human resource data, and developing a transition plan."

"Yes, establishing a committee is an excellent idea, as is including a union representative," Igor Ivanovich said. "I expect all of you to serve on this committee. We must take a leadership role in ensuring that the transition goes smoothly, with little or no disruption in services. And we must think of ways to make facility-level staff part of this transition process. Let's meet again next week. I would like you to have ready some suggestions of facility managers to invite to join us. And Galina Victorovna, I would like you to prepare the draft of an announcement about the Regional Office proposals and the actions that we are taking, that we can send to all district staff."

Case Questions:-

1. What are the changes proposed by the Regional Office? What are the human resource implications of these changes?
2. What kinds of actions might the District Health Office take in order to handle its new responsibilities?
3. What are first steps that the team plans to take in preparing to take on their new responsibilities?