Inter-Professional Cohesion and Harmony in Health.
I have been inspired to post this piece following recent social media conversations on this topic of inter-professional harmony and cohesion in the health sector. As you know, the Health Workforce is made up of different health professions who at best work in inseparable interdependent teams in which each profession has defined roles which reciprocally support and complement each other in delivering health services to individuals and communities. The four dimensions of health workforce performance; namely, availability, competence, responsiveness and productivity are all enhanced when there is team work, harmony and cohesion within and between the health professions in health service planning and delivery.
Yet we are also aware that there is what was described as “Tribalism of the professions i.e. the tendency of the various professions to act in isolation from or even competition with each other” by the Lancet Commission on Health Professional for a New Century. We also know of harmful intra-professional conflicts. Our priority must be to focus our efforts in detribalizing the health professions and promoting intra and trans-professional harmony in order to serve the people and not the professions or individuals. How can this be achieved?
First let us appreciate the context: The World Health Organization has articulated six building blocks of the health system. These are Services Delivery, Information, Health Workforce, Financing, Medical products and Leadership and governance. Two of these namely, Leadership and Governance along with Health Workforce are critical as together they are the drivers that operationalize all other health system building blocks. Between these two, it is the Health Workforce that ranks highest because the Leadership and Governance function is in turn mediated and driven by people who constitute the Health Workforce.
Secondly, the ILO classification of health occupations, recognizes many health professions and with several layers within each profession.
Traditional health professions however include medicine and dentistry, nursing and midwifery, pharmacy and pharmacology, physical therapy, allied health etc. They operate in diverse settings, public, private, hospitals, nursing homes, community, day care centers, operating theaters, critical care etc. These professions work together in mutually supportive teams for the common good of society.
Building effective HWF teams depends on certain factors especially quality of leadership and management exhibited by health workers playing leadership roles at all levels. Clear job descriptions, clear vision and values for institutions or particular setting, recognizing and appreciating each individual, listening, building trust, receiving and giving feedback and transparent reward and sanction procedures are needed.
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