report on and assessment of human resources...
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Report on and assessment of human
resources management system in San
Martin and other approved regions,
including activities undertaken to
strengthen the system and
recommendations for future activities
USAID|Politicas en Salud
Contract No. GHS-I-10-07-00003-00
June 30, 2014
Prepared for:
Armando Cotrina, COR
USAID/Peru Health Office
Av. Encalada s.n.
Lima - Perú
Submitted by:
Abt Associates Inc.
4550 Montgomery Avenue
Suite 800 North
Bethesda, MD 20814
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This document has been elaborated by USAID|Políticas en Salud Project, financed by the United States
Agency for International Development (USAID) under contract No. GHS-I-10-07-00003-00.
The author’s views expressed in this publication do not necessarily reflect the views of the United
States Agency for International Development or the United States Government.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Contents ▌pg. i
Report on and assessment of HH.RR. management system in San Martin and
other approved regions, including activities undertaken to strengthen and
recommendations for future activities
Table of Contents
Acronyms ............................................................................................................................................... i
Executive summary .............................................................................................................................. 1
Introduction .......................................................................................................................................... 3
1. Tools and methodologies to assess HRMS implementation at national level ....................... 4
2. Results of HRMS evaluation at national level ......................................................................... 7
2.1 HHR policy and strategic planning ................................................................................. 11
2.2 Work organization ........................................................................................................... 16
2.3 Employment management ............................................................................................... 21
2.4 Development and training management .......................................................................... 26
2.5 Performance management ............................................................................................... 30
2.6 Compensation management ............................................................................................. 35
2.7 Managing human and social relations ............................................................................. 41
3. Analysis of results of HRMS evaluation in five selected regions ......................................... 45
3.1 Loreto Regional Health Directorate ................................................................................ 48
3.2 Pasco Regional Health Directorate .................................................................................. 50
3.3 Huánuco Regional Health Directorate ............................................................................. 51
3.4 Lambayeque Regional Health Directorate ....................................................................... 52
3.5 Piura Regional Health Directorate ................................................................................... 54
4. Analysis of HRMS assessment results in San Martin Regional Health Directorate
compared with national results ......................................................................................................... 57
5. Activities undertaken by MoH to strengthen HRMS and proposals for future activities . 75
6. Conclusions and Recommendations ....................................................................................... 79
7. References ................................................................................................................................. 81
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Contents ▌pg. ii
8. Annex ........................................................................................................................................ 87
8.1 Analysis of performance evaluation results in the HHR policy and strategic planning
sub-system, in selected regions .................................................................................................. 87
8.2 Analysis of performance evaluation results in the work organization sub-system, in
selected regions .......................................................................................................................... 93
8.3 Analysis of performance evaluation results in the employment management sub-system,
in selected regions ...................................................................................................................... 97
8.4 Analysis of performance evaluation results in the performance management sub-system,
in selected regions .................................................................................................................... 103
8.5 Analysis of performance evaluation results in the development and training management
sub-system, in selected regions ................................................................................................ 108
8.6 Analysis of performance evaluation results in the compensation management sub-
system, in selected regions ....................................................................................................... 112
8.7 Analysis of performance evaluation results in the managing human and social relations
sub-system, in selected regions ................................................................................................ 117
8.8 HRMS evaluation results by Region and sub-systems. ................................................. 122
8.9 Ministerial Resolutions and Legislative Decree ............................................................ 123
Figures
Figure 1: Results for each sub-system, Peru 2014.................................................................................. 8
Figure 2: Human Resources Management System by region, Peru 2014. ............................................. 9
Figure 3: HHR policy and strategic planning, Peru 2014. .................................................................... 11
Figure 4: HHR policy and strategic planning by region, Peru 2014. ................................................... 12
Figure 5: Work organization sub-system, Peru 2014. .......................................................................... 16
Figure 6: Work organization, Peru and regions in 2014. ...................................................................... 17
Figure 7: Work organization, Peru and regions in 2014. ...................................................................... 18
Figure 8: Employment management sub-system, Peru 2014. .............................................................. 21
Figure 9: Employment management, Peru and regions in 2014. .......................................................... 22
Figure 10: Development and training management sub-system, Peru 2014 ........................................ 26
Figure 11: Development and training management sub-system. Peru and Regions in 2014 ............... 27
Figure 12: Performance management sub-system, Peru 2014. ............................................................ 30
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Contents ▌pg. iii
Figure 13: Performance management sub-system, Peru and regions in 2014. ..................................... 31
Figure 14: Compensation management sub-system, Peru 2014. .......................................................... 35
Figure 15: Compensation management sub-system, Peru and regions in 2014. .................................. 36
Figure 16: Managing human and social relations sub-system, Peru 2014. .......................................... 41
Figure 17: Managing human and social relations sub-system, Peru and regions in 2014. ................... 42
Figure 18: Human Resources Management System by sub-system in Peru and San Martin, 2014. .... 59
Figure 19: Human Resources Management System by UE, San Martin 2014. .................................... 59
Figure 20: HHR policy and strategic planning sub-system, San Martin 2014. .................................... 61
Figure 21: HHR policy and strategic planning by UE, San Martin 2014. ............................................ 62
Figure 22: Work organization sub-system, San Martin 2014. .............................................................. 63
Figure 23: Work organization, San Martin and UEs in 2014. .............................................................. 64
Figure 24: Employment management sub-system, San Martin 2014. .................................................. 65
Figure 25: Employment management, San Martin and UEs in 2014. .................................................. 66
Figure 26: Performance management sub-system, San Martin 2014. .................................................. 67
Figure 27: Performance management sub-system, San Martin and UEs in 2014. ............................... 68
Figure 28: Development and training management sub-system, San Martin 2014. ............................. 69
Figure 29: Development and training management sub-system, San Martin and UEs in 2014. .......... 70
Figure 30: Compensation management sub-system, San Martin 2014. ............................................... 71
Figure 31: Compensation management sub-system, San Martin and UEs in 2014. ............................. 72
Figure 32: Managing human and social relations sub-system, San Martin 2014. ................................ 73
Figure 33: Managing human and social relations sub-system, San Martin and UEs in 2014. ............. 74
Tables
Table 1: HRMS assessment tool: Total number of assessed processes and questions by sub-system. .. 4
Table 2: Key processes for each HRMS sub-system in health institutions. ........................................... 5
Table 3: Budget Spending Units assessed by region, Peru 2014. ........................................................... 7
Table 4: Results for each sub-system, Peru 2014. .................................................................................. 8
Table 5: Human Resources Management System by sub-system and region, Peru 2014. ................... 10
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Contents ▌pg. iv
Table 6: HHR policy and strategic planning, Peru 2014. ..................................................................... 12
Table 7: HHR policy and strategic planning by region, Peru 2014. ..................................................... 13
Table 8: HHR policy and strategic planning, Peru 2014. ..................................................................... 15
Table 9: Work organization sub-system, Peru 2014............................................................................. 16
Table 10: Work organization, Peru and regions in 2014. ..................................................................... 17
Table 11: Work organization, Peru 2014. ............................................................................................ 20
Table 12: Employment management sub-system, Peru 2014. .............................................................. 21
Table 13: Employment management, Peru and regions in 2014. ......................................................... 22
Table 14: Employment management. Peru, 2014 ................................................................................. 24
Table 15: Development and training management sub-system, Peru 2014 .......................................... 26
Table 16: Development and training management sub-system. Peru and Regions in 2014 ................. 27
Table 17: Development and training management processes, Peru and Regions in 2014 ................... 28
Table 18: Development and training management sub-system, Peru 2014. ......................................... 29
Table 19: Performance management sub-system, Peru 2014. .............................................................. 30
Table 20: Performance management processes, Peru and regions in 2014. ......................................... 31
Table 21: Performance management sub-system, Peru 2014. .............................................................. 33
Table 22: Compensation management sub-system, Peru 2014. ........................................................... 36
Table 23: Compensation management, Peru and regions in 2014........................................................ 37
Table 24: Compensation management sub-system, Peru 2014. ........................................................... 39
Table 25: Managing human and social relations sub-system, Peru 2014. ............................................ 41
Table 26: Managing human and social relations, Peru and regions in 2014. ....................................... 42
Table 27: Managing human and social relations sub-system, Peru 2014. ............................................ 44
Table 28: Human Resources Management System progress rating by region, Peru 2014. .................. 45
Table 29: General characteristics of the five selected RHDs, Peru 2014. ............................................ 46
Table 30: General characteristics of the five selected RHDs, Peru 2014. ............................................ 47
Table 31: Distribution of networks and micro-networks by UE, San Martin 2014.............................. 57
Table 32: Human Resources Management System processes by UE, San Martin 2014. ..................... 60
Table 33: HHR policy and strategic planning by UE, San Martin 2014. ............................................. 62
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Contents ▌pg. v
Table 34: Work organization, San Martin and UEs in 2014. ............................................................... 64
Table 35: Employment management, San Martin and UEs in 2014. ................................................... 66
Table 36: Performance management sub-system, San Martin 2014. ................................................... 68
Table 37: Development and training management sub-system, San Martin and UEs in 2014. ........... 70
Table 38: Compensation management sub-system, San Martin 2014. ................................................. 72
Table 39: Human Resources Management System processes by UE, San Martin 2014. ..................... 74
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Acronyms ▌pg. i
Acronyms
AETA Asignación Extraordinaria por Trabajo Asistencial / Extraordinary Assignment
for Health Care Work
ANGR Asamblea Nacional de Gobiernos Regionales
CAS Contrato administrativo de servicios / Administrative services contract
CAP Cuadro de asignación de personal / Staffing Table
CIGS Comité integubernamental en Salud / Intergovernmental Committee on Health
CLAS Comités Locales de Administración de Salud / Health Administration Local
Communities
COREPRES Comité Regional de Pre-Grado en Salud
RHD Dirección Regional de Salud / Region Health Directorate
DL Legislative Decree
ENDES Encuesta Demográfica y de Salud Familiar / National Survey of Demography
and Family Health
HR Human resources
HHR Health human resources
HRMS Human Resources Management System
INEI Instituto Nacional de Estadística e Informática / National Institute of Statistics
and Informatics
INFORHUS Información de Recursos Humanos en Salud / Human Resources Health
Information
MAPRO Manual de procesos / Procedures Manual
MINTRA Ministerio de Trabajo y Promoción del Empleo / Ministry of Work and
Employee Promotion
MOF Manual of Organizations and Functions
MoF Ministry of Finance
MoH Ministry of Health
PAP Presupuesto analítico de personal / Staff budget
PDP Plan de Desarrollo Personal / Personal Development Plan
PLAME Planilla mensual de pagos / Monthly payroll
RENIEC Registro Nacional de Identificación y Estado Civil / National Registry of
Identification and Civil Status
RHD Regional health directorate
RIT Reglamento interno de trabajo / Internal labor regulations
RNSDD Registro Nacional de Sanciones de Destitución y Despido / National Registry
of Sanctions and Dismissals
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Acronyms ▌pg. ii
ROF Reglamento de Organización y Funciones / Regulation of Organization and
Functions
SERUMS Servicio Rural y Urbano Marginal en Salud / Civil Health Service in Rural and
Marginal Urban Areas
SERVIR Autoridad Nacional del Servicio Civil / National Civil Service Authority
SMT-RHD San Martin Regional Health Directorate
TA Asistencia Técnica( Technical Assistance
UE Unidades ejecutoras de presupuesto / Budget spending units
USAID United States Agency for International Development
WHO World Health Organization
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Executive Summary ▌pg. 1
Executive summary
Implementation of health reform requires improvements in the availability and quality of health human resources (HHR) at all levels of the health sector. Regarding human resources (HR) improvements, in June 2008, the National Civil Service Authority (SERVIR) was created as the lead agency in managing the Human Resources Management System (HRMS) for public institutions. Within this institutional framework, the project developed a methodology and a tool to assess HRMS implementation in order to identify existing weaknesses and opportunities for improvements. In 2012, this methodology was applied in San Martin Regional Health Directorate (SMT-RHD) and results were presented in the project deliverable entitled “Report on and assessment of the human resources management system, including activities undertaken to strengthen the system and recommendations for us in other regions”.
On the other hand, within the Intergovernmental Committee on Health (Comité Intergubernamental en Salud –CIGS), the Ministry of Health (MoH) and all Regional Health Directorates (RHDs) agreed to design a strategy to strengthen HRMS at the Budget Administration Unit (Unidad Ejecutora de Presupuesto –UE) level. For this purpose, CIGS formed a HR sub-committee to develop a quick assessment of HRMS implementation. This sub-committee asked the project for TA and for using the methodology and tools designed by the project. Tools consisted in a standardized questionnaire, a spreadsheet and a technical report template.
MoH sent the questionnaire, the spreadsheet and the template to all RHDs in order to organize workshops with all its UEs and collect information. Twenty one out of twenty five RHDs sent the required information (88% of RHDs), although not all the UEs within each RHDs sent their respective results. One hundred and eight UEs out of one hundred and sixty two UEs (67%) sent all the information on time.
After consolidating the results of all 108 UEs, the HR sub-committee and the project came up with the following results at national level:
Regarding HRMS sub-systems and processes, all of them achieved between poor and moderate
level of development, on average RHDs achieved a 35% implementation rate.
The employment management sub-system achieved the best implementation rating at 45%.
Lambayeque RHD exhibited the best performance with a 62% progress rating while Cusco, San
Martin and Amazonas had the lowest scores with a 31% progress rating.
In general, all UEs focus their attention to hire personnel, control attendance and manage staff
files. However, it is surprising that UEs performance in this aspect is not adequate.
The performance management sub-system achieved the lowest level of development: 20%.
Supervision and feedback, and design of plans for individual performance improvement
processes are poorly developed: 12% and 16% respectively. Junín RHD exhibited the best
performance with a 44% progress rate while Tumbes and Piura RHDs had the lowest score with
a 1% and 5% rate respectively.
Absence of methodologies and tools add to the lack of skilled staff as main explanations of these
low rates. Regarding Junín RHD, their UEs have developed a performance evaluation last year
Human resources, the different
kinds of clinical and non-clinical
staff who make each individual
and public health intervention
happen, are the most important of
the health system´s inputs. The
performance of health care
systems depends ultimately on
the knowledge, skills and
motivation of the people
responsible for delivering
services. (WHO, 2000)
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Executive Summary ▌pg. 2
and 60% of them have defined individual performance goals and informed workers in advance
about issues to be assessed.
Regarding HRMS performance by RHD, Loreto, Callao, Junín, and Cusco showed highest
progresses with attainments of 47%, 45%, 44%, and 43% in functions assessed. These RHDs
showed best scores in the development and training management sub-system, as compared with
the rest of RHDs where employment management was the most relevant function deployed.
Piura and Tumbes RHD had the lowest progress with attainments of 21% and 25% in functions
assessed. In these RHDs, performance management was the sub-system with the lowest rate:
5% and 1% respectively; and the lowest considering all RHDs.
Information aggregated on national perspective allows the identification of common constraints in all
UEs that the MoH should overcome through a national plan to strengthen HRMS and achieve
competent, motivated and committed health workers in the improvement of health conditions of
people living in poor and undeveloped areas.
Based on HRMS evaluation results, the CIGS-HR committee defined a plan and a group of activities
to tackle the main and common constraints in HRMS implementation. But, it is necessary to work with
each of the UEs in order to define specific improvement plans since these results have demonstrated
the existence of different levels of development in each of the HRMS processes.
Regarding activities undertaken by the MoH to strengthen HRMS, MoH has approved the following methodology and tools:
Technical guide to calculate HHR gaps for the first level of care, which was approved in March
2014.
Technical guide to identify labor competencies and design tools and standards for specific
competency assessment using the functional analysis, which was approved in March 2014.
Technical guide to calculate HHR gaps for the second and third-level-of-care, which was
approved in June 2014.
Legislative decree regulating the compensation comprehensive policy and the economic delivery
of health service staff of the State1, approved in September 2013.
.
This report presents detailed information about the results of the human resources management system assessment as well as an explanation of the results in selected regions.
1 Decreto Legislativo N° 1153
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Introduction ▌pg. 3
Introduction
Once a package of health reform measures was approved, MoH and RHDs gathered to identify a
group of constraints which could limit the success of health reform implementation.
Some of these constraints included the poor availability of competent HHR at all levels; the lack of
reliable information about the HHR situation to determine the magnitude of necessary HHR
investment; and deficiencies in payroll administration, among others.
To improve this situation, MoH and the RHDs agreed at the Thirteenth Session of the
Intergovernmental Committee on Health (CIGS) to focus on
strengthening institutional management of HHR through a rapid
capacity assessment of HR teams at the regional level. Participants
also agreed to develop a strategy to strengthen teams after the
assessment is completed.
In this report, the project presents assessment results for all Budget
Spending Units (Unidades ejecutoras de presupuesto, UE) at the
national level using project-designed methodology and tools which
was validates in SMT-RHD.
In a previous report, the project presented in detail, HRMS
assessment results in SMT-RHD and activities undertaken to
strengthen the system. This work was an important input to develop
a HRMS evaluation at national level in a short period of time.
As part of this national assessment, each SMT-RHD UEs was evaluated and its results are presented
in each of the HRMS processes report. On average, HRMS implementation in SMT-RHD is 30%
completed, placing it in ranked 12th of 17. Progresses made with the project TA such as measuring
HHR gap in the first-level-of-care, the design and approval of the pay scale, the design of job profiles,
have been recognized in the survey despite existing high staff turnover; but it was not enough to
impact the average result of each of the processes evaluated. Regulations and technical documents
which are in the design and validation stage such as recruitment and selection directive and
performance evaluation tools, by not being in implementation process, have not been recorded as
advances in the survey.
This report attempts to go beyond analyzing only SMT-RHD and other selected regions but rather
from the work done in SMT-RHD, presenting the results at the national level in each of the HRMS
processes.
The first chapter describes the process used to collect information from MoH and the consolidation of
information at the national and regional levels, from tools and methodologies applied in SMT-RHD.
The second chapter presents the results at the national level for each process involved in HRMS
implementation.
In the third chapter, the project selected five regions in order to provide a snapshot of regional teams’
analyses of their respective HRMS assessment results.
In the final chapter, the project describes MoH proposals to counter HHR problems and constraints
based on these results.
A country’s health workforce is
made up of health workers who
are at many different stages of
their working lives; they work in
many different organizations and
under changing conditions and
pressures. Whatever the
circumstances, an effective
workforce strategy has to focus
on three core challenges:
improving recruitment, helping the
existing workforce to perform
better, and slowing the rate at
which workers leave the health
workforce. (WHO, 2006)
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Tools and methodologies to assess HRMS Implementations ▌pg. 4
1. Tools and methodologies to assess HRMS implementation at
national level
To implement health reforms, MoH and RHDs agreed to design a strategy to strengthen HRM at the
UE level. Towards this end, CIGS formed a committee composed of MoH offices in charge of HHR;
officials from Callao, Pasco, Loreto, and Ica RHDs; and a representative from the National Assembly
of Regional Governments (Asamblea Nacional de Gobiernos Regionales, ANGR).
This committee proposed the development of the following tasks:
A quick assessment of HRMS process implementation.
A proposal for the basic organizational structure of a HR unit at the RHD level in order to
incorporate new processes approved under the civil service law and move away from personnel
administration offices to HRM offices.
A proposal for a job profile for the new HRM office head.
Regarding the quick assessment, MoH asked the project for TA.
The project presented to MoH HRMS performance evaluation methodology and tools applied in SMT-
RHD and Cajamarca RHD. Tools and methodology were reported to USAID in December 2013
through deliverable of the project entitled, “Report on and assessment of the human resources
management system, including activities undertaken to strengthen the system and recommendations
for use in other regions”.
Over several meetings, MoH reviewed each part of the assessment tool and made appropriate
adjustments. The tool was then approved to be distributed at the national level.
The instrument evaluates 29 processes within the seven sub-systems through a total of 662 closed
questions. In the form of a checklist, these questions have only two possible answers: YES or NO.
Table 1: HRMS assessment tool: Total number of assessed processes and questions by sub-
system.
HRMS sub-systems # assessed
processes # questions
HHR policy and strategic planning 6 124
Work organization 3 92
Employment management 5 137
Performance management 4 66
Development and training management 3 105
Compensation management 5 70
Managing human and social relations 3 68
HUMAN RESOURCES MANAGEMENT SYSTEM 29 662
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Tools and methodologies to assess HRMS Implementations ▌pg. 5
Table 2: Key processes for each HRMS sub-system in health institutions.
Sub-system Key Processes
HHR policy and strategic planning Policies and strategies for HHR management and development
Development of operational research
HHR information management
HHR management control
HHR strategic planning
HHR financing
Work organization Design of job profiles
Identification of labor competencies
Job rating
Employment management Recruitment, selection, incorporation, and induction
Staff mobility
Management of personnel files, control of attendance
Administration of disciplinary process
Staff termination and retirement
Development and training management Labor advancement (promotion and career path)
Capacity building
Regulation of the teaching-service process
Performance management Performance planning
Supervision
Performance evaluation
Feedback and design of plans for individual performance
improvement
Compensation management Design of salary scales
Management of payroll and salaries
Administration of benefits and bonuses
Incentive management
Pension management
Managing human and social relations Management of the organizational climate and culture
Management of labor relations
Workplace health, safety, and welfare
The project-designed spreadsheet was used to facilitate consolidation of results and subsequent
analysis. It immediately allows the aggregation of results into tables and graphs for easy analysis.
Additionally, each question has been weighted according to its strategic importance in proper HRMS
functioning.
The following ratings were used to analyze the results:
High development: > 80% complete
Moderate development: 40% - 80% complete
Little Development: <40% complete
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Tools and methodologies to assess HRMS Implementations ▌pg. 6
To obtain qualitative information from each UE, the project provided the scheme used to design the
SMT-RHD technical report, which contains results and analysis with proposals for improvement.
The questionnaire, spreadsheet, and technical report scheme were distributed to all RHDs.
To gather information, each RHD developed workshops with their respective UEs. All files and reports
produced by UEs were sent to MoH.
The project supported the consolidation of the information and the subsequent analysis.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 7
2. Results of HRMS evaluation at national level
Once approved, MoH distributed HRMS performance evaluation tools to all regional health
directorates for use by Budget Spending Units (Unidades ejecutoras de presupuesto - UE). MoH
established a deadline for evaluation results, and 67% of all UEs gathered these results.
Table 3: Budget Spending Units assessed by region, Peru 2014.
N° Regional Health
Directorate (RHD)
N° UE assessed Total UE % UE assessed
1 Tumbes 2 3 67%
2 Piura 7 7 100%
3 Lambayeque 4 4 100%
4 La Libertad 0 11 0%
5 Ancash 9 9 100%
6 Lima 9 9 100%
7 Callao 2 4 50%
8 Ica 7 8 88%
9 Arequipa 0 7 0%
10 Moquegua 3 3 100%
11 Tacna 0 2 0%
12 Cajamarca 6 6 100%
13 Huánuco 7 7 100%
14 Pasco 3 3 100%
15 Junín 5 9 56%
16 Huancavelica 8 8 100%
17 Ayacucho 6 9 67%
18 Cusco 5 8 63%
19 Puno 0 12 0%
20 Apurímac 6 10 60%
21 San Martín 5 5 100%
22 Amazonas 4 5 80%
23 Ucayali 2 5 40%
24 Loreto 6 6 100%
25 Madre de Dios 2 2 100%
Perú 108 162 67%
SOURCE: Technical report on HRMS evaluation results for each RHD.
Regarding response rates, all UEs from 12 regions answered the questionnaire while four regions did
not send any information regarding their UEs.
Obtaining information from 67% of UEs was an unexpected outcome for MoH as the regions had
approximately one month to send results, which is a relatively short period of time.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 8
After consolidating the results for all 108 UEs, the project came up with the following results (Table
4.2):
HRMS achieved a 35% implementation rate, which is an average rating based on the level of
implementation for seven subsystems.
The employment management sub-system achieved the best implementation rating at 45%
followed by the development and training management sub-system at 43%.
The performance management sub-system achieved the lowest level of development at 20%.
The work organization sub-system also achieved a poor level of development at 29%.
Table 4: Results for each sub-system, Peru 2014.
Human Resource Management System % complete Result
Subsystem: HHR policy and strategic planning 31% Little development
Subsystem: Work organization 29% Little development
Subsystem: Employment management 45% Moderate development
Subsystem: Performance management 20% Little development
Subsystem: Development and training management 43% Moderate development
Subsystem: Compensation management 37% Little development
Subsystem: Managing human and social relations 38% Little development
Human Resource Management System 35% Little development
SOURCE: Technical report on HRMS evaluation results for each RHD.
Figure 1: Results for each sub-system, Peru 2014
SOURCE: Technical report on HRMS evaluation results for each RHD.
0% 10% 20% 30% 40% 50%
HUMAN RESOURCES MANAGEMENT SYSTEM
HHR policy and strategic planning
Work organization
Employment management
Performance management
Development and training management
Compensation management
Managing human and social relations
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 9
The following tables and graphs contain the results obtained by region for each HRMS sub-system.
Regarding RHD performance on HRMS implementation, the project found that Loreto and Callao
have the highest progress rates at 47% and 45%, respectively, while Piura has the lowest rate at
21%. Several explanations for these results are presented in the next chapter.
Figure 2: Human Resources Management System by region, Peru 2014.
SOURCE: Technical report on HRMS evaluation results for each RHD.
Regarding RHD performance on each HRMS sub-system, the project obtained the following results:
Loreto achieved the highest progress rate for three sub-systems: work organization (38%);
development and training management (67%); and compensation management (60%).
Cusco achieved the best results in the HHR policy and strategic planning sub-system with a 50%
progress rate, which can be classified as “moderate development”.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 10
Lambayeque achieved the best results in the employment management sub-system with a 62%
progress rating.
Junín achieved the best results in the performance management sub-system with a 44%
progress rating, which can be classified as “little development”.
Callao achieved the best results in the managing human and social relations sub-system with a
56% progress rating.
Piura achieved the lowest rating in the HHR policy and strategic planning and work organization
sub-systems.
Tumbes UEs have only managed to achieve a 1% progress rating for the management sub-
system and 13% in the compensation management sub-system. They have achieved the lowest
ratings for all sub-systems.
Ayacucho has the lowest progress rating in two sub-systems: the development and training
management sub-system and the managing human and social relations sub-system.
Cusco, San Martín, and Amazonas achieved the lowest ratings in the employment management
sub-system at 31%.
Table 5: Human Resources Management System by sub-system and region, Peru 2014.
Region HRMS
HHR policy
and strategic
planning
Work
organization
Employment
management
Performance
management
Development
and training
management
Compensation
management
Managing
human and
social
relations
PERÚ 35% 31% 29% 45% 20% 43% 37% 38%
Tumbes 25% 31% 28% 33% 1% 30% 13% 42%
Piura 21% 19% 15% 35% 5% 27% 27% 22%
Lambayeque 39% 29% 27% 62% 26% 46% 38% 45%
Ancash 30% 25% 17% 46% 13% 34% 41% 33%
Lima 41% 29% 36% 51% 32% 49% 38% 55%
Callao 45% 35% 29% 54% 36% 61% 46% 56%
Ica 31% 34% 19% 42% 14% 43% 33% 31%
Moquegua 32% 25% 20% 49% 22% 30% 38% 39%
Cajamarca 40% 43% 34% 53% 29% 46% 40% 39%
Huancavelica 31% 33% 36% 44% 15% 29% 31% 26%
Ayacucho 27% 28% 26% 41% 20% 19% 34% 20%
Pasco 35% 42% 19% 41% 17% 45% 50% 29%
Junín 44% 41% 29% 50% 44% 60% 41% 41%
Cusco 43% 50% 36% 31% 35% 57% 40% 49%
Apurímac 41% 35% 33% 41% 16% 61% 45% 55%
Huánuco 33% 35% 36% 45% 19% 38% 26% 32%
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 11
Region HRMS
HHR policy
and strategic
planning
Work
organization
Employment
management
Performance
management
Development
and training
management
Compensation
management
Managing
human and
social
relations
San Martín 30% 30% 30% 31% 13% 31% 39% 33%
Amazonas 26% 30% 19% 31% 11% 28% 37% 27%
Ucayali 32% 29% 25% 32% 11% 42% 49% 38%
Loreto 47% 34% 38% 54% 24% 67% 60% 51%
Madre de Dios 29% 21% 22% 45% 11% 42% 26% 37%
SOURCE: Technical report on HRMS evaluation results for each RHD.
The instruments used to gather information allowed for detailed results for each of the processes
involved in the HRMS sub-systems. The results were analyzed by regional teams in conjunction with
MoH, and the conclusions are presented in tables.
2.1 HHR policy and strategic planning
This sub-system primarily encompasses HRMS alignment to national and regional policies; national
health strategies; and the comprehensive care model. This sub-system also facilitates coordination
among all HRMS processes to ensure suitable and competent workers where they are needed.
The following graph and table show results from six of the processes that are within this sub-system
at the national level.
On average, implementation of this subsystem is 31% completed, which indicates “little
development”. Some processes are particularly poorly developed, including operational research and
HHR management control with 8% and 18%, respectively.
According to the reported information, HHR financing and HHR information management are
functioning better but still have achieved a progress rating of less than 50%.
Figure 3: HHR policy and strategic planning, Peru 2014.
0% 5% 10% 15% 20% 25% 30% 35% 40% 45%
Policies and strategies for HHR management and development
Development of operational research
HHR information management
HHR management control
HHR strategic planning
HHR financing
HHR POLICY AND STRATEGIC PLANNING SUB-SYSTEM
SOURCE: Technical report on HRMS evaluation results for each RHD.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 12
Table 6: HHR policy and strategic planning, Peru 2014.
KEY PROCESSES Expected
result Obtained
result %
Complete Result
Policies and strategies for HHR management and development
2,392 408 17% Little development
Development of operational research 624 53 8% Little development
HHR information management 5,304 2,147 40% Moderate development
HHR management control 1,872 336 18% Little development
HHR strategic planning 1,872 658 35% Little development
HHR financing 890 365 41% Moderate development
Average 12,954 3,967 31% Little development
SOURCE: Technical report on HRMS evaluation results for each RHD.
For this sub-system, Cusco has the best performance at 50% while Piura has the lowest score at
19%.
Figure 4: HHR policy and strategic planning by region, Peru 2014.
0%
10%
20%
30%
40%
50%
60%
HHR policy and strategic planning sub-system
SOURCE: Technical report on HRMS evaluation results for each RHD.
The table below displays RHD results for each HR policy and strategic planning process.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 13
Table 7: HHR policy and strategic planning by region, Peru 2014.
RHD
HHR POLICY AND
STRATEGIC PLANNING
SUB-SYSTEM
Policies and strategies for
HHR management
and development
Development of operational
research
HHR information
management
HHR management
control
HHR strategic planning
HHR financing
PERÚ 31% 17% 8% 40% 18% 35% 41%
Tumbes 31% 7% 0% 53% 17% 33% 15%
Piura 19% 4% 0% 32% 4% 20% 30%
Lambayeque 29% 0% 5% 43% 0% 50% 54%
Ancash 25% 2% 6% 41% 12% 20% 43%
Lima 29% 42% 20% 38% 12% 15% 42%
Callao 35% 41% 9% 42% 24% 24% 58%
Ica 34% 7% 4% 54% 13% 42% 36%
Moquegua 25% 0% 0% 37% 8% 44% 21%
Cajamarca 43% 29% 18% 46% 21% 63% 73%
Huancavelica 33% 14% 26% 35% 21% 52% 53%
Ayacucho 28% 17% 20% 22% 19% 44% 67%
Pasco 42% 58% 9% 54% 7% 46% 54%
Junín 41% 21% 0% 61% 41% 30% 40%
Cusco 50% 20% 9% 68% 61% 42% 42%
Apurímac 35% 35% 20% 43% 19% 39% 31%
Huánuco 35% 23% 10% 49% 22% 34% 38%
San Martín 30% 3% 5% 50% 8% 39% 26%
Amazonas 30% 2% 0% 56% 25% 11% 29%
Ucayali 29% 5% 0% 33% 11% 54% 62%
Loreto 34% 13% 9% 46% 25% 30% 71%
Madre de Dios 21% 4% 0% 35% 0% 21% 54%
SOURCE: Technical report on HRMS evaluation results for each RHD.
Considering the results for each of the processes, the project formed the following conclusions:
For policies and strategies within the HHR management and development process, Pasco
achieved the best performance (58%). However, some RHDs have achieved a 0% progress
rating, including Lambayeque and Moquegua.
In the development of the operational research process, Huancavelica achieved the best
performance with 26%, but some RHDs have achieved a 0% progress rating, including Tumbes,
Piura, Moquegua, Junín, Amazonas, and Ucayali. On average, this process is the least
developed process within this sub-system at the national level.
For the HHR information management process, all RHDs have achieved a progress rating of
higher than 20%. Cusco achieved the best rating with 68% while Ayacucho had the lowest
progress rating with 22%.
For the HHR management control process, Cusco showed the best performance with 61%, but
some RHDs achieved a progress rating of 0%, including Lambayeque and Madre de Dios.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 14
For the HHR strategic planning process, Cajamarca achieved the highest progress rating with
63% while Amazonas had the lowest score with 11%.
Regarding the HHR financing process, Cajamarca and Loreto achieved the highest progress
rating with 73% and 71%, respectively, while Tumbes had the lowest score with 15%.
An aggregate analysis of possible explanations for these results is shown in the subsequent table. In
the next chapter, results and corresponding analysis for six regions will be presented.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 15
Table 8: HHR policy and strategic planning, Peru 2014.
KEY PROCESSES
% Complete Strengths Problem Description Analysis Proposals for Improvement
Policies and strategies for HHR management and development
17%
Little development
At least 10% of UEs have HHR policies at regional level
Only 4% of UEs implement and monitor policies.
96% of UEs have not designed a unit responsible for the management of HHR policies, and 97% of UEs have not trained their staff in the management of HHR policies.
Managers are appointed based on trust.
There is high staff turnover and no proper transfer of the advances in HRM
Regional governments do not prioritize HR issues.
Develop training programs in the design and management of HHR policies.
MoH should provide technical assistance for the management of HHR policies.
Development of operational research
8%
Little development
At least 14% of UEs have analyzed the HHR situation.
No competent HR to perform research.
No support for research funding.
No incentives.
Partner with universities to develop research projects.
Create awards for best research.
HHR information management
40%
Moderate development
48% of UEs have HHR information systems.
95% have no information from other sub-sectors.
70% have no current information on HHR availability.
Lack of coordination with other sub-sectors.
UEs do not periodically send HHR information to RHDs, nor do they possess updated information.
MoF has parallel HHR information systems.
Coordinate with MoF to force UEs to send information through RHDs.
Keep budget allocation tied to MoH HHR information systems.
Coordinate with MoF and SERVIR, the interoperability among all HHR information systems (HR Module/INFORHUS/RENIEC).
HHR management control
18%
Little development
At least 17% of UEs have designated a responsible unit for HRM monitoring.
93% of UEs did not define indicators to monitor HRM.
Lack of capacity to monitor HRM indicators.
Develop skills in designing indicators and dashboards.
Add a HHR management module to INFORHUS.
TA to MoH in handling management information systems.
MoH should define key indicators based on critical areas encountered in diagnosis and promote a space for national monitoring with incentives to improve performance in HRM.
HHR strategic planning
35%
Little development
At least 32% of UEs are estimating HR requirements.
97% of UEs report that they have not received training in HR planning.
UEs do not have staff with the right profile for HHR planning and do not have tools for estimating HR needs.
Develop skills in HR planning.
Develop tools and methodologies for estimating HR needs.
MoH should provide TA to UE for HR planning.
HHR financing 41%
Moderate development
At least 34% of UEs have designated a responsible unit for estimating the HR budget.
90% of responsible personnel are not trained in HHR financing.
UEs do not have trained personnel or personnel with the appropriate profile for HR funding based on technical criteria.
Develop skills in HHR financing.
SOURCE: Technical report on HRMS evaluation results for each RHD.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 16
2.2 Work organization
This sub-system exists to optimize HHR working capacity by specifying the content of functions,
activities, and tasks as well as staff qualifications.
The following graph and table show the results of three processes included in this sub-system. On
average, the progress rating for this sub-system has been measured at 29%, which is classified as
“little development”. According to regional reports, slight improvements have taken place in the
design of job profile category with a progress rating of 42%.
Figure 5: Work organization sub-system, Peru 2014.
0% 5% 10% 15% 20% 25% 30% 35% 40% 45%
Design of job profiles
Identification of labor competencies
Job rating
WORK ORGANIZATION SUB-SYSTEM
SOURCE: Technical report on HRMS evaluation results for each RHD.
Table 9: Work organization sub-system, Peru 2014
KEY PROCESSES Expected
result Obtained
result %
Complete Result
Design of job profiles 5,304 2,228 42% Moderate development
Identification of labor competencies 2,288 327 14% Little development
Job rating 1,976 244 12% Little development
Average 9,568 2,799 29% Little development
SOURCE: Technical report on HRMS evaluation results for each RHD.
On average for this sub-system, Loreto exhibited the best performance with a 38% progress rating
while Piura and Ancash had the lowest scores with 15% and 17%, respectively.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
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Figure 6: Work organization, Peru and regions in 2014.
0%
5%
10%
15%
20%
25%
30%
35%
40%
Work organization sub-sytem
SOURCE: Technical report on HRMS evaluation results for each RHD.
The results of work organization processes for each RHD are displayed in the table and graph below.
Table 10: Work organization, Peru and regions in 2014.
RHD WORK
ORGANIZATION SUB-SYSTEM
Design of job profiles
Identification of labor competencies
Job rating
PERÚ 29% 42% 14% 12%
Tumbes 28% 43% 13% 8%
Piura 15% 28% 1% 1%
Lambayeque 27% 50% 0% 0%
Ancash 17% 27% 7% 2%
Lima 36% 52% 18% 17%
Callao 29% 38% 17% 20%
Ica 19% 29% 8% 5%
Moquegua 20% 37% 0% 0%
Cajamarca 34% 44% 15% 31%
Huancavelica 36% 52% 21% 16%
Ayacucho 26% 39% 13% 7%
Pasco 19% 31% 9% 0%
Junín 29% 42% 9% 19%
Cusco 36% 43% 34% 19%
Apurímac 33% 45% 27% 8%
Huánuco 36% 43% 27% 29%
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 18
RHD WORK
ORGANIZATION SUB-SYSTEM
Design of job profiles
Identification of labor competencies
Job rating
San Martín 30% 35% 21% 30%
Amazonas 19% 26% 17% 4%
Ucayali 25% 42% 9% 0%
Loreto 38% 58% 15% 13%
Madre de Dios 22% 41% 0% 3%
SOURCE: Technical report on HRMS evaluation results for each RHD.
Figure 7: Work organization, Peru and regions in 2014.
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
55%
60%
65%
Work organization Design of job profiles Identification of labor competencies Job rating
SOURCE: Technical report on HRMS evaluation results for each RHD.
Considering results for each of the processes, the project formed the following conclusions:
RHDs achieved their highest progress ratings in the job
profile design category. Loreto had the highest progress
rating at 58% while Amazonas had the lowest progress rating
with 26%.
Regarding identification of labor competencies, Cusco
exhibited the best performance with a progress rating of
34%. However, some RHDs, including Lambayeque,
Moquegua, and Madre de Dios, achieved no progress
towards implementation of this process. It should be noted
that there has been little development of this process among
RHDs in general.
Job profile design that clearly set
out objectives, responsibilities,
authority and lines of
accountability are consistently
associated with improved
achievement of work goals, for all
sorts of worker. Moreover, moves
to develop clear job profiles can
produce quite rapid effects.
Health workers in many countries
still lack proper job profiles, so
this strategy has widespread
potential. (WHO, 2006)
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 19
Regarding the job rating process, Cajamarca exhibited the best performance with a 31% progress
rating. However, some RHDs, including Lambayeque, Moquegua, Pasco, and Ucayali, achieved
no progress towards implementation of this process. It should be noted that there has been little
development of this process among RHDs in general.
On average, the job rating process is the least developed process at the national level.
An aggregate analysis of possible explanations for these results is shown in the subsequent table. In
the next chapter, results and corresponding analysis for six regions will be presented.
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Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 20
Table 11: Work organization, Peru 2014.
KEY PROCESSES
% Complete Strengths Problem Description Analysis Proposals for Improvement
Design of job
profiles
42%
Moderate
development
About 50% of UEs use
the Staffing Table
(Cuadro de asignación
de personal, CAP), Staff
budget (Presupuesto
analítico de personal,
PAP), and the Manual
of Organizations and
Functions (MOF) to
design job profiles.
Only 3% of UEs have assigned staff
to design job profiles, and only 1%
of UEs state that these staff
members have been trained.
Lack of capacities and suitable guides
and tools for work organization for
application in the health sector.
Coordinate with SERVIR for the adequacy of its MPP
methodology for implementation in the health sector.
Develop skills in designing job profiles.
MoH should provide technical assistance to UEs in the
use of work organization tools, which should be specially
designed for health sector application.
Identification of
labor
competencies
14%
Little development
About 15% of UEs have
competency profiles for
health care jobs. In the
design of profiles,
teams have used MoH-
defined labor
competencies as
references.
Over 90% of UEs do not have tools
or methodologies for defining
labor competencies.
MoH has defined a methodology and
tools for the design of labor
competencies, and these have been
approved by ministerial resolution.
However, they have not yet been
distributed for implementation.
MoH should disseminate the methodology to identify
labor competencies. Moreover, MoH should organize
training workshops in designing labor competencies and
target regional teams.
Job rating 12%
Little development
About 23% of UEs state
that they have
performed job rating in
the past year, and 25%
used it to set wages.
98% of UEs state that they do not
have staff trained in job
evaluation.
Lack of skills, tools, and methodologies
for job rating.
The importance and implementation
of job valuation is not understood.
MoH should propose a methodology and tools for job
rating in coordination with SERVIR.
MoH must provide TA in the application of job rating
tools.
SOURCE: Technical report on HRMS evaluation results for each RHD.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 21
2.3 Employment management
Employment management seeks to establish a set of policies and standards to optimize the entrance,
movement, and exit of staff in health care organizations. These policies and standards should be
based on job profiles and competencies established by the employer and should foster the
achievement of sector health objectives.
The graph presents results for the five processes involved in this sub-system.
On average, the sub-system achieved a 45% progress rating, which is classified as “moderate
development”.
Figure 8: Employment management sub-system, Peru 2014.
0% 10% 20% 30% 40% 50% 60%
Recruitment, selection, incorporation and induction
Staff mobility
Management of staff files and attendance control
Administration of disciplinary process
Staff termination and retirement
EMPLOYMENT MANAGEMENT SUB-SYSTEM
SOURCE: Technical report on HRMS evaluation results for each RHD.
In general, most processes have achieved some level of progress. The recruitment, selection,
incorporation, and induction process is the most developed with a 48% progress rating. According to
regional reports, however, some processes lag behind in development, including the staff mobility
process with a 32% progress rating and the administration of disciplinary process with a 35% rating.
Table 12: Employment management sub-system, Peru 2014.
KEY PROCESSES Expected
result Obtained
result %
Complete Result
Recruitment, selection, incorporation and
induction 8,632 4,149 48% Moderate development
Staff mobility 728 325 45% Moderate development
Management of staff files and attendance control 2,184 953 44% Moderate development
Administration of disciplinary process 1,352 479 35% Little development
Staff termination and retirement 1,352 437 32% Little development
EMPLOYMENT MANAGEMENT SUB-SYSTEM 14,248 6,343 45% Moderate development
SOURCE: Technical report on HRMS evaluation results for each RHD.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 22
On average for this sub-system, Lambayeque exhibited the best performance with a 62% progress
rating while Cusco, San Martín, and Amazonas had the lowest scores with a 31% progress rating.
Figure 9: Employment management, Peru and regions in 2014.
0%
10%
20%
30%
40%
50%
60%
70%
Employment management sub-system
SOURCE: Technical report on HRMS evaluation results for each RHD.
In the table below, results for each employment management process for all RHDs are presented.
Table 13: Employment management, Peru and regions in 2014.
RHD
EMPLOYMENT MANAGEMENT
SUB-SYSTEM
Recruitment, selection,
incorporation and induction
Staff mobility
Management of staff files and attendance
control
Administration of disciplinary
process
Staff termination and retirement
PERÚ 45% 48% 45% 44% 35% 32%
Tumbes 33% 38% 14% 50% 20% 5%
Piura 35% 37% 33% 34% 36% 24%
Lambayeque 62% 65% 32% 65% 63% 63%
Ancash 46% 44% 60% 59% 34% 40%
Lima 51% 54% 46% 61% 29% 37%
Callao 54% 56% 21% 70% 34% 63%
Ica 42% 46% 37% 44% 33% 29%
Moquegua 49% 53% 62% 51% 32% 33%
Cajamarca 53% 57% 55% 54% 54% 24%
Huancavelica 44% 57% 66% 29% 16% 13%
Ayacucho 41% 52% 48% 25% 22% 23%
Pasco 41% 42% 43% 55% 39% 4%
Junín 50% 54% 54% 49% 44% 40%
Cusco 31% 33% 34% 37% 12% 29%
Apurímac 41% 52% 38% 26% 23% 23%
Huánuco 45% 55% 39% 40% 22% 33%
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 23
RHD
EMPLOYMENT MANAGEMENT
SUB-SYSTEM
Recruitment, selection,
incorporation and induction
Staff mobility
Management of staff files and attendance
control
Administration of disciplinary
process
Staff termination and retirement
San Martín 31% 39% 17% 31% 16% 12%
Amazonas 31% 38% 29% 31% 20% 8%
Ucayali 32% 36% 21% 32% 41% 5%
Loreto 54% 57% 60% 55% 37% 45%
Madre de Dios 45% 48% 57% 46% 32% 34%
SOURCE: Technical report on HRMS evaluation results for each RHD.
Based on results for each of the processes, the project formed the following conclusions:
Callao achieved a 70% progress rating, which is the highest rating among all RHDs, in the
management of staff files and attendance control process.
Tumbes, Pasco, and Ucayali had progress ratings of 5%, 4% and 5%, respectively, which are the
lowest progress ratings among all RHDs, for the staff termination and retirement process.
Lambayeque achieved the best performance in the recruitment, selection, incorporation, and
induction process with a progress rating of 62%; the administration of disciplinary process
category with a 63% rating; and the staff termination and retirement process with a 63% rating.
Regarding the staff mobility process, Moquegua exhibited the best performance with a 62%
progress rating while Tumbes had the lowest progress rating with 14%.
An aggregate analysis of possible explanations for these results is shown in the subsequent table. In
the next chapter, results and corresponding analysis for six regions will be presented.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 24
Table 14: Employment management. Peru, 2014
KEY PROCESSES
% Complete Strengths Problem Description Analysis Proposals for Improvement
Recruitment,
selection,
incorporation and
induction
48%
Moderate
development
About 80% of UEs have:
- the "user area
requirement" to
begin the hiring
process;
- calls for tenders are
only published in
the institution
mural,
- staff evaluate the
CVs using a
checklist;
- keep competition
rules on file;
- keep records and
the results of
evaluations of
contract
committees. .
18% of UEs disseminate job
opportunities via the MINTRA
(Ministerio de Trabajo – Ministry
of Labor) website.
About 30% of UEs reported that
more than 75% of employees
work in contracted positions.
In 4% of UEs, the contracted sign
the contracts after more than 30
days from the end of the contest.
Only 47% of UEs completed
induction for new staff.
There is political pressure to quickly
develop a hiring process, but this
process, done quickly, would not take
into consideration existing rules and
regulations.
The user area requirement does not
correspond to a job description or HR
needs assessment as previously
defined.
Health authorities do not provide
resources to develop induction
programs for new staff.
MoH should adapt existing norms for application in the
health sector.
MoH should provide TA to develop recruitment and
selection processes based on existing regulations.
PENDING: Coordinate with SERVIR on the design of
strategies to monitor compliance with recruitment,
selection, and hiring regulations. Should establish
penalties for noncompliance.
Staff mobility 45%
Moderate
development
Only 30% of UEs have
designated a
responsible unit to
manage staff mobility.
94% of UEs report that their staff
has not received training in staff
mobility management.
86% of UEs do not have tools to
record staff turnover.
There is no reliable information on
staff mobility to determine the
magnitude of this problem and
sensitize the authorities towards
improving this process.
MoH should provide TA to manage staff mobility.
Improve HHR information system (InfoRhus) to register
staff mobility.
Management of
staff files and
attendance
control
44%
Moderate
development
30% of UEs have
designated a
responsible unit to
manage staff files and
staff attendance
control.
80% of UEs have
designated a
responsible unit to
track staff attendance.
70% of UEs have designated a
responsible unit to manage staff
files, but only 15% of unit staff
have been trained.
Only 22% of UEs have a system to
register data and information
contained within staff files.
In 65% of UEs, only some staff,
primarily doctors, mark
attendance.
Lack of authority in requiring
attendance control for all personnel.
Lack of methodology and tools to keep
files updated.
Remove alternative attendance control systems (e.g.
manual control) and maintain a single system to register
and monitor attendance.
MoH should design a tool to keep staff files updated.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 25
KEY PROCESSES
% Complete Strengths Problem Description Analysis Proposals for Improvement
70% of UEs have a staff
attendance control
system as well as a
manual attendance
control.
9% of UEs has directorial
resolution to exonerate to mark
attendance
91% of those responsible for staff
files have not been trained.
Administration of
disciplinary
process
33%
Little development
At least 13% of UEs
have disseminated the
Internal Labor
Regulations
(Reglamento interno de
trabajo, RIT) to
recently hired
78% do not have RIT.
68% do not have a Disciplinary
Commission Process.
88% have updated the National
Registry of Sanctions and
Dismissals (Registro Nacional de
Sanciones y Destitucines del
Estado, RNSSD).
Authorities do not consider RIT to be
important.
Despite being in the national
regulations, regional authorities have
not named the person responsible for
updating RNSDD.
The office team has many tasks and
does not have time to update the RIT
MoH will provide TA to RHD in designing RIT.
MoH will provide a tool to RHD to monitor the updating
of RNSDD at the UE level.
Staff termination
and retirement
32%
Little development
UEs have updated
guidelines to develop
staff disengagement
processes in cases of
death (45%); waiver
(41%); dismissal (37%);
dismissal for serious
misconduct (46%);
permanent disability
(39%); retirement
(35%); and end of the
contract (38%).
Only 14% of UEs have designated
a responsible unit for managing
staff retirement, and only 4% of
unit staff has received training to
administer the process of staff
disengagement.
Only 28% of UEs have information
regarding personnel severance
and retirement.
SOURCE: Technical report on HRMS evaluation results for each RHD.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 26
2.4 Development and training management
The development and training management sub-system defines practices to encourage professional
and job development opportunities by providing learning opportunities as well as career path planning
within the organization.
The following graph shows results of the three processes within this sub-system.
On average, this sub-system has achieved a 43% progress rating, which is classified as “moderate
development”.
Figure 10: Development and training management sub-system, Peru 2014
0% 10% 20% 30% 40% 50% 60%
Labor advancement (promotion and career path)
Capacity building
Regulation of the teaching & service process
DEVEOPMENT AND TRAINING MANAGEMENT SUBSYSTEM
SOURCE: Technical report on HRM evaluation results for each RHD.
The regulation of teaching-service process has progressed the least with a 33% progress rating.
According to information provided by participants, the process with the greatest level of development
is the capacity building process with a 48% rating.
Table 15: Development and training management sub-system, Peru 2014
KEY PROCESSES Expected
result
Obtained
result
%
Complete Result
Labor advancement (promotion and career path) 4,160 1,748 42% Moderate development
Capacity building 4,992 2,405 48% Moderate development
Regulation of the teaching & service process 1,768 587 33% Little development
Development and training management sub-system 10,920 4,740 43% Moderate development
SOURCE: Technical report on HRM evaluation results for each RHD.
On average for this sub-system, Loreto exhibited the best performance with a 67% progress rating
while Ayacucho had the lowest with 19%.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 27
Table 16: Development and training management sub-system. Peru and Regions in 2014
0%
10%
20%
30%
40%
50%
60%
70%
Development and training management sub-system
SOURCE: Technical report on HRM evaluation results for each RHD.
Results by RHD in each of the development and training management processes are presented in
the graph and table below.
Figure 11: Development and training management sub-system. Peru and Regions in 2014
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
DEVELOPMENT AND TRAINING MANAGEMENT Labor advancement (promotion and career path)
Capacity building Regulation of the teaching & service process
SOURCE: Technical report on HRM evaluation results for each RHD.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 28
Table 17: Development and training management processes, Peru and Regions in 2014
DEVELOPMENT AND
TRAINING MANAGEMENT
Labor advancement (promotion and career
path) Capacity building
Regulation of the teaching & service
process
PERÚ 43% 42% 48% 33%
Tumbes 30% 21% 43% 12%
Piura 27% 18% 34% 27%
Lambayeque 46% 34% 48% 65%
Ancash 34% 34% 36% 26%
Lima 49% 45% 59% 30%
Callao 61% 48% 68% 65%
Ica 43% 57% 38% 31%
Moquegua 30% 30% 32% 25%
Cajamarca 46% 43% 54% 27%
Huancavelica 29% 30% 36% 7%
Ayacucho 19% 19% 26% 1%
Pasco 45% 48% 48% 30%
Junín 60% 70% 57% 50%
Cusco 57% 60% 61% 38%
Apurímac 61% 62% 69% 41%
Huánuco 38% 41% 42% 24%
San Martín 31% 36% 32% 20%
Amazonas 28% 27% 31% 19%
Ucayali 42% 42% 40% 47%
Loreto 67% 52% 81% 55%
Madre de Dios 42% 36% 49% 35%
SOURCE: Technical report on HRM evaluation results for each RHD.
Considering results for each of the processes, the project formed the following conclusions:
Regarding labor advancement, Cusco exhibited the best performance with a progress rating of
60% while Piura had the lowest progress rating with 18%.
Regarding capacity building, Loreto exhibited the best performance with a progress rating of 81%
while Ayacucho had the lowest progress rating with 26%.
Regarding regulation of the teaching and service process, Lambayeque and Callao had the best
performance with a progress rating of 65%, while Ayacucho reached only 1%.
An aggregate analysis of possible explanations for these results is shown in the subsequent table. In
the next chapter, results and the corresponding analysis of six regions will be presented.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 29
Table 18: Development and training management sub-system, Peru 2014.
KEY PROCESSES
% Complete Strengths Problem Description Analysis Proposals for Improvement
Labor
advancement
(promotion and
career path)
42%
Moderate
development
32% of UEs have promoted or advanced
staff in the last year.
41% of UEs have promoted staff taking
into account years of service.
31% of UEs have promoted staff by
taking into account the evaluation of the
staff files.
94% of UEs do not have approved staff promotion
policies and regulations.
91% of UEs do not have a responsible unit for the
development of staff promotion policies.
97% of UEs stated that they do not have staff
trained in labor advancement.
Only 15% of UEs have a permanent commission for
staff promotion.
21% use "interviews" as a tool in selecting
personnel to promote.
Lack of policies governing labor
advancement process.
Lack of HR with capabilities
and competencies to manage
staff promotion.
Lack of tools to qualify and
select staff to promote.
SERVIR and MoH
should develop and
implement policies
governing labor
advancement
processes for the
sector.
Capacity building
48%
Moderate
development
84% of UEs developed training activities
last year.
More than 80% of training activities are
short courses and lectures.
66% of UEs report that the main activity
of the training unit is to manage local or
classroom and refreshments.
24% of UEs have dedicated staff to
manage training activities.
42% of UEs conducted staff training
processes last year.
37% of UEs have taken into account
regional health priorities to identify staff
training needs.
91% of UEs do not have approved training policies.
82% of UEs do not have a methodological guide for
capacity development.
Only 12% of responsible units have been trained to
manage staff training.
50% of UEs reported that participants can only be
stable staff.
Lack of knowledge and/or lack
of interest in the application of
training policies and
methodological guidelines.
Limited HR capabilities and
competencies in training
management.
MoH should
provide TA to
RHDs in the design
and implementation
of staff training
policies.
Regulation of the
teaching &
service process
33%
Little
development
23% of UEs signed agreements with
educational institutions last year.
28% of UEs currently have existing
agreements with educational institutions
for the provision of technicians to operate
teaching facilities for student practice.
96% of UEs do not have approved criteria for
qualifying teaching hospitals.
Only 4% of UEs have officially formed a Regional
Undergraduate Committee (Comité Regional de
Pre-Grado en Salud, COREPRES).
84% of UEs do not have dedicated staff to manage
teaching-service agreements.
Only 9% of responsible staff has been trained to
administer teaching-service agreements.
Lack of tools to establish
criteria for qualifying teaching
hospitals.
HR staff do not have the
capacity to manage teaching-
service agreements.
Lack of interest in forming
COREPRES.
MoH should
provide TA to
RHDs in designing
instruments to
establish criteria for
qualifying teaching
hospitals.
SOURCE: Technical report on HRM evaluation results for each RHD.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 30
2.5 Performance management
The performance management sub-system seeks to align the strategy of the institution with individual
objectives through continuous improvement of staff performance and hence institutional performance.
Performance evaluation, which is part of performance management, sets specific employee
expectations in terms of quantitative and qualitative attributes for a given period. The aim of the
evaluation is to establish strategies for solving performance problems, motivate employees, and
encourage personal development.
The following graph shows results of the four processes that are involved in this sub-system.
Figure 12: Performance management sub-system, Peru 2014.
0% 5% 10% 15% 20% 25% 30%
Performance planning
Supervision
Performance evaluation
Feedback and design of plans for individual performance improvement
PERFORMANCE MANAGEMENT SUB-SYSTEM
SOURCE: Technical report on HRMS evaluation results for each RHD.
On average, this sub-system only achieved a 20% progress rating, which is classified as “little
development”.
Some processes are particularly poorly developed, including the feedback and design of plans for
individual performance improvement process and the supervision process with 12% and 16%,
respectively.
According to reported information, the performance planning and performance evaluation processes
are functioning better but still have achieved a progress rating of less than 30%.
Table 19: Performance management sub-system, Peru 2014.
KEY PROCESSES Expected
result
Obtained
result
%
Complete Result
Performance planning 1,248 327 26% Little development
Supervision 1,144 182 16% Little development
Performance evaluation 3,432 734 21% Little development
Feedback and design of plans for individual
performance improvement 1,040 126 12% Little development
PERFORMANCE MANAGEMENT SUB-SYSTEM 6,864 1,369 20% Little development
SOURCE: Technical report on HRMS evaluation results for each RHD.
Regarding results by region for this sub-system, Junín exhibited the best performance with a 44%
progress rating while Tumbes had the lowest score with a 1% rating.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 31
Figure 13: Performance management sub-system, Peru and regions in 2014.
0%5%
10%15%20%25%30%35%40%45%50%
Performance management sub-system
SOURCE: Technical report on HRMS evaluation results for each RHD.
In the table below, results for each performance management process for all RHDs are presented.
Table 20: Performance management processes, Peru and regions in 2014.
PERFORMANCE MANAGEMENT
SUB-SYSTEM
Performance planning
Supervision Performance
evaluation
Feedback and design of plans for
individual performance improvement
PERÚ 20% 26% 16% 21% 12%
Tumbes 1% 0% 0% 0% 4%
Piura 5% 5% 11% 3% 2%
Lambayeque 26% 38% 0% 32% 24%
Ancash 13% 12% 10% 16% 13%
Lima 32% 50% 19% 33% 15%
Callao 36% 50% 0% 51% 16%
Ica 14% 18% 14% 14% 10%
Moquegua 22% 28% 20% 25% 5%
Cajamarca 29% 32% 23% 33% 21%
Huancavelica 15% 27% 17% 11% 3%
Ayacucho 20% 36% 23% 15% 0%
Pasco 17% 19% 3% 22% 19%
Junín 44% 47% 29% 57% 22%
Cusco 35% 40% 30% 36% 34%
Apurímac 16% 19% 13% 14% 21%
Huánuco 19% 15% 21% 22% 14%
San Martín 13% 10% 12% 16% 13%
Amazonas 11% 15% 11% 9% 13%
Ucayali 11% 13% 0% 16% 4%
Loreto 24% 35% 23% 23% 13%
Madre de Dios 11% 25% 0% 10% 0%
SOURCE: Technical report on HRMS evaluation results for each RHD.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 32
Considering the results for each of the processes, the project formed the following conclusions:
For the performance planning process, Lima and Callao achieved the most progress with ratings
of 50%. However, Tumbes achieved a 0% progress rating.
For the supervision process, Cusco exhibited the best performance with a 30% rating. However,
some RHDs, including Tumbes, Lambayeque, Callao, Ucayali, and Madre de Dios, achieved no
progress towards implementation of this process.
For the performance evaluation process, Junín achieved the highest progress rating with 57%
while Tumbes had the lowest score with 0%.
Regarding the feedback and design of plans for individual performance improvement process,
Cusco achieved the highest progress rating with 34% while Ayacucho and Madre de Dios had the
lowest score with 0%.
An aggregate analysis of possible explanations for these results is shown in the subsequent table. In
the next chapter, results and corresponding analysis for six regions will be presented.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 33
Table 21: Performance management sub-system, Peru 2014.
KEY PROCESS % Complete Strengths Problem Description Analysis Proposals for Improvement
Performance
planning
26%
Little
development
52% of UEs plan to
develop performance
evaluations this year.
At least 40% of UEs
have tools to evaluate
staff performance
objectively.
88% of UEs do not have staff
responsible for job performance
planning.
Only 4% of UEs have received training
for performance planning.
90% of UEs do not have the
methodology to define individual goals
for job performance.
79% of UEs do not have tools for
performance assessment.
HR with limited
capabilities and skills for
job performance planning.
Lack of methodologies
and tools for job
performance planning for
staff.
MoH shall provide TA to RHDs in the
design and implementation of
methodologies and tools for job
performance planning for staff.
RHDs should strengthen skills and
capabilities of those responsible for
job performance planning for staff.
Supervision
16%
Little
development
At least 30% of UEs
have supervision
reports recommending
corrective measures to
improve individual
performance.
96% of UEs do not have a responsible
unit for monitoring and evaluating staff
performance.
Only 4% of UEs have a responsible
person with training in supervision.
92% of UEs do not have methodologies
or tools related to management
processes for staff performance
evaluation and supervision.
HR with limited skills and
competencies for
supervision and
monitoring of staff
performance.
Lack of methodologies
and tools to develop staff
assessment and
supervision processes.
RHDs should strengthen skills and
capabilities of those responsible for
staff assessment and supervision
processes.
MoH should provide TA to RHDs in
the design and implementation of
methodologies and tools for job
performance supervision and
supervision of staff.
Performance
evaluation
21%
Little
development
At least 18% of UEs
executed performance
evaluations last year.
22% of UEs have
conducted biannual
evaluations.
48% of UEs included
hired staff in
performance
evaluations.
38% of UEs inform
workers about details
of performance
89% of UEs do not have staff
responsible for evaluating job
performance.
Personnel in 4% of UEs have received
training in performance evaluation.
Over 95% of UEs are not using job
profiles to design performance
evaluation tools nor have they
established individual performance goals
or assessed required knowledge for the
position based on a job profile.
HR with limited
capabilities and
competencies to develop
performance evaluation
processes.
Lack of methodologies
and tools to be
implemented at the
regional level.
MoH should provide TA to RHDs in
the design and implementation of
methodologies and tools for
performance evaluation.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 34
KEY PROCESS % Complete Strengths Problem Description Analysis Proposals for Improvement
evaluation process
with sufficient advance
notice.
Feedback and
design of plans
for individual
performance
improvement
12%
Little
development
At least 38% of UEs
believe that conditions
exist to develop
performance
evaluation processes
at the institutional
level.
99% of UEs did not disseminate
performance evaluation results to staff.
96% of UEs have not designated a unit
or staff to manage dissemination of
performance evaluation results to staff.
Only 3% of UEs have received training
in feedback dissemination.
99% of UEs did not make plans for
improvement of staff performance based
on performance evaluation results.
Limited HR capabilities
and competencies to
disseminate performance
evaluation feedback to
staff.
MoH should provide TA to RHDs in
the design and implementation of
methodologies and tools to develop
feedback and design plans for
individual performance improvement.
SOURCE: Technical report on HRMS evaluation results for each RHD.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 35
2.6 Compensation management
Compensation is the remuneration received by an employee in return for his/her contribution to the
organization. It is an organized practice that involves balancing the work-employee relationship by
providing monetary and non-monetary benefits to employees. Compensation is an integral part of
human resource management that helps in motivating employees and improving organizational
effectiveness.
A good compensation package is important to motivate employees to increase organizational
productivity. Adequate compensation aids in the effective functioning of an organization to help it
accomplish its goals. Salary is just one part of the compensation system. A competitive compensation
package will help an organization to attract and retain talent.
The graph below presents results for the five processes involved in this sub-system.
On average, the sub-system achieved a 37% progress rating, which is classified as “little
development”.
Figure 14: Compensation management sub-system, Peru 2014.
0% 10% 20% 30% 40% 50% 60% 70% 80%
Design of salary scales
Management of payroll and salaries
Administration of benefits and bonuses
Incentive management
Pension management
COMPENSATION MANAGEMENT SUB-SYSTEM
SOURCE: Technical report on HRMS evaluation results for each RHD.
Processes related to the payment of salaries and the components of salaries, including the
administration of benefits and bonuses; pension management; and the management of payroll and
salaries, have exhibited moderate development with progress ratings of 71%, 62%, and 60%,
respectively. All tasks related to these processes are regulated, and sanctions exist in case of non-
observance. This may explain the relatively high level of progress in these processes.
However, the results also show that little development has taken place in the management of
incentives and the design of salary scales. These two processes had progress ratings of 30% and
24%, respectively.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 36
Table 22: Compensation management sub-system, Peru 2014.
KEY PROCESSES Expected
result
Obtained
result
%
Complete Result
Design of salary scales 3,328 808 24% Little development
Management of payroll and salaries 936 566 60% Moderate development
Administration of benefits and bonuses 520 367 71% Moderate development
Incentive management 1,976 601 30% Little development
Pension management 520 323 62% Moderate development
Compensation management sub-
system 7,280 2,665 37% Little development
SOURCE: Technical report on HRMS evaluation results for each RHD.
Regarding results by region for this sub-system, Loreto exhibited the best performance with a 60%
progress rating while Tumbes had the lowest score with a 13% progress rating.
Figure 15: Compensation management sub-system, Peru and regions in 2014.
0%
10%
20%
30%
40%
50%
60%
70%
Compensation management sub-system
SOURCE: Technical report on HRMS evaluation results for each RHD.
In the table below, results for each compensation management process for all RHDs are presented.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 37
Table 23: Compensation management, Peru and regions in 2014.
COMPENSATION MANAGEMENT
SUB-SYSTEM
Design of salary scales
Management of payroll and
salaries
Administration of benefits and
bonuses
Incentive management
Pension management
PERÚ 37% 24% 60% 71% 30% 62%
Tumbes 13% 2% 53% 13% 20% 0%
Piura 27% 19% 64% 61% 20% 26%
Lambayeque 38% 0% 100% 100% 45% 65%
Ancash 41% 14% 85% 93% 34% 98%
Lima 38% 13% 78% 64% 34% 91%
Callao 46% 10% 100% 90% 50% 90%
Ica 33% 9% 90% 86% 25% 71%
Moquegua 38% 29% 59% 62% 27% 80%
Cajamarca 40% 29% 75% 70% 29% 67%
Huancavelica 31% 34% 54% 59% 14% 40%
Ayacucho 34% 31% 67% 77% 18% 37%
Pasco 50% 38% 100% 69% 36% 87%
Junín 41% 24% 76% 72% 36% 68%
Cusco 40% 24% 74% 89% 33% 64%
Apurímac 45% 43% 67% 68% 34% 60%
Huánuco 26% 18% 61% 53% 16% 40%
San Martín 39% 38% 64% 65% 25% 56%
Amazonas 37% 12% 94% 72% 31% 80%
Ucayali 49% 27% 94% 90% 39% 100%
Loreto 60% 51% 95% 88% 58% 50%
Madre de Dios 26% 0% 85% 83% 19% 60%
SOURCE: Technical report on HRMS evaluation results for each RHD.
Considering the results for each of the processes, the project formed the following conclusions:
For the design of salary scales process, Loreto achieved the
best performance with a 51% rating. However, Lambayeque
and Madre de Dios achieved little to no progress with a 0%
rating.
For the management of payroll and salaries process,
Lambayeque, Callao and Pasco exhibited the best
performances with 100% progress ratings while Tumbes
achieved a progress rating of 53%.
Regarding the administration of benefits and bonuses
process, Lambayeque achieved the highest progress rating
with 100% while Tumbes had the lowest score with 13%.
For the incentive management process, Loreto achieved the
highest progress rating with 58% while Huancavelica had the lowest score with 14%.
Three aspects of remuneration
influence the behavior of health
workers: the level and regularity
of pay, the way people are paid,
and other incentives. Health
workers must be paid reasonably
for the work they do. They need
to receive a living wage; they also
need to believe that the wage is
commensurate with their
responsibilities and that it is fair
when compared with others in the
same or equivalent jobs. (WHO,
2006)
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 38
Regarding the pension management process, Ucayali achieved the highest progress rating with
100% while Tumbes had the lowest score with 0%.
An aggregate analysis of possible explanations for these results is shown in the subsequent table. In
the next chapter, results and corresponding analysis for six regions will be presented.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 39
Table 24: Compensation management sub-system, Peru 2014.
KEY PROCESS % Complete Strengths Problem Description Analysis Proposals for Improvement
Design of salary
scales
24%
Little
development
33% of UEs have designed
salary scales that take into
account budget availability
and geographical area
where health facility is
located.
30% of UEs have used pay
scales for new contracts.
87% of UEs reported that the
responsible unit has not received
training in pay scale management.
81% of UEs did not rate jobs
before the definition of pay scales.
Only 26% of UEs designed a salary
scale last year.
Only 19% of UEs reported having a
methodology to define a pay scale.
There are no tools or
methodologies to aid in
designing pay scales.
MoH should design methodologies
or general guidelines to aid in the
design of pay scales and provide
TA for regional implementation.
Management of
payroll and
salaries
60%
Moderate
development
92% of UEs are using an up-
to-date payroll and wage
system.
81% of UEs have
designated a responsible
unit to manage payroll.
77% of UEs have
regulations to manage
salaries and payroll.
96% of UEs stated that payroll was
updated a year ago.
61% of UEs do not have a policy to
manage some aspects of payrolls
of stable staff such as survival
control, orphans, an adult
unmarried daughter, etc.
Those responsible for
payroll do not ask for a
survival certificate on a
monthly basis.
The heads of HR offices do
not know rules and
regulations for handling
payroll and therefore cannot
monitor payroll staff.
MoH should coordinate with MoF to
train HR office teams in managing
payroll and the computerized
payroll system.
Administration of
benefits and
bonuses
71%
Moderate
development
78% of UEs have a current
institutional regulation to
manage bonuses and
benefits.
92% of UEs manage
benefits and bonuses
according to current
national regulations.
46% of UEs have designated a
responsible unit to manage
benefits and bonuses without
training.
Direct and indirect beneficiaries of
bonuses and social benefits (due to
disability, death, an accident at
work, etc.) do not know their rights.
Policies are not well
understood or known
among employees and their
beneficiaries.
MoH should establish a
mechanism to ensure that UEs
implement strategies to
communicate workers’ rights
related to compensation, benefits,
and bonuses.
Incentive
management
30%
Little
development
At least 57% of UEs have
approved rules to provide
incentives.
56% of UEs are
implementing incentives for
permanent staff according
67% of UEs do not employ staff
trained in handling incentives. 79%
of UEs have not designated a
responsible unit to manage non-
monetary incentives.
95% of UEs do not provide
The performance evaluation
system is not implemented.
MoH should promote mechanisms
for coordination among regional
and local government as well as
universities to award non-monetary
incentives.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 40
KEY PROCESS % Complete Strengths Problem Description Analysis Proposals for Improvement
to existing regulations.
41% of UEs do not offer
monetary incentives to
employees.
40% of UEs grant days off
as an incentive.
incentives based on performance
evaluation.
Pension
management
62%
Moderate
development
70% of UEs have
designated staff to manage
pensions.
85% of UEs manage
pensions according to
existing regulations.
66% of UEs have not received
training in pension management.
There is no regulation for
granting pensions.
No dissemination of
documents detailing
workers’ rights.
MoH should ensure that EUs
implement strategies to
communicate workers’ rights with
regard to pensions.
MoH should provide TA to UEs in
pension management.
SOURCE: Technical report on HRMS evaluation results for each RHD.
.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 41
2.7 Managing human and social relations
This sub-system seeks to regulate and harmonize interactions between members of the institution
with a focus on the collective dimension. It includes policies and practices related to organizational
climate; labor relations; social welfare; and safety at work.
The graph below presents results for the three processes involved in this sub-system.
On average, the sub-system achieved a 38% progress rating, which is classified as “little
development”.
Figure 16: Managing human and social relations sub-system, Peru 2014.
0% 5% 10% 15% 20% 25% 30% 35% 40% 45%
Management of the organizational climate and culture
Management of labor relations
Workplace health, safety and welfare
MANAGING HUMAN AND SOCIAL RELATIONS
SOURCE: Technical report on HRMS evaluation results for each RHD.
Some processes are particularly poorly developed, including the workplace health, safety, and
welfare process and the management of the organizational climate process with 30% and 39%,
respectively.
According to reported information, the management of labor relations process is functioning better
with a 42% progress rating.
Table 25: Managing human and social relations sub-system, Peru 2014.
KEY PROCESSES Expected
result
Obtained
result
%
Complete Result
Management of the organizational climate
and culture 1,352 402 30% Little development
Management of labor relations 2,496 1,037 42% Moderate development
Workplace health, safety, and welfare 3,224 1,264 39% Little development
Managing human and social relations 7,072 2,703 38% Little development
SOURCE: Technical report on HRMS evaluation results for each RHD.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 42
Regarding results by region for this sub-system, Callao, Lima, and Apurimac exhibited the best
performances with 56%, 55%, and 55% progress ratings while Ayacucho had the lowest score with a
20% progress rating.
Figure 17: Managing human and social relations sub-system, Peru and regions in 2014.
0%
10%
20%
30%
40%
50%
60%
Managing human and social relations
SOURCE: Technical report on HRMS evaluation results for each RHD.
The table below presents results for each managing and social relations process for all RHDs.
Table 26: Managing human and social relations, Peru and regions in 2014.
MANAGING HUMAN
AND SOCIAL RELATIONS SUB-SYSTEM
Management of the organizational climate
and culture
Management of labor relations
Workplace health, safety and welfare
PERÚ 38% 30% 42% 39%
Tumbes 42% 3% 48% 53%
Piura 22% 5% 34% 20%
Lambayeque 45% 22% 70% 36%
Ancash 33% 32% 39% 30%
Lima 55% 45% 59% 56%
Callao 56% 61% 35% 69%
Ica 31% 10% 33% 38%
Moquegua 39% 61% 41% 28%
Cajamarca 39% 25% 55% 33%
Huancavelica 26% 16% 41% 21%
Ayacucho 20% 10% 29% 17%
Pasco 29% 11% 42% 27%
Junín 41% 12% 45% 51%
Cusco 49% 32% 41% 61%
Apurímac 55% 49% 45% 65%
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 43
MANAGING HUMAN
AND SOCIAL RELATIONS SUB-SYSTEM
Management of the organizational climate
and culture
Management of labor relations
Workplace health, safety and welfare
Huánuco 32% 27% 29% 35%
San Martín 33% 19% 19% 48%
Amazonas 27% 12% 24% 34%
Ucayali 38% 26% 53% 32%
Loreto 51% 37% 52% 57%
Madre de Dios 37% 53% 38% 29%
SOURCE: Technical report on HRMS evaluation results for each RHD.
Considering the results for each of the processes, the project formed the following conclusions:
For the workplace health, safety, and welfare process, Callao achieved the best performance with
a 69% rating. However, Ayacucho achieved little progress with a 17% rating.
For the management of labor relations process, Lambayeque exhibited the best performance with
a 70% progress rating while San Martín achieved a progress rating of 19%.
Regarding the management of the organization climate process, Callao and Moquegua achieved
the highest progress ratings with 61% while Tumbes had the lowest score with 3%.
An aggregate analysis of possible explanations for these results is shown in the subsequent table. In
the next chapter, results and corresponding analysis for six regions will be presented.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Results of HRMS evaluation at national level ▌pg. 44
Table 27: Managing human and social relations sub-system, Peru 2014.
KEY PROCESS %
Complete Strengths Problem Description Analysis Proposals for Improvement
Management of
the organizational
climate and
culture
30%
55% of UEs have designated
a responsible unit to manage
the organizational climate.
44% of UEs have
methodologies and
instruments for measuring
organizational climate.
44% of UEs have scheduled
a measurement of the
organizational climate in the
current year.
90% of UEs have not analyzed
results of the organizational
climate measurement, and only
7% of UEs have implemented
any corrective measures.
80% of UEs have not received
training in organizational climate
measurement.
Lack of interest from the
highest authority in
implementation of
organizational climate
improvement plans.
MoH should provide TA to RHD to
promote measurement, analysis,
and use of results to improve the
organizational climate.
Management of
labor relations 42%
At least 37% of UEs have had
negotiations with unions, and
the results have satisfied both
parties.
91% of UEs have not received
training in negotiation.
71% of UEs believe that relations
inside RHD workers are not
good. 61% of UEs believe that
relations between networks and
micro-network workers are not
good.
Institutions do not promote
activities or opportunities to
improve relations with
workers.
Perception of workers'
satisfaction with their work
environment is not taken
into consideration by
authorities.
MoH should provide TA to RHD to
train HR team in strategies to
improve worker satisfaction,
negotiation, and conflict
management.
Workplace health,
safety, and
welfare
39%
78% of UEs celebrate the
institution’s anniversary as
part of welfare activities.
73% of UEs developed intra-
office sport competition as
part of welfare activities.
65% of UEs have developed
vaccination campaigns for
workers as part of health and
work safety programs.
80% of UEs have not received
training in health and safety at
work.
65% of UEs do not have health
and work safety policies and
regulations.
Despite passage of a
national law requiring public
and private institutions to
implement health and work
safety programs, health
institutions have not initiated
activities to implement this
law. There are currently no
penalties for
noncompliance.
MoH should provide TA to RHD to
establish a better manage in
welfare, health, and work safety
initiatives.
SOURCE: Technical report on HRMS evaluation results for each RHD.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 45
3. Analysis of results of HRMS evaluation in five selected regions
The previous chapter presented results obtained by each UE after application of the spreadsheet
provided by MoH. These results were consolidated at the RHD level and then consolidated at the
national level. These quantitative results measure the level of progress that RHDs reached. However,
it is necessary to analyze the factors that have led to these results and the limitations of regions with
the lowest scores.
In this chapter, an analysis of the quantitative results for the five selected regions is presented.
The following criteria were used to select the five regions:
RHD with the highest comprehensive average score.
RHD with the lowest comprehensive average score.
Three RHDs with intermediate comprehensive average scores.
RHDs with 100% of UEs assessed.
RHDs with technical reports containing an analysis of the results.
For this purpose, RHDs were ranked from highest to lowest score and five selections were made:
Loreto RHD had the highest score with a 47% rating.
Piura RHD had the lowest score with a 21% rating.
Lambayeque, Pasco, and Huánuco RHDs had intermediate scores with 39%, 35%, and 33%
ratings, respectively.
All UEs within these five RHDs were assessed, and each UE sent MoH a technical report containing
an analysis of the results.
The following table shows RHDs ranked by highest to lowest score.
Table 28: Human Resources Management System progress rating by region, Peru 2014.
RHD HRMS progress
rating RANK
Loreto 47% 1
Callao 45% 2
Junín 44% 3
Cusco 43% 4
Lima 41% 5
Apurímac 41% 5
Cajamarca 40% 6
Lambayeque 39% 7
Pasco 35% 8
Huánuco 33% 9
Ucayali 32% 10
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 46
RHD HRMS progress
rating RANK
Moquegua 32% 10
Ica 31% 11
Huancavelica 31% 11
Ancash 30% 12
San Martín 30% 12
Madre de Dios 29% 13
Ayacucho 27% 14
Amazonas 26% 15
Tumbes 25% 16
Piura 21% 17
The next table presents more detailed information on the five selected RHDs.
Table 29: General characteristics of the five selected RHDs, Peru 2014.
RHD PERÚ Loreto Lambayeque Pasco Huánuco Piura
N° of UEs 162 6 4 3 7 7
HRMS progress rating 35% 47% 39% 35% 33% 21%
N° of physicians, nurses
and midwives per 10,000
inhabitants, in 2012 /1
26.1 14 21.7 26.9 18 15
Population density
(inhabitants per Km2) /3 23 3 86 12 23 50.1
Chronic malnutrition
prevalence in 2012/2013
/2
18.12 /
17.49
32.32 /
27.64
13.96 /
14.2
26 /
26.5
30.85 /
29.05
21.65/
24.9
-3% -14% 2% 2% -6% 15%
Neonatal mortality in 2011 /
2013 /2
9.8
11.97
22.1
19.1
10.2
7.62
18.9
15.79
13.9
13.93
12.1
13.62
22.1% -13.6% -25.3% -16.5% 0.2% 12.6%
Physician turnover (2012-
2013) 34% 28% 41% 68% 63% 27%
Nurse turnover (2012-2013) 26% 17% 33% 18% 49% 24%
Midwife turnover (2012-
2013) 32% 13% 28% 24% 48% 12%
Geographical location Jungle Coast Highland Highland and
Jungle Coast
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Source:
1/ Ministry of Health: HR observatory.
2/ National Institute of Statistics and Informatics (INEI) - National Survey of Demography and Family Health
(ENDES).
3/ National Institute of Statistics and Informatics (INEI).
Loreto, with the best performance, is located in the jungles of Perú and has the lowest population
density. Given the region’s dispersed population, Loreto faces problems in providing access to health
services. Due to its geography, this region requires more health workers to reach its dispersed
population than other regions. In contrast, Piura, with the lowest performance, is located on the coast
of Perú and has 17 times more inhabitants per square kilometer than Loreto. Accordingly, Piura
should be better able to provide health care services in fixed facilities.
Loreto’s dispersed population and problems related to service access could explain high rates of
malnutrition and neonatal mortality. In order to correlate HRMS performance results 1 with
improvements in health indicators, the project compared the level of variation between rates found
over the last two periods.
Through this comparison, Loreto achieved a 14% reduction in chronic malnutrition while Piura
malnutrition rates increased by 15%. Similarly, the neonatal mortality rate in Loreto decreased by
14% while it increased in Piura by 13%.
Loreto and Piura have fewer health professionals per inhabitant and less turnover than other regions.
However, HHR availability is not enough to improve a population’s health status. Many other factors
influence health status improvement, including the level of labor competencies; policies to improve
individual performance; establishment of clear tasks and responsibilities; fair remuneration; incentive
policies; recruitment based on merit; and a pleasant working environment endowed with the
necessary equipment, among others.
Table 30: General characteristics of the five selected RHDs, Peru 2014.
RHD PERÚ Loreto Lambayeque Pasco Huánuco Piura
N° of UEs 162 6 4 3 7 7
HRMS progress rating 35% 47% 39% 35% 33% 21%
Sub-system with the
best development
Employment
management
(45%)
Development
and training
management
(67%)
Employment
management
(62%)
Compensation
management
(50%)
Employment
management
(45%)
Employment
management
(35%)
Sub-system with the
worst development
Performance
management
(20%)
Performance
management
(24%)
Performance
management
26%)
Performance
management
(17%)
Performance
management
(19%)
Performance
management
(5%)
Source:
1/ Ministry of Health: HR observatory.
2/ National Institute of Statistics and Informatics (INEI) - National Survey of Demography and Family
Health (ENDES).
3/ National Institute of Statistics and Informatics (INEI).
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Regarding the best developed sub-system in these five regions, Lambayeque, Huánuco, and Pasco
exhibited good performances in the employment management sub-system. Loreto achieved the
highest score in the development and training management sub-system. However, in spite of efforts
to improve and build capacities in health workers through training programs, Loreto RHD is poorly
developed in the performance management sub-system as well as all RHDs at national level.
Improving the population’s health status depends not only on designing good health policies,
programs, and strategies but also correctly implementing them. HHR are both directly and indirectly
responsible for policy implementation; therefore, the quality of implementation depends on the quality
of HHR. Managing HHR is not only the management of a group of isolated processes. Rather, HHR
processes must be integrated into interrelated sub-systems whereby an output of one process is an
input for one or more processes.
At this time, Loreto has exhibited the best HRM performance. However, this does not mean that
HRMS in Loreto is properly developed as it only achieved a 47% progress rating. This rating implies
that much remains to be done in improving HRM nationwide.It is important to highlight the
achievement made by Loreto RHD in spite of unfavorable conditions as it managed to achieve the
greatest progress in HRMS implementation.The analysis developed by each UE team, consolidated
by RHD, is presented below. Detailed information about each HRMS sub-system is presented in the
annexes.
3.1 Loreto Regional Health Directorate
Regarding HR office, Loreto RHD has not designated a responsible unit to govern HRM process.
There is no budget to create staff positions for each process. Offices and units share overlapping
functions, as is the case with the quality office and social welfare unit.
In spite of this, one of the main achievements is the development of strategies to improve staff
capacities.
Achievements and opportunities for improvement in Loreto RHD and its UEs are:
In this RHD, responsible units have been designated to manage HRMS processes, including
HHR strategic planning and finance management monitoring; information management; design of
job profiles; identification of labor competencies to select human resources; management of
recruitment, selection, incorporation and induction; management of attendance control; staff
mobility and staff termination; payroll management; incentive management; labor advancement
including promotion and career paths; supervision; performance evaluation; salary scale
management; and administration of benefits and bonuses. However, management documents
are outdated in relation to national regulations.
Loreto RHD also has an approved ROF that specifies the responsible unit in identifying
institutional competencies. However, specific functions are not defined in ROF, MOF, and other
management tools; and defining specific functions has not been prioritized in HHR management
and development policies.
Loreto RHD has identified the following issues in its UEs related to capacity building and training:
- Despite weak support for skills development, training policies have been approved to support
these processes.
- Additionally, there is a designated unit and trained staff to support these policies and
processes.
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- A regional health undergraduate committee (COREPRES) was approved by executive
resolution, but it does not always meet. Loreto RHD has signed agreements with training
institutions and has coordinated with other institutions on short-term training sessions.
- The limited budget for capacity building has prevented all staff from being trained.
- Training staff has not been prioritized as a key factor in institutional development.
To improve HRM, Loreto RHD is training personnel and utilizing an Excel application to determine
the HHR gap at the three levels of care. In Loreto, there are also technical and management
documents as well as HHR legislation, including the Annual Training Plan, which was approved
by RHD executive resolution.
Unlike in Loreto RHD, in most UEs there is no responsible unit or trained staff to manage HRM
processes, including planning and HR budget needs identification; information system
management; and designing, monitoring, and analyzing HR indicators, among others.
A research management unit has been implemented in Loreto RHD but not in its UEs. In UEs,
there is a lack of professionals to develop research.
There are regulations and tools for recruitment, selection, incorporation, and induction; technical
tools for supervision; and regulations to define salary scales and grant benefits, bonuses, and
incentives.
There is trained staff turnover, and permanent relocation of workers to different offices and units.
Staff performs multiple functions.
But managers are also generally uninterested in training staff. There is no unit with an exclusive
mandate to train personnel in the development of competency profiles, job rating, and personnel
recruitment.
One of senior management´s priorities is planning and implementing skills development training
for professional groups. However, given the prioritization of other activities, staff does not
exclusively perform these functions on a full time basis but rather periodically according to office
needs.
The large size of the Loreto region affects HHR management and development in a variety of
ways:
- One important issue to consider is the difficulty of developing training opportunities..
- With few training opportunities, staff are not able to develop their skills, which further
exacerbates coordination between UEs and Loreto RHD.
- There is insufficient budget to supervise each health facility.
- It has been noted that there is no equity in the management of payroll and salaries using the
job rating for remote and undeveloped areas (ZAF).
Loreto RHD does not performed objective performance evaluations.
UEs staff has little knowledge of policies, regulations, and laws that govern different HHR
processes, including the management of disciplinary proceedings and the technical criteria
required for job rating, among others.
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3.2 Pasco Regional Health Directorate
Achievements and opportunities for improvement in Pasco RHD and its UEs are:
Pasco RHD has formulated and approved eight regional policies for HHR development
management. However, not all policies have been implemented, and few personnel are familiar
with them. There is little interest in their implementation at the national level. Many HR
management processes require national regulatory arrangements. There is no HR strategic
planning policy nor have HR strategic plans been developed. Few staff in the Office is dedicated
to HHR management. There is high staff turnover.
Information systems, including the Human Resources MoF Module and the PLAME Module, have
been established to filter and control HR management.
Pasco RHD and the Daniel Alcides Carrion Hospital have identified three job skills: prenatal care;
growth and development; and demonstration sessions. The first two competencies have been
assessed at health facility pilot sites. Job profiles and job rating have not been designed or
developed. No skills have been identified for staff functions.
RHD has selected and approved regional research priorities and the research management
regulation. However, a research management unit has not been implemented, and operational
research has not been developed. There is no budget for compliance, and there is a lack of
interest among professionals to develop research. The A research component and guidelines
have not been incorporated into institutional management documents.
There is coordination with training institutions, and there is a framework agreement between
universities, the regional government, and MoH. However, the lack of specialized hospitals has
resulted in limited clinical field. Training activities are not aligned with institutional needs; there is
no reliable information about training; and there are no plans for capacity development in the
medium and long term.
While there are instruments to measure the performance of first-level-of-care health facilities,
there is no policy that governs HR performance improvement planning. Performance assessment
tools have not been institutionalized nor are there monitoring tools that incorporate performance
evaluation. Institutional targets exist, but individual targets do not exist. There are no validated
models of performance improvement plans, and feedback processes as well individual
performance plans have not been designed.
Pasco RHD and the Daniel Alcides Carrion Hospital have a PDP but need to improve its content.
There is no budget to finance PDP.
No HR competencies have been identified for the design of profiles and job rating. Few
professionals have been trained in the methodology for identification and standardization of labor
skills. There is little interest in defining and developing job competencies, and there has been
slow progress in developing job profiles at the national level.
There are population density gap indicators that RHD has used for HR management, but there is
no directive governing the recruitment, selection, and incorporation of HR.
RHD and the Daniel Alcides Carrion Hospital have started entering data in INFORHUS. However,
HHR data is outdated and incomplete, and personnel displacements are not recorded.
INFORHUS also does not include goals and productivity indicators. In general, INFORHUS entry
and reporting data is more limited than with SIRHUS. RHD has little control over networks,
hospitals, and micro-grids. Little importance is given to HR information management.
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Budgeting by results and capitation budget agreements establish mandatory performance targets.
However, these targets have not been monitored, and strategic budget outcomes related to
quality and health care services have not been evaluated.
There is a limited availability of financial resources to improve staff remuneration for CAS
contracts. The salary scale for CAS contracts is not standardized. SERUMS and permanent staff
salary scales are a national-level responsibility.
A disciplinary process committee has been established, but sanctioning capacity is almost not
exist. Thus personnel who are subject to the disciplinary process continue to work. The internal
audit unit does not perform prior and concurrent monitoring of administrative and disciplinary
proceedings.
There are national tools for measuring organizational climate, but they have not been
implemented in this RHD. There is a lack of interest in developing the process. Some UEs are not
currently operating under a good organizational climate.
Staff does not know their rights and responsibilities. Few social welfare activities are developed.
There is no personnel welfare service. There is no permanent staff to manage labor relations.
Safety regulations have not been developed, and therefore, personnel are vulnerable to accidents
at work. Some UEs do not provide complementary insurance to cover work safety (SCRT) for
CAS contracts.
There are resources and expertise available to implement monetary and non-monetary
incentives. Benefits and bonuses are distributed to staff. However, incentive management is not
implemented, and there is no directive or incentive plan for personnel. Benefit and bonus
payments are delayed.
Salary scales are approved at the national level. There is increased funding to hire HR, and
mandatory designation processes have been initiated at the national level. DL 1153 establishes
remunerative improvements. However, there is no increased funding for improved remuneration
for CAS contracts, administrative staff, and staff covered under DL 728.
A unit has been designated to manage attendance control in all health facilities and micro-grids,
but not all staff is in agreement to this task.
Vacant positions are not immediately filled as they are not attractive due to low salaries. New
contracted personnel do not go through the induction process. There is no induction policy for
new contracted and appointed personnel.
3.3 Huánuco Regional Health Directorate
Regarding HR office, there is a lack of personnel and physical space for the development of activities
related to HRMS processes. However, there are some achievements and several opportunities for
improvement, such as:
There is a HR unit in Huanuco RHD that is responsible for designing HR policies. But, no HHR
operational research is done to support HR policies.
There is no timely and accurate data to define HHR needs and there is insufficient budget to
cover HHR.
Insufficient HR allocation was identified as a priority and is partially a result of high staff turnover.
Qualified staff is scarce for higher level health facilities. Level I-4 health facilities are generally
under staff in terms of HHR and specialist physicians.
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Huanuco RHD does utilize information systems and criteria to define HHR training requirements.
CAP, MOF are used as references in designing job profiles, but Huanuco RHD are not using
MAPRO and standardized processes to define them.
There is also a designated unit for managing the recruitment, selection, incorporation, and
induction of staff. However, staff recruitment is not based on a HHR gap study..
Specific personnel are responsible for updating staff mobility; updating staff files; and managing
staff termination and retirement.
There is no information system to record, maintain, and update staff information by occupational
group and labor regime, including staff retirement information. Information management is
considered to consist mainly of managing the names of workers and staff files. There is no
budget to hire and train staff to carry out these functions.
Huanuco RHD has defined job competencies for staff who work on growth and development in
children under five; though, trainers’ availability is very limited.
No unit exists to manage regulations for staff development, training, and teaching personnel.
There is a lack of criteria to measure knowledge and develop performance evaluations, which
would help to determine training needs.
There is a lack of skilled and committed staff to achieving institutional goals. Personnel and
management staff display little initiative in their work. As a consequence, institutional goals are
not achieved.
In general, the lack personnel with skills, commitment, and initiative negatively affects the
efficiency and performance of employees in carrying out their work.
There is no designated unit or personnel responsible for planning, organizing, implementing,
evaluating, and monitoring the individual performance evaluation process. Similarly, there is no
designated unit to provide tools to develop feedback and design plans for individual performance
improvement.
No approved rules or policies exist for implementation of incentives.
There is no designated unit to manage monetary and non-monetary incentives; benefits; and
bonuses.
Staff welfare activities are not planned.
3.4 Lambayeque Regional Health Directorate
Achievements and opportunities for improvement in Lambayeque RHD and its UEs are:
There is support from senior management and staff and budget availability to hire HR in some
UEs. However, there is no responsible unit for HHR planning. SIGA and INFORHUS systems
have been updated in each UE, and they are customizable. There are management documents
that demonstrate the need for HHR. However, management tools are outdated, and the
information entered is not analyzed.
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A HHR gap analysis for primary care has been completed, but gap analyses have not been done
for the second and third levels of care.
HR requirements and financing needs have been estimated for some UEs, and information is
available as a guide in the development of indicators. However, HHR management indicators do
not exist, and HHR is not trained in the development of HR management indicators. There are no
procedures for strategic policy formulation or management.
In general, research units have not been established within health facilities. However, one does
exist in a hospital, but HHR operational research is not carried out within it.
HR is willing to participate in processes that will create changes, but little importance is assigned
to HHR management issues. There is no designated unit or specialized staff to design job
profiles, labor competencies, or job rating.
Most management documents, including a methodological guide to develop job profiles in public
institutions, are available. Reference documents on the design and definition of labor
competencies are available from other institutions like MoH and professional associations.
Unfortunately, they are not utilized. There are guidelines for selection processes, but the
induction process is insufficient for new personnel.
There is limited budget available for optimal HHR development management. As a consequence,
staff is working in positions that do not correspond to their academic training, experience, or
capabilities. Job functions do not correspond to MOF, MAPRO, and CAP.
There is an office responsible for staff file administration, affidavits, and attendance control. There
is a permanent commission for HHR recruitment and selection. However, these units are
insufficiently staffed, and the staff within the unit is often unqualified to manage employment
processes.
There is a disciplinary process commission and internal regulations for disciplinary processes.
However, there are insufficient logistical supplies and no competent legal advisors.
There is an office responsible for updating staff termination data, and updated regulations exist.
However, there is a lack of software for registering and updating staff termination by occupational
group and labor regime.
Staff files management and attendance control are not properly performed.
There is a limited number of job offers made, and low remunerative levels as well as better offers
from the private sector prevent the immediate filling of positions.
There is a job promotion regulation but no internal promotion policies. No promotion selection
processes exist.
The budget for training has increased, and there is a regulation for guaranteeing future budget
allocation. Lambayeque RHD has designated a unit and experienced staff to manage training
processes, but there are no units or specialized staff in UEs for this purpose.
Training policies have not been designed. There is no methodological guide for skills
development, and staff training needs have not been identified. There is no information system to
record training provided to staff.
There are approved tools for supervising and evaluating staff performance. However, there is no
designated unit or trained staff to plan performance targets, monitoring, evaluation, feedback, and
design of individual performance improvement plans.
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There is no methodology for designing performance evaluation plans. Performance goals are not
defined. Staff performance monitoring is not performed. Performance evaluation tools modeled
on a traditional approach do not evaluate skills required for the position.
There is a different salary scale for CAS contracts in the Andean high zone and a bonus for
positions in remote and dispersed areas. However, job positions remain unattractive due to low
salaries. CAS staff salaries are particularly low.
There is a designated unit for salary and payroll management; bonus and benefit administration;
and incentive management. However, UEs are not authorized to devise their own salary scales.
There is limited budget to support these processes.
There are trained HR personnel to manage the payroll record. Payroll records are updated on a
monthly basis; however, MoH does not have an updated payroll system.
Bonus and pension regulations are followed, but there is limited budget to pay pensions at the
end of the year.
AFP does not report the transfer of employees within AFP in a timely manner. Staff is not
knowledgeable about pension systems. Payment to AFP is delayed.
Personnel are not trained in staff benefits and current bonus regulations. Non-monetary
incentives are not granted. There is no budget for CAS staff incentives.
There is no designated unit to manage organizational climate and culture. There is no trained
staff to implement and monitor the organizational climate improvement plan. The organizational
climate is not measured.
There is a designated unit and personnel to manage workplace health and safety processes.
However, there is no workplace health and safety program. Due to this, staff is not well protected
from job-related accidents.
There is a social service office, and welfare programs exist.
3.5 Piura Regional Health Directorate
Achievements and opportunities for improvement in Piura RHD and its UEs are:
Staff is available to implement policies, strategic planning, and HHR information management
despite the fact that HR planning is not promoted by the state and the absence of HHR
information management policy. Job performance is not assessed; staff profiles are not updated;
staff is not motivated by; and safety and occupational health procedures do not exist.
ROF identifies the need for systematization and updating of HR information for decision-making
and development planning. However, there are no HR policies or strategies, and there are no
specific functions for these processes in ROF. While a monthly analysis of the HHR situation
within the institution is performed, data is mostly outdated. Current systems do not record non-
remunerative concepts such as attendance, tardiness, and absences. Only remuneration data is
updated and maintained through the PLH system. There is no budget to purchase software.
Recruiting processes have been implemented based on profiles for HHR hiring, but personnel
selection is not based on HR merits. While staffing requirements have been met based on WHO
rates and service need projections, no research policy exists nor is operational research
development performed.
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Over 80% of units possess management documents, including MOF, ROF, and CAP, which are
used as references in job design. However, the Piura regional government has not approved the
institutional CAP and MOF; instead, it is using outdated documents. MoH labor competencies
documents are used, but UEs are not conform with current conditions and realities. There is no
designated unit to design job profiles or identify labor competencies. There is a lack of funding,
minimum criteria, and tools for assessing and defining labor competencies (job profile,
experience, training, etc.).
Each job has a profile, and personnel know their job functions. However, there are no job rating
policies nor is there a designated unit for job evaluation. There is no training plan to improve staff
performance and competitiveness levels. Some staffs currently perform functions that are not part
of their respective job profile.
Due to the lack of knowledge, some hospital departments have not developed MAPRO or other
administrative manuals.
Piura RHD has designated a unit for employment management processes, but staff is not trained
and are responsible for. The National Register of Dismissal and Sanctions (RNSDD) is not
consulted during the selection and recruitment process.
Selection phases are carried out in accordance with DL 276. UE managers are part of the
recruitment committee. Few candidates fit the required profile, and they are not evaluated based
on their knowledge or experiences. Once selected, personnel do not go through an induction
process.
Staff mobility occurs according to health facility needs. PIURA RHD has a designated and staffed
unit to update staff mobility information within and outside the institution; UEs do not have a
designated office or staff to perform this function.
Some UEs have designated a unit and staff to manage files and attendance control. However,
personnel do not update job files, and staff tardiness and absences are not reported.
Some UEs use a computer program called SYNASYS for attendance control. However,
attendance registration is done manually in remote health facilities.
There is a permanent disciplinary process committee. Unfortunately, it rarely meets, and
members are not trained. The RNSDD data is not updated.
Some UEs have designated a unit for development and training management. The HR offices do
not fulfill its functions to manage training processes due to limited budget and lack of staff.
Staff promotion does not take into account criteria such as performance evaluations.
There are several criteria for recruitment, including no disciplinary offenses and experience in the
public sector. However, job profiles, performance evaluations, and training plans for recruitment
and selecting staff are not used.
Regional health needs were not taken into account when training programs were developed.
Some UEs have designated a unit for teaching and research. However, there are few agreements
with technological institutes, and there is no designated teaching staff. Students who have been
trained are not registered in an information system.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 56
There is no designated unit for developing performance evaluations or implementing supervision
processes. Staff is afraid to be evaluated since evaluations are associated with dismissal.
Therefore, performance evaluations are not performed.
Job rating is not defined. The salary scale is based on national legislation, but do not pay
employees according to the scale.
There is a designated unit to manage salaries and payroll. However, staff have not been trained,
and only follow MoH directives. Payroll system information is obsolete.
The current directive for benefits and incentives management comes from the central level, but
performance is not considered in the administration of benefits and incentives. UEs have not
designated personnel to administer benefits and incentives. Benefits, including AETAS and other
legal benefits, are regulated by law.
The budget allocation for payment of benefits and bonuses is timely managed. Incentives and
bonuses are not provided according to performance evaluation results.
The Annual Budget Law restricts salary increases even when there is sufficient budget for it.
There is no designated unit or personnel responsible for managing pensions.
An organizational climate measurement has not been planned. Additionally, personnel do not
want to complete the organizational climate survey. Interpersonal relationships between staff
members are not good.
There is a designated unit responsible for managing health and safety at work. However, basic
workplace health and safety regulations have not been updated. The improvement of welfare
conditions and job safety is not considered in the budget allocation.
There are isolated activities for improving well-being at work, including workshops and contests to
improve working relationships.
There is no designated unit for workplace welfare. The Social Assistance Unit does not perform
these functions. Welfare programs, including child care and a club for the elderly, are not offered.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 57
4. Analysis of HRMS assessment results in San Martin Regional
Health Directorate compared with national results
In the previous technical report submitted in September 2013, the project presented results obtained
by SMT-RHD after application of the project-designed spreadsheet. For that report, data was
collected from the SMT-RHD HR unit and selected networks at a workshop.
On December 2014, MoH dispatched tools and instruments to each UE to aid in information collection
related to HRMS implementation.
SMT-RHD was in charge of gathering of information from each of its UEs.
In this chapter, the project will present results for each SMT-RHD UE to compare them with results
obtained for all other UEs with the exception of La Libertad, Arequipa, Tacna and Puno RHDs, which
did not send the required information2.
Table 31: Distribution of networks and micro-networks by UE, San Martin 2014.
UE Health Network Micro-network
400: Bajo Mayo
(San Martín)
RED EL DORADO
MR AGUA BLANCA
MR SAN JOSE DE SISA
MR SAN MARTIN ALAO
RED LAMAS
MR HOSPITAL LAMAS
MR CUÑUMBUQUI
MR TABALOSOS
MR BARRANQUITA
MR CAYNARACHI
MR PACAYZAPA
RED PICOTA
MR LEONCIO PRADO
MR PICOTA
MR PUCACACA
RED SAN MARTIN
MR CHAZUTA
MR HUIMBAYOC
MR SAUCE
MR BANDA DE SHILCAYO
MR MORALES
MR TARAPOTO (NUEVE ABRIL)
MR PAPAPLAYA
MR JUAN GUERRA
2 These RHDs argued that they lacked information from all UEs, and they agreed to send the
information to MoH as soon as it is complete.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 58
UE Health Network Micro-network
401: Alto Mayo
RED MOYOBAMBA
MR JEPELACIO
MR JERILLO
MR LLUILLUCUCHA
MR SORITOR
MR YANTALÓ
MR PUEBLO LIBRE
MR CALZADA
MR ROQUE ALONSO DE ALVARADO
RED RIOJA
MR NARANJOS
MR NUEVA CAJAMARCA
MR NUEVO RIOJA
MR BAJO NARANJILLO
MR SEGUNDA JERUSALEN
MR SAN FERNANDO
MR JUAN DE RIO SORITOR
MR YURAYACU
402: Huallaga Central
RED BELLAVISTA
MR ALTO BIAVO
MR BAJO BIAVO
MR BELLAVISTA
MR SAN PABLO-CONSUELO
RED HUALLAGA MR SACANCHE
MR SAPOSOA
RED MARISCAL
CACERES
MR CAMPANILLA
MR COSTA RICA
MR HUICUNGO
MR JUANJUI
403: Alto Huallaga RED TOCACHE
MR NUEVO PROGRESO
MR POLVORA
MR TOCACHE
MR UCHIZA
404: Hospital de
Tarapoto Hospital de Tarapoto
After consolidating results for all five SMT-RHD UEs, the project determined the following results:
SMT-RHD achieved a 29% rating for HRMS implementation, which is the average level of
implementation for all seven sub-systems. This rating is lower than the average national rating of
35%.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 59
The compensation management sub-system achieved the best implementation rating at 39%.
This is the only sub-system in which the results are better than the national average, which, in
this case, is 37%.
The performance management sub-system achieved the lowest level of development at 13%,
which is less than the national average of 20%.
Figure 18: Human Resources Management System by sub-system in Peru and San Martin,
2014.
0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%
HHR POLICY AND STRATEGIC PLANNING SUB-SYSTEM
WORK ORGANIZATION SUB-SYSTEM
EMPLOYMENT MANAGEMENT SUB-SYSTEM
PERFORMANCE MANAGEMENT SUB-SYSTEM
DEVELOPMENT AND TRAINING MANAGEMENT SUB-SYSTEM
COMPENSATION MANAGEMENT SUB-SYSTEM
MANAGING HUMAN AND SOCIAL RELATIONS SUB-SYSTEM
HUMAN RESOURCES MANAGEMENT SYSTEM
PERU
TOTALDIRES-SMT
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
Regarding UE performance on HRMS implementation, the project found that UE 404-Tarapoto
Hospital achieved the highest progress rating at 38%, which is higher than the national average. UE
400-Bajo Mayo had the lowest rating at 23%.
Figure 19: Human Resources Management System by UE, San Martin 2014.
0% 5% 10% 15% 20% 25% 30% 35% 40%
UE 400San Martin
UE 401Alto Mayo
UE 402Huallaga Central
UE 403Alto Huallaga
UE 404Hosp Tarapoto
TOTAL
DIRES-SMT
PERU
UE 400San Martin
UE 401Alto Mayo
UE 402Huallaga Central
UE 403Alto Huallaga
UE 404Hosp Tarapoto
TOTALDIRES-SMT
PERU
HRMS 23% 25% 34% 24% 38% 29% 35%
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
The following table shows results obtained by each UE in each of the HRMS processes.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 60
Table 32: Human Resources Management System processes by UE, San Martin 2014.
Human Resources Management System processes
UE
40
0:
Sa
n M
art
in
UE
40
1:
Alt
o M
ayo
UE
40
2:
Hu
all
ag
a C
en
tra
l
UE
40
3:
Alt
o H
ua
lla
ga
UE
40
4:
Ho
sp
Ta
rap
oto
DIRES SMT
PERU
HHR policy and strategic planning 26% 35% 23% 45% 23% 30% 31%
Policies and strategies for HHR
management 0% 4% 0% 11% 0% 3% 17%
Development of operational research 0% 0% 0% 27% 0% 5% 8%
HHR information management 43% 52% 39% 80% 37% 50% 40%
HHR management control 0% 0% 17% 0% 23% 8% 18%
HHR strategic planning 42% 53% 26% 42% 26% 38% 35%
HHR financing 23% 77% 0% 62% 0% 32% 41%
Work organization 24% 22% 28% 22% 28% 25% 29%
Design of job profiles 25% 25% 25% 25% 25% 25% 42%
Identification of labor competencies 19% 11% 33% 11% 33% 21% 14%
Job rating 30% 30% 30% 30% 30% 30% 12%
Employment management 27% 31% 27% 32% 40% 31% 45%
Recruitment, selection, incorporation, and induction 35% 40% 39% 44% 39% 39% 48%
Staff mobility 0% 0% 14% 0% 71% 17% 45%
Management of staff files and attendance control 41% 30% 5% 35% 43% 31% 44%
Administration of disciplinary process 5% 23% 14% 9% 32% 16% 35%
Staff termination and retirement 0% 11% 21% 0% 26% 12% 32%
Performance management 4% 12% 24% 4% 24% 13% 20%
Performance planning 0% 0% 17% 17% 17% 10% 26%
Supervision 10% 0% 25% 0% 25% 12% 16%
Performance evaluation 5% 25% 25% 0% 25% 16% 21%
Feedback and design of plans for individual
performance improvement 0% 8% 28% 0% 28% 13% 12%
Development and training management 3% 18% 57% 19% 61% 31% 43%
Labor advancement (promotion and career path) 0% 12% 68% 39% 62% 36% 42%
Capacity building 0% 28% 56% 10% 64% 32% 48%
Regulation of the teaching & service process 14% 0% 38% 5% 49% 21% 33%
Compensation management 46% 32% 39% 32% 47% 39% 37%
Design of salary scales 31% 37% 31% 38% 51% 38% 24%
Management of payroll and salaries 100% 88% 47% 35% 47% 64% 60%
Administration of benefits and bonuses 87% 53% 67% 53% 67% 65% 71%
Incentive management 26% 11% 33% 16% 33% 24% 30%
Pension management 100% 20% 60% 40% 60% 56% 62%
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 61
Human Resources Management System processes
UE
40
0:
Sa
n M
art
in
UE
40
1:
Alt
o M
ayo
UE
40
2:
Hu
all
ag
a C
en
tra
l
UE
40
3:
Alt
o H
ua
lla
ga
UE
40
4:
Ho
sp
Ta
rap
oto
DIRES SMT
PERU
Managing human and social relations 34% 25% 45% 17% 45% 33% 38%
Management of the organizational climate and culture 0% 0% 47% 0% 47% 19% 30%
Management of labor relations 33% 24% 9% 21% 9% 19% 42%
Workplace health, safety, and welfare 48% 35% 69% 21% 69% 48% 39%
HUMAN RESOURCES MANAGEMENT SYSTEM 23% 25% 34% 24% 38% 29% 35%
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
HHR policy and strategic planning sub-system
The following graphs show regional-level results from six of the processes that are within this sub-
system compared with national results.
Figure 20: HHR policy and strategic planning sub-system, San Martin 2014.
0% 10% 20% 30% 40% 50% 60%
Policies and strategies for HHR management and development
Development of operational research
HHR information management
HHR management control
HHR strategic planning
HHR financing
HHR POLICY AND STRATEGIC PLANNING SUB-SYSTEM
PERU
TOTALDIRES-SMT
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
On average, implementation of this sub-system is 30% complete, which indicates “little development”;
this is similar to the national average. Some processes are particularly poorly developed, including
policies and strategies for HHR management as well as operational research with 3% and 5%,
respectively. For these processes, SMT-RHD UEs scored lower than national averages.
According to the reported information, HHR information management and HHR strategic planning are
functioning better than the national averages: for these two processes, SMT-RHD UEs achieved 50%
and 38% ratings, respectively.
The project worked with SMT-RHD in the design, validation, and implementation of a methodology to
calculate HR staffing needs at the first level of care. One important factor in generating reliable
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 62
calculations is having timely information on current HR availability. The project’s assistance in this
area could explain the relatively high ratings for these processes.
UE 403-Alto Huallaga exhibited the best performance for this sub-system with a 45% rating while UE
402-Huallaga Central and UE 404-Hospital Tarapoto obtained the lowest score with 23% ratings.
Figure 21: HHR policy and strategic planning by UE, San Martin 2014.
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
UE 400San Martin
UE 401Alto Mayo
UE 402Huallaga Central
UE 403Alto
Huallaga
UE 404Hosp
Tarapoto
TOTALDIRES-SMT
PERU
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
Table 33: HHR policy and strategic planning by UE, San Martin 2014.
Human Resources Management System processes
UE
40
0:
Sa
n M
art
in
UE
40
1:
Alt
o M
ayo
UE
40
2:
Hu
all
ag
a
Cen
tral
UE
40
3:
Alt
o H
ua
lla
ga
UE
40
4:
Ho
sp
Ta
rap
oto
DIRES SMT
PERU
HHR policy and strategic planning 26% 35% 23% 45% 23% 30% 31%
Policies and strategies for HHR
management 0% 4% 0% 11% 0% 3% 17%
Development of operational research 0% 0% 0% 27% 0% 5% 8%
HHR information management 43% 52% 39% 80% 37% 50% 40%
HHR management control 0% 0% 17% 0% 23% 8% 18%
HHR strategic planning 42% 53% 26% 42% 26% 38% 35%
HHR financing 23% 77% 0% 62% 0% 32% 41%
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 63
Considering the results for each of the UEs, the project formed the following conclusions:
For policies and strategies within the HHR management and development process, UE 403
achieved the best performance rating with 11%. However, some UEs, including UE 400, UE 402,
and UE 404, failed to achieve any progress in this category. On average, SMT-RHD UEs
achieved a 3% progress rating while the national average was 17% for this process.This process
is related to the design, approval, and implementation of HR policies. In spite of USAID project
support in helping to design SMT-RHD HHR policies, these policies have not yet been approved,
and therefore, they have not been implemented.
In the development of operational research process, UE 403 achieved the best performance
rating with 27% while all other UEs failed to achieve any progress in this category. On average,
this process is the least developed process within this sub-system at the national and regional
level.
For the HHR information management process, UEs scored an average progress rating of 50%.
UE 403 achieved the best rating with 80% while Tarapoto Hospital had the lowest progress rating
with 37%.
For the HHR management control process, Tarapoto Hospital showed the best performance with
a 23% rating. While UE 402 scored a 17% progress rating, all other UEs failed to achieve any
progress in this category.
For the HHR strategic planning process, UE 401 achieved the highest progress rating with 53%,
which is higher than the national average of 35%. UE 402 and UE404 had the lowest scores with
26% each.
Regarding the HHR financing process, UE 401 achieved the highest progress rating with 77%,
which is higher than the regional and national averages. UE 402 and UE 404 failed to achieve
any progress in this category.
A detailed analysis and proposals for improvement were presented in the previous technical report.
Work organization sub-system
The following graph shows the results of three processes included in this sub-system. On average,
the progress rating for this sub-system within SMT-RHD was measured at 25%. According to regional
reports, slight improvements have taken place in the job rating category resulting in a progress rating
of 30%, which is higher than the national average of 12%.
Figure 22: Work organization sub-system, San Martin 2014.
0% 5% 10% 15% 20% 25% 30% 35% 40% 45%
Design of job profiles
Identification of labor competencies
Job rating
WORK ORGANIZATION SUB-SYSTEM
PERU
TOTALDIRES-SMT
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 64
The project provided technical assistance to SMT-RHD in the design and validation of a tool to
measure job positions for the first level of care. Job rating implementation is a prerequisite in
designing salary scales. The project’s assistance in this area could explain the relatively high ratings
for these processes compared with the national average.
The design of job profiles process includes tasks related not only to the design and implementation of
job profiles but mainly to the design, updating, and use of managerial documents such as the
Organization and Functions Regulations (ROF); the Functions Manual (MOF); the Staff Allocation
Table (Cuadro de asignación de personal, CAP); and the Staff Analytical Budget (Presupuesto
Analitico de Personal, PAP). Although these documents are mandatory for all public institutions, very
few of them have been updated. This could be explain why the job profiles design process is poorly
developed for all SMT-RHD units in spite of strengthened elements within the process.
Figure 23: Work organization, San Martin and UEs in 2014.
0%
5%
10%
15%
20%
25%
30%
35%
UE 400San Martin
UE 401Alto Mayo
UE 402Huallaga Central
UE 403Alto
Huallaga
UE 404Hosp
Tarapoto
TOTALDIRES-SMT
PERU
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
UE 402 and UE 404 achieved the best performance ratings for this sub-system with 28%, which is
higher than the regional average and very close to the national average. UE 401 and UE 403
obtained the lowest ratings with 22%.
Table 34: Work organization, San Martin and UEs in 2014.
Human Resources Management System processes
UE
40
0:
Sa
n M
art
in
UE
40
1:
Alt
o M
ayo
UE
40
2:
Hu
all
ag
a
Cen
tral
UE
40
3:
Alt
o H
ua
lla
ga
UE
40
4:
Ho
sp
Ta
rap
oto
DIRES SMT
PERU
Work organization 24% 22% 28% 22% 28% 25% 29%
Design of job profiles 25% 25% 25% 25% 25% 25% 42%
Identification of labor competencies 19% 11% 33% 11% 33% 21% 14%
Job rating 30% 30% 30% 30% 30% 30% 12%
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 65
Considering results for each of the processes, the project formed the following conclusions:
All UEs achieved a progress rating of 25% in job profile design and 30% for the job rating
process.
Regarding identification of labor competencies, SMT-RHD exhibited better performance than the
national average with a progress rating of 21%. However, some UEs, including UE 401 and UE
403, achieved less progress with an 11% rating.
While the job rating process is the least developed process at the national level, UEs throughout
SMT-RHD scored higher than the national average.
Employment management sub-system
The graph presents results for the five processes involved in this sub-system. The SMT-RHD average
progress rating for this sub-system was 31%, which is lower than the national average of 45%.
Figure 24: Employment management sub-system, San Martin 2014.
0% 10% 20% 30% 40% 50% 60%
Recruitment, selection, incorporation and induction
Staff mobility
Management of staff files and attendance control
Administration of disciplinary process
Staff termination and retirement
EMPLOYMENT MANAGEMENT SUB-SYSTEM
PERU
TOTAL
DIRES-SMT
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
The recruitment, selection, incorporation, and induction process is the most developed process within
this sub-system with a 39% progress rating. The staff termination and retirement process is the least
developed process with a 12% progress rating.
The results are worrying since these processes are the only processes with designated staff to
manage them. The average ratings for all processes are lower than national averages. The lack of
training, high staff turnover, and implementation of a new organizational structure could explain this
poor performance.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 66
Figure 25: Employment management, San Martin and UEs in 2014.
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
UE 400San Martin
UE 401Alto Mayo
UE 402Huallaga Central
UE 403Alto
Huallaga
UE 404Hosp
Tarapoto
TOTALDIRES-SMT
PERU
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
On average for this sub-system, UE 404 exhibited the best performance with a 40% progress rating,
which is higher than the regional average but lower than the national average. UE 400 and UE 402
had the lowest scores with 27% progress ratings.
Table 35: Employment management, San Martin and UEs in 2014.
Human Resources Management System processes
UE
40
0:
Sa
n M
art
in
UE
40
1:
Alt
o M
ayo
UE
40
2:
Hu
all
ag
a
Cen
tral
UE
40
3:
Alt
o
Hu
all
ag
a
UE
40
4:
Ho
sp
Ta
rap
oto
DIRES SMT
PERU
Employment management 27% 31% 27% 32% 40% 31% 45%
Recruitment, selection, incorporation, and induction 35% 40% 39% 44% 39% 39% 48%
Staff mobility 0% 0% 14% 0% 71% 17% 45%
Management of staff files and attendance control 41% 30% 5% 35% 43% 31% 44%
Administration of disciplinary process 5% 23% 14% 9% 32% 16% 35%
Staff termination and retirement 0% 11% 21% 0% 26% 12% 32%
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
Based on results for each of the processes, the project formed the following conclusions:
UE 404 achieved the best performance in the majority of the processes with a 71% progress
rating in staff mobility, which is higher than regional and national averages; a 43% progress rating
in the management of staff files and attendance control process, which is higher than the regional
average; 32% in the administration of disciplinary process category, which is higher than the
regional average; and 26% for the staff termination and retirement process, which is higher than
the regional average.
Regarding recruitment, selection, incorporation, and induction processes, UE 400 had the lowest
score with a 35% progress rating.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 67
Regarding the staff mobility process, UE 400, UE 401, and UE 403 failed to achieve any progress
in this category.
Regarding the management of staff files and attendance control process, UE 402 achieved a 5%
progress rating.
In the administration of the disciplinary process category, UE 400 and UE 402 achieved progress
ratings of 5%.
Regarding the staff termination and retirement process, UE 400 and UE 403 failed to achieve any
progress in this category.
Performance management sub-system
The following graph shows results for the four processes within this sub-system.
Figure 26: Performance management sub-system, San Martin 2014.
0% 5% 10% 15% 20% 25% 30%
Performance planning
Supervision
Performance evaluation
Feedback and design of plans for individual performance improvement
PERFORMANCE MANAGEMENT SUB-SYSTEM
PERU
TOTALDIRES-SMT
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
SMT-RHD UEs achieved a 13% average progress rating for this sub-system, which is classified as
“little development” and is lower than the national average of 20%.
The majority of processes within this sub-system are particularly poorly developed, including
performance planning; supervision; and the feedback and design of plans for individual performance
improvement with 10%, 12%, and 13% progress ratings, respectively. Progress ratings for
performance planning, supervision, and performance evaluation are lower than national averages.
According to reported information, the performance evaluation process is functioning relatively well
but has still achieved a progress rating of only 16%, which is lower than the national average of 21%.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 68
Figure 27: Performance management sub-system, San Martin and UEs in 2014.
0%
5%
10%
15%
20%
25%
UE 400San Martin
UE 401Alto Mayo
UE 402Huallaga Central
UE 403Alto
Huallaga
UE 404Hosp
Tarapoto
TOTALDIRES-SMT
PERU
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
Regarding results by UE for this sub-system, UE 402 and UE 404 exhibited the best performances
with progress ratings of 24%, which is higher than national and regional averages. UE 400 and UE
403 had the lowest scores with a 4% rating.
Table 36: Performance management sub-system, San Martin 2014.
Human Resources Management System processes
UE
40
0:
Sa
n M
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in
UE
40
1:
Alt
o M
ayo
UE
40
2:
Hu
all
ag
a
Cen
tral
UE
40
3:
Alt
o H
ua
lla
ga
UE
40
4:
Ho
sp
Ta
rap
oto
DIRES SMT
PERU
Performance management 4% 12% 24% 4% 24% 13% 20%
Performance planning 0% 0% 17% 17% 17% 10% 26%
Supervision 10% 0% 25% 0% 25% 12% 16%
Performance evaluation 5% 25% 25% 0% 25% 16% 21%
Feedback and design of plans for individual
performance improvement 0% 8% 28% 0% 28% 13% 12%
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
Considering the results for each of the processes, the project formed the following conclusions:
For the performance planning process, UE 402, UE 403, and UE 404 achieved the most progress
with ratings of 17%, which is higher than the regional average. However, UE 400 and UE 401
failed to achieve any progress in this category.
For the supervision process, UE 402 and UE 404 exhibited the best performances with progress
ratings of 25%, which is higher than regional and national averages. However, some UEs,
including UE 401 and UE 403, achieved no progress towards implementation of this process.
For the performance evaluation process, UE 402, UE 402, and UE 404 achieved the highest
progress ratings with 25%, which is higher than regional and national averages. UE 403 failed to
achieve any progress in this category.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 69
Regarding the feedback and design of plans for individual performance improvement process, UE
402 and UE 404 achieved the highest progress ratings with 28%, which is higher than regional
and national results. UE 400 and UE 403 failed to achieve any progress in this category.
Development and training management sub-system
The following graph shows results for the three processes within this sub-system.
On average, this sub-system achieved a 31% progress rating, which is lower than the national
average of 43%.
Figure 28: Development and training management sub-system, San Martin 2014.
0% 10% 20% 30% 40% 50% 60%
Labor advancement (promotion and career path)
Capacity building
Regulation of the teaching & service process
DEVELOPMENT AND TRAINING MANAGEMENT SUB-SYSTEM
PERU
TOTALDIRES-SMT
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
The teaching-service process has progressed the least with a 21% rating. According to information
provided by participants, the process with the greatest level of development is the labor advancement
process with a 36% progress rating.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 70
Figure 29: Development and training management sub-system, San Martin and UEs in 2014.
0%
10%
20%
30%
40%
50%
60%
70%
UE 400San Martin
UE 401Alto Mayo
UE 402Huallaga Central
UE 403Alto
Huallaga
UE 404Hosp
Tarapoto
TOTALDIRES-SMT
PERU
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
On average for this sub-system, UE 404 exhibited the best performance with a 61% progress rating,
which is higher than regional and national averages. UE 400 made the least amount of progress with
a rating of 3% for this sub-system.
Table 37: Development and training management sub-system, San Martin and UEs in 2014.
Human Resources Management System processes
UE
40
0:
Sa
n M
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in
UE
40
1:
Alt
o M
ayo
UE
40
2:
Hu
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a
Cen
tral
UE
40
3:
Alt
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ua
lla
ga
UE
40
4:
Ho
sp
Ta
rap
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DIRES SMT
PERU
Development and training management 3% 18% 57% 19% 61% 31% 43%
Labor advancement (promotion and career path) 0% 12% 68% 39% 62% 36% 42%
Capacity building 0% 28% 56% 10% 64% 32% 48%
Regulation of the teaching & service process 14% 0% 38% 5% 49% 21% 33%
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
Considering results for each of the processes, the project formed the following conclusions:
UE 402 exhibited the best performance in the capacity building process and the regulation of the
teaching-service process with 65% and 49% ratings, respectively. Both scores are higher than
national and regional averages.
UE 400 failed to achieve any progress in the labor advancement and capacity building processes.
Regarding labor advancement, UE 402 exhibited the best performance with a progress rating of
68%, which is higher than national and regional averages.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 71
Regarding regulation of the teaching-service process, UE 401 failed to achieve any progress in
this category.
Compensation management sub-system
The graph below presents results for the five processes involved in this sub-system.
On average, the sub-system achieved a 39% progress rating, which is classified as “little
development” and is slightly higher than the national average of 37%.
Figure 30: Compensation management sub-system, San Martin 2014.
0% 10% 20% 30% 40% 50% 60% 70% 80%
Design of salary scales
Management of payroll and salaries
Administration of benefits and bonuses
Incentive management
Pension management
COMPENSATION MANAGEMENT SUB-SYSTEM
PERU
TOTALDIRES-SMT
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
The management of payroll and salaries process is the only process within this sub-system that is
more developed in SMT-RHD UEs than it is nationally. However, the results also show that little
development has taken place in the management of incentives. For this process, SMT-RHD UEs had
an average progress rating of 24%.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 72
Figure 31: Compensation management sub-system, San Martin and UEs in 2014.
0%5%
10%15%20%25%30%35%40%45%50%
UE 400San Martin
UE 401Alto Mayo
UE 402Huallaga Central
UE 403Alto
Huallaga
UE 404Hosp
Tarapoto
TOTALDIRES-SMT
PERU
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
Regarding results by UE for this sub-system, UE 404 exhibited the best performance with a 47%
progress rating, which is higher than regional and national averages. UE 401 and UE 403 had the
lowest scores with a 32% progress rating.
Table 38: Compensation management sub-system, San Martin 2014.
Human Resources Management System processes
UE
40
0:
Sa
n M
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in
UE
40
1:
Alt
o M
ayo
UE
40
2:
Hu
all
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a
Cen
tral
UE
40
3:
Alt
o H
ua
lla
ga
UE
40
4:
Ho
sp
Ta
rap
oto
DIRES SMT
PERU
Compensation management 46% 32% 39% 32% 47% 39% 37%
Design of salary scales 31% 37% 31% 38% 51% 38% 24%
Management of payroll and salaries 100% 88% 47% 35% 47% 64% 60%
Administration of benefits and bonuses 87% 53% 67% 53% 67% 65% 71%
Incentive management 26% 11% 33% 16% 33% 24% 30%
Pension management 100% 20% 60% 40% 60% 56% 62%
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
Considering the results for each of the processes, the project formed the following conclusions:
For the design of salary scales process, all UEs exhibited better performances than the national
average. UE 404 exhibited the best performance with a 51% rating. UE 401 and UE 403 achieved
the lowest scores with a 31% progress rating.
For the management of payroll and salaries process, UE 400 exhibited the best performance with
a 100% progress rating, which is higher than regional and national averages. UE 403 achieved
the lowest score with a progress rating of 35%.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 73
Regarding the administration of benefits and bonuses process, UE 400 achieved the highest
progress rating with 87%, which is higher than regional and national averages. UE 401 and UE
403 had the lowest scores with 53%.
For the incentive management process, UE 402 and UE 404 achieved the highest progress
ratings with 33%, which is higher than regional and national averages. UE 401 had the lowest
score with 11%.
Regarding the pension management process, UE 400 achieved the highest progress rating with
100%, which is higher than regional and national averages. UE 401 had the lowest score with
20%.
Managing human and social relations sub-system
The graph below presents results for the three processes within this sub-system.
On average, the sub-system achieved a 33% progress rating, which is classified as “little
development” and is lower than the national average of 38%.
Figure 32: Managing human and social relations sub-system, San Martin 2014.
0% 10% 20% 30% 40% 50% 60%
Management of the organizational climate and culture
Management of labor relations
Workplace health, safety and welfare
MANAGING HUMAN AND SOCIAL RELATIONS SUB-SYSTEM
PERU
TOTALDIRES-SMT
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
The workplace health, safety, and welfare process within SMT-RHD is more developed than at the
national level with a 48% progress rating.
The two other processes within this sub-system achieved progress ratings of 19%, which is lower
than the national averages.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 74
Figure 33: Managing human and social relations sub-system, San Martin and UEs in 2014.
0%
10%
20%
30%
40%
50%
UE 400San Martin
UE 401Alto Mayo
UE 402Huallaga Central
UE 403Alto
Huallaga
UE 404Hosp
Tarapoto
TOTALDIRES-SMT
PERU
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
Regarding results by UE for this sub-system, UE 402 and UE 404 exhibited the best performances
with 45% progress ratings, which is higher than national and regional averages. UE 403 had the
lowest score with a 17% progress rating.
Table 39: Human Resources Management System processes by UE, San Martin 2014.
Human Resources Management System processes
UE
40
0:
Sa
n M
art
in
UE
40
1:
Alt
o M
ayo
UE
40
2:
Hu
all
ag
a
Cen
tral
UE
40
3:
Alt
o H
ua
lla
ga
UE
40
4:
Ho
sp
Ta
rap
oto
DIRES SMT
PERU
Managing human and social relations 34% 25% 45% 17% 45% 33% 38%
Management of the organizational climate and culture 0% 0% 47% 0% 47% 19% 30%
Management of labor relations 33% 24% 9% 21% 9% 19% 42%
Workplace health, safety, and welfare 48% 35% 69% 21% 69% 48% 39%
SOURCE: Technical report on HRMS evaluation results for each SMT-RHD UE.
Considering the results for each of the processes, the project formed the following conclusions:
Regarding the management of the organizational climate process, UE 402 and UE 404 achieved
the highest progress ratings with 47%, which is higher than regional and national averages. UE
400, UE 401, and UE 403 failed to achieve any progress in this category.
For the management of labor relations process, UE 400 exhibited the best performance with a
33% progress rating, which is higher than the regional average of 19% but lower than the national
average of 42%. UE 402 and UE 404 both achieved a progress rating of 9% for this process.
For the workplace health, safety, and welfare process, UE 402 and UE 404 achieved the best
performances with progress ratings of 69%, which is higher than regional and national averages.
However, UE 403 achieved little progress with a 21% rating.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 75
5. Activities undertaken by MoH to strengthen HRMS and
proposals for future activities
The following guidelines and measures for HHR health sector reform have been approved by the
national government:
Implementation of a new comprehensive remunerative policy based on merit, performance, and
risk by level of care.
Regulation of HHR post-graduate training to match supply of health professionals to the health
needs of the country.
Application of non-monetary incentive schemes to recruit and retain staff who work in less
developed areas.
Implementation of these reforms requires key arrangements in the human resources management
system.
Towards this end, MoH and RHDs have agreed to develop executive agreements to implement health
policy priorities in national and regional government agendas with the goal of universal health
coverage. Agreements and their respective priorities will be monitored during CIGSs meetings.
One CIGS agreement focused on strengthening the managerial skills of HR office staff. Accordingly,
a HR committee was formed to analyze HRMS functioning in health institutions.
MoH and the CIGS-HR committee collected the necessary information from all UEs at the national
level through the HRMS evaluation.
Based on HRMS evaluation results, the CIGS-HR committee proposed that MoH develop the
following activities:
Regarding norms and regulations for HRMS functioning
Design key indicators to monitor HRM based on critical areas encountered in the assessment.
Design of incentives to UEs which demonstrate improvements in HRMS performance.
Develop tools and methodologies for estimating HHR requirements at all levels, including
administrative and managerial units.
Design, approve, and diffuse a methodology for defining job competencies.
Propose a methodology and tools for job evaluation in coordination with SERVIR.
Approve regulations to remove alternative attendance control systems (e.g. manual control) and
maintain a single system to register and monitor attendance.
Design a tool to keep staff files updated.
Design tools and methodologies to supervise individual job performance; assess job
performance; develop feedback; and design plans for individual performance improvement.
Design tools to establish criteria for qualifying teaching hospitals and health centers.
Design methodology and tools to define fair and equitable salary scales for hired staff.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 76
Design HHR management information system as part of the existing information system
(INFORHUS).
Establish a mechanism to ensure that UEs implement strategies to communicate workers’ rights
related to compensation, benefits, and bonuses.
Establish a mechanism to promote the measurement, analysis, and use of organizational climate
measurement results to improve personnel satisfaction.
Design tool to monitor RNSDD updates at the UE level.
Regarding the provision of direct TA from MoH and SERVIR
In the framework of decentralization and according to the analysis of HRMS assessment results, the
project has identified the need for TA from MoH and/or SERVIR in the following areas:
HHR policy and planning management
Management of the HHR information system
Design of labor competencies at all levels
Use of job rating tools and methodologies
Management of staff turnover and mobility as well as timely and proper registration of this
information in INFORHUS
Design RIT according to institutional policies
Implement tools and methodologies to plan individual performance evaluations
Implement tools and methodologies to supervise individual performance
Implement tools and methodologies to evaluate individual performance and respective feedback
Implement training policies at the regional and UE level
Establish criteria to qualify teaching hospitals at the regional level
Define fair and equitable salary scales for hired staff
Manage pensions
Regarding development of HR units’ capacity
According to the analysis of HRMS assessment results, MoH should organize training programs to
satisfy the following training needs:
Design and management of HHR policies
Design of HRM indicators and a HR balanced scorecard
HHR planning and finance as well as strategies for HHR provision
Job profile design
Performance management
Staff file management and staff file information system (in coordination with MoF)
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 77
Health and work safety policy and strategies for implementation (in coordination with SERVIR and
the Ministry of Labor)
Regarding strategic alliances with institutions on HHR issues
According to the analysis of HRMS assessment results, MoH should establish coordination and
partnerships with educational institutions, MoF, and SERVIR to improve HRM offices at the regional
and local levels.
The following HHR issues require coordination with SERVIR:
Training in the design and management of HR policies
Institute awards for best HR researches
Design of HRM indicators and a HR balanced scorecard
Adapt methodology for job profile design for easy implementation at the health sector level
Management of tools and methodologies for job rating
Strategies to manage compliance with regulations governing recruitment, selection and hiring
processes as well as the application of penalties for noncompliance
Develop regulatory policies for staff promotion in the health sector
The following HHR areas require coordination with MoF:
MoF asks for HR information through RHDs.
MoF keeps budget allocation linked to the HR information systems sector.
MoF trains HR office teams in handling payroll and the payroll computer system.
The following HHR issues require coordination with both SERVIR and MoF:
The development of standards to encourage interoperability of all information systems, including
the RHUS module (HR/INFORHUS/RENIEC).
Provide TA to define salary scales for hired staff.
The following activities require coordination with other institutions:
Partner with universities to development HHR research projects and give awards for excellence in
research.
MoH should promote coordination mechanisms with regional and local governments as well as
universities to award non-monetary incentives to staff exhibiting good performance.
MoH will coach HR office team in staff welfare as well as health and work safety in coordination
with SERVIR and MINTRA.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 78
Regarding HRM policies, MoH has approved the following methodology and tools:
Technical guide to calculate HHR gaps for the first level of care3, which was approved in March
2014.
Technical guide to identify labor competencies and design tools and standards for specific
competency assessment using the functional analysis4, which was approved in March 2014.
Technical guide to calculate HHR gaps for the second and third-level-of-care5, which was
approved in June 2014.
Legislative decree regulating the compensation and comprehensive policy and the economic
delivery of health service staff of the State6, approved in September 2013.
(See annex 6.9)
3 Resolución Ministerial N° 176-2014/MINSA.
4 Resolución Ministerial N° 251-2014/MINSA
5 Resolución Ministerial N° 437-2014/MINSA.
6 Decreto Legislativo N° 1153
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 79
6. Conclusions and Recommendations
Improving the population’s health status in San Martin requires skilled HHR who are correctly
positioned and capable of providing good quality health care services that meet standards.
Achieving this outcome requires the implementation of strategies to recruit and retain competent staff
in the most remote and least developed areas. These strategies entail the implementation of
processes to determine the quantity of human resources needed and the type, taking into account
experience, knowledge, and skills. Based on this information, SMT-RHD can develop recruitment,
selection, and hiring processes based on job profiles, and it can allocate HHR to positions where they
are most needed while offering a fair and equitable salary. Additionally, it is necessary to evaluate
staff performance to ensure that individual performance is continuously improving. It also necessary
to ensure that an institution is able to reward good performance as well as encourage staff by
designing training programs to fill gaps found in performance evaluations.
Implementation of these processes requires a trained and committed management team.
Unfortunately, policymakers do not place enough importance on this issue as they often allocate
untrained staff to HR offices. The lack of methodologies and tools to guide and help HR teams in
adequately managing HR processes also undercuts successful implementation.
Encouragingly, MoH is now committed to better understanding how HRM is developing in UEs
nationwide through its analytical efforts.
Prior to analyzing the technical reports, one concern was that the information within the reports, which
was provided by UEs, might not be valid. The CIGS-HR Committee and MoH began to look for
specific data in specific UEs in order to verify the veracity of the information. There was no systematic
investigation, but all queries showed that the specific information analyzed was true. MoH also
informed all RHDs that their information would be verified in supervision visits conducted by MoH.
In SMT-RHD, all HRMS processes were evaluated for each UE, and the results were presented in
tables and graphs. UEs exhibited varying levels of performance in HRMS processes:
UE 404, which only includes the Tarapoto hospital, exhibited the highest level of development for
HRMS processes in SMT-RHD with a 38% progress rating. This UE exhibited the best
performance in the staff mobility process with a 71% rating but failed to achieve any progress in
three processes within the HHR policy and strategic planning sub-system
UE 400-Bajo Mayo, which includes the El Dorado, Lamas, Picota, and San Martin networks,
obtained the lowest score for HRMS processes with a 23% progress rating. While it achieved
100% progress ratings in the management of payroll and salaries process and the pension
management process, it failed to achieve any progress in ten processes within the five sub-
systems.
UE 401-Alto Mayo, which includes the Moyobamba and Rioja networks, exhibited the best
performance in the management of payroll and salaries process with an 88% progress rating.
However, it failed to achieve any progress in seven processes within the five sub-systems.
UE 402-Huallaga Central, which includes the Bellavista, Huallaga, and Mariscal Caceres
networks, had the best performance in the workplace health, safety, and welfare process with a
69% progress rating. However, it failed to achieve any progress in three processes within the
HHR policy and strategic planning sub-system.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Activities undertaken by MoH to strengthen HRMS ▌pg. 80
UE 403-Alto Huallaga, which only includes the Tocache network, exhibited the best performance
in the HHR information system process with an 80% progress rating. However, it failed to achieve
any progress in seven processes within four sub-systems.
These results demonstrate the generally poor state of HRM processes and illustrate the necessity of
developing a long-term program to encourage improvement of the 29 processes evaluated. Due to
differences in UE performance related to HRM, each UE should design and implement its own plan.
Improving HRM means designing management tools that would facilitates implementation of HRMS
processes. These tools would help train personnel in HR management, problem solving, negotiation,
and timely decision making to incrementally improve staff performance.
MoH designed a national plan to counter common problems uncovered in this assessment, but each
UE has their own problems. Given this, MoH must provide feedback on UE technical reports and
support the improvement of processes.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. References ▌pg. 81
7. References
1. Ley del Servicio Civil, in Ley 30057 2013, Congreso de la República: Perú.
2. GORESAM, Ordenanza Regional N° 003-2013-GRSM/CR, in OR 003-2013-GRSM/CR.
2013: Región San Martín.
3. Nivel de implementación del sistema de gestión de recursos humanos de la DIRES San
Martín. 2013, Dirección de Desarrollo de RR.HH. de la DIRESA San Martín.
4. Informe de sistemas de gestión de RR.HH. de la DIRESA Cajamarca.
5. Chiavenato, I., Gestión del Talento Humano. Mc Graw-Hill ed. 2009, México D.F.
6. WHO, Working together for health - The World Health Report 2006. 2006, World Health
Organization: Ginebra.
7. WHO, Health Systems: Improving performance - The World Health Report 2000. 2000,
World Health Organization: Ginebra.
8. DIRES Loreto - UE de Salud Loreto. Documento Técnico “Nivel de implementación del Sistema
de Gestión de Recursos Humanos”.
9. DIRES Loreto - UE de Salud Alto Amazonas. Documento Técnico: “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
10. DIRES Loreto - UE de Salud Datem del Marañon. Documento Técnico “Nivel de implementación
del Sistema de Gestión de Recursos Humanos”.
11. DIRES Loreto - UE Hospital Santa Gema, Yurimaguas. Documento Técnico “Nivel de
implementación del Sistema de Gestión de Recursos Humanos”.
12. DIRES Huánuco – UE Red Huánuco. Documento Técnico “Nivel de implementación del Sistema
de Gestión de Recursos Humanos”.
13. DIRES Huánuco – UE Red Humalíes. Documento Técnico “Nivel de implementación del Sistema
de Gestión de Recursos Humanos”.
14. DIRES Huánuco – UE Red Dos de Mayo. Documento Técnico “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
15. DIRES Pasco - UE Salud Pasco. Documento Técnico “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
16. DIRES Pasco - UE Hospital Daniel Alcides Carrión. Documento Técnico “Nivel de
implementación del Sistema de Gestión de Recursos Humanos”.
17. DIRES Pasco – UE Red de Salud Oxapampa. Documento Técnico “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
18. GERESA Lambayeque – UE Gerencia Regional de Salud Lambayeque. Documento Técnico
“Nivel de implementación del Sistema de Gestión de Recursos Humanos”.
19. GERESA Lambayeque – UE Hospital Regional Docente “Las Mercedes” de Chiclayo. Documento
Técnico “Nivel de implementación del Sistema de Gestión de Recursos Humanos”.
20. GERESA Lambayeque – UE Hospital Provincial Docente “Belén” de Lambayeque. Documento
Técnico “Nivel de implementación del Sistema de Gestión de Recursos Humanos”.
21. GERESA Lambayeque – UE Hospital Regional de Lambayeque. Documento Técnico “Nivel de
implementación del Sistema de Gestión de Recursos Humanos”.
22. DIRESA Piura – UE Dirección Sub Regional de Salud Luciano Castillo Colonna. Documento
Técnico “Nivel de implementación del Sistema de Gestión de Recursos Humanos”.
23. DIRESA Piura – UE Hospital de Apoyo Sullana II. Documento Técnico “Nivel de implementación
del Sistema de Gestión de Recursos Humanos”.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. References ▌pg. 82
24. DIRESA Piura – UE Red de Salud Morropón - Chulucanas. Documento Técnico “Nivel de
implementación del Sistema de Gestión de Recursos Humanos”.
25. DIRESA Piura – UE Hospital de Chulucanas. Documento Técnico “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
26. DIRESA Piura – UE Hospital Las Mercedes - Paita. Documento Técnico “Nivel de
implementación del Sistema de Gestión de Recursos Humanos”.
27. DIRESA Amazonas – UE DIRESA. Aplicativo “Nivel de implementación del Sistema de Gestión
de Recursos Humanos”.
28. DIRESA Amazonas – UE Bagua. Aplicativo “Nivel de implementación del Sistema de Gestión de
Recursos Humanos”.
29. DIRESA Amazonas – UE Hospital Gustavo Lannata. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
30. DIRESA Amazonas – UE Red de Salud Utcubamba. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
31. DIRESA Ancash – UE Salud Ancash. Aplicativo “Nivel de implementación del Sistema de Gestión
de Recursos Humanos”.
32. DIRESA Ancash – UE Red Recuay-Carhuaz. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
33. DIRESA Ancash – UE Red Huaraz. Aplicativo “Nivel de implementación del Sistema de Gestión
de Recursos Humanos”.
34. DIRESA Ancash – UE Hospital Eleazar Guzmán Barrón. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
35. DIRESA Ancash – UE Red La Caleta. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
36. DIRESA Ancash – UE Red Caraz. Aplicativo “Nivel de implementación del Sistema de Gestión de
Recursos Humanos”.
37. DIRESA Ancash – UE Red Pomabamba. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
38. DIRESA Ancash – UE Red Huari. Aplicativo “Nivel de implementación del Sistema de Gestión de
Recursos Humanos”.
39. DIRESA Ancash – UE Red Pacífico Sur. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
40. DIRESA Ayacucho – UE Salud Ayacucho. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
41. DIRESA Ayacucho – UE Hospital de Huamanga. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
42. DIRESA Ayacucho – UE Red de Salud Centro Ayacucho. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
43. DIRESA Ayacucho – UE Red de Salud Ayacucho Norte. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
44. DIRESA Ayacucho – UE Red de Salud Huamanga. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
45. DIRESA Ayacucho – UE Red de Salud San Miguel. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
46. DIRESA Ayacucho – UE Red de Salud San Francisco. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. References ▌pg. 83
47. DIRESA Cajamarca – UE Salud Cajamarca. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
48. DIRESA Cajamarca – UE Red de Salud Chota. Aplicativo “Nivel de implementación del Sistema
de Gestión de Recursos Humanos”.
49. DIRESA Cajamarca – UE Red de Salud Cutervo. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
50. DIRESA Cajamarca – UE Red de Salud Jaén. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
51. DIRESA Callao – UE Hospital de Apoyo San José. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
52. DIRESA Callao – UE Hospital de Ventanilla. Aplicativo “Nivel de implementación del Sistema
de Gestión de Recursos Humanos”.
53. DIRESA Cusco – UE Red de Salud Canas-Canchis-Espinar. Aplicativo “Nivel de implementación
del Sistema de Gestión de Recursos Humanos”.
54. DIRESA Cusco – UE Hospital Lorena. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
55. DIRESA Cusco – UE Red de Salud La Convención. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
56. DIRESA Cusco – UE Red Cusco Sur. Aplicativo “Nivel de implementación del Sistema de Gestión
de Recursos Humanos”.
57. DIRESA Huancavelica – UE Red Acobamba. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
58. DIRESA Huancavelica – UE Red Angaraes. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
59. DIRESA Huancavelica – UE Red Castro Virreyna. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
60. DIRESA Huancavelica – UE Red Churcampa. Aplicativo “Nivel de implementación del Sistema
de Gestión de Recursos Humanos”.
61. DIRESA Huancavelica – UE DIRESA Huancavelica. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
62. DIRESA Huancavelica – UE Hospital Departamental. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
63. DIRESA Huancavelica – UE Red Huaytará. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
64. DIRESA Huancavelica – UE Red Pampas. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
65. DIRESA Huánuco – UE Salud Huánuco. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
66. DIRESA Huánuco – UE Red Tingo María. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
67. DIRESA Huánuco – UE Hospital Hermilio Valdizán. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
68. DIRESA Huánuco – UE Red Leoncio Prado. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
69. DIRESA Huánuco – UE Red Huánuco. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. References ▌pg. 84
70. DIRESA Huánuco – UE Red Huamalíes. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
71. DIRESA Huánuco – UE Red Dos de Mayo. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
72. DIRESA Ica – UE Salud Ica. Aplicativo “Nivel de implementación del Sistema de Gestión de
Recursos Humanos”.
73. DIRESA Ica – UE Hospital San José de Chincha. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
74. DIRESA Ica – UE Red de Salud Palpa-Nazca. Aplicativo “Nivel de implementación del Sistema
de Gestión de Recursos Humanos”.
75. DIRESA Ica – UE Hospital Regional de Ica. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
76. DIRESA Ica – UE Hospital San Juan de Dios - Pisco. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
77. DIRESA Ica – UE Hospital de Apoyo Santa María de Socorro. Aplicativo “Nivel de
implementación del Sistema de Gestión de Recursos Humanos”.
78. DIRESA Ica – UE Red de Salud Ica. Aplicativo “Nivel de implementación del Sistema de Gestión
de Recursos Humanos”.
79. DIRESA Junín – UE Red de Salud Daniel Alcides Carrión. Aplicativo “Nivel de implementación
del Sistema de Gestión de Recursos Humanos”.
80. DIRESA Junín – UE Red de Salud El Carmen. Aplicativo “Nivel de implementación del Sistema
de Gestión de Recursos Humanos”.
81. DIRESA Junín– UE Red de Salud Tarma. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
82. DIRESA Junín – UE Red de Salud Chanchamayo. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
83. DIRESA Lambayeque – UE Salud Lambayeque. Aplicativo “Nivel de implementación del Sistema
de Gestión de Recursos Humanos”.
84. DIRESA Lambayeque – UE Hospital Regional Docente Las Mercedes. Aplicativo “Nivel de
implementación del Sistema de Gestión de Recursos Humanos”.
85. DIRESA Lambayeque – UE Hospital Belén de Lambayeque. Aplicativo “Nivel de implementación
del Sistema de Gestión de Recursos Humanos”.
86. DIRESA Lambayeque – UE Hospital Regional de Lambayeque. Aplicativo “Nivel de
implementación del Sistema de Gestión de Recursos Humanos”.
87. Dirección de Salud III-Lima Norte. Aplicativo “Nivel de implementación del Sistema de Gestión
de Recursos Humanos”.
88. DISA III-Lima – Hospital Huacho - Huaura. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
89. DISA III-Lima – UE Servicios Básicos de Salud Cañete. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
90. DISA III-Lima – UE Hospital de Apoyo Rezola. Aplicativo “Nivel de implementación del Sistema
de Gestión de Recursos Humanos”.
91. DISA III-Lima – UE Hospital de Barranca. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
92. DISA III-Lima – UE Hospital de Chancay. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. References ▌pg. 85
93. DISA III-Lima – UE Servicios Básicos de Salud Chilca. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
94. DISA III-Lima – UE Hospital de Huaral. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
95. DISA III-Lima – UE Red de Salud Huarochiri. Aplicativo “Nivel de implementación del Sistema
de Gestión de Recursos Humanos”.
96. DIRESA Loreto – UE Salud Loreto. Aplicativo “Nivel de implementación del Sistema de Gestión
de Recursos Humanos”.
97. DIRESA Loreto – UE Salud Yurimaguas. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
98. DIRESA Loreto – UE Hospital de Apoyo Iquitos. Aplicativo “Nivel de implementación del Sistema
de Gestión de Recursos Humanos”.
99. DIRESA Loreto – UE Hospital Regional de Loreto. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
100. DIRESA Loreto – UE Red de Salud Datem del Marañon. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
101. DIRESA Loreto – UE Hospital Santa Gema Yurimaguas. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
102. DIRESA Madre de Dios – UE Salud Madre de Dios. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
103. DIRESA Madre de Dios – UE Hospital Santa Rosa. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
104. DIRESA Moquegua – UE Salud Moquegua. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
105. DIRESA Moquegua – UE Red de Salud Ilo. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
106. DIRESA Moquegua – UE Hospital Regional de Moquegua. Aplicativo “Nivel de implementación
del Sistema de Gestión de Recursos Humanos”.
107. DIRESA Pasco – UE Salud Pasco. Aplicativo “Nivel de implementación del Sistema de Gestión de
Recursos Humanos”.
108. DIRESA Pasco – UE Hospital Daniel Alcides Carrión. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
109. DIRESA Pasco – UE Salud UTES Oxapampa. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
110. DIRESA Piura – UE Salud Piura. Aplicativo “Nivel de implementación del Sistema de Gestión de
Recursos Humanos”.
111. DIRESA Piura – UE Luciano Castillo Colonna. Aplicativo “Nivel de implementación del Sistema
de Gestión de Recursos Humanos”.
112. DIRESA Piura – UE Hospital III Sullana. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
113. DIRESA Piura – UE Red Morropón-Chulucanas. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
114. DIRESA Piura – UE Hospital de Chulucanas. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
115. DIRESA Piura – UE Hospital Nuestra Señora de las Mercedes. Aplicativo “Nivel de
implementación del Sistema de Gestión de Recursos Humanos”.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. References ▌pg. 86
116. DIRESA Piura – UE Hospital Santa Rosa. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
117. DIRESA San Martín – UE Salud San Martín. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
118. DIRESA San Martín – UE Red de Salud Alto Mayo. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
119. DIRESA San Martín – UE Red de Salud Huallaga Central. Aplicativo “Nivel de implementación
del Sistema de Gestión de Recursos Humanos”.
120. DIRESA San Martín – UE Red de Salud Alto Huallaga. Aplicativo “Nivel de implementación del
Sistema de Gestión de Recursos Humanos”.
121. DIRESA San Martín – UE Hospital de Tarapoto. Aplicativo “Nivel de implementación del Sistema
de Gestión de Recursos Humanos”.
122. DIRESA Tumbes – UE Salud Tumbes. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
123. DIRESA Tumbes – UE Hospital de Apoyo JAMO-Tumbes. Aplicativo “Nivel de implementación
del Sistema de Gestión de Recursos Humanos”.
124. DIRESA Ucayali – UE Salud Ucayali. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
125. DIRESA Ucayali – UE Salud Ucayali. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
126. DIRESA Ucayali – UE Hospital Amazónico. Aplicativo “Nivel de implementación del Sistema de
Gestión de Recursos Humanos”.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 87
8. Annex
8.1 Analysis of performance evaluation results in the HHR policy and strategic planning sub-system, in selected regions
Loreto RHD
Strengths Problem Description Restrictions Consequences Proposals for Improvement
Senior management
committed.
Annual Training Plan
approved by Executive
Resolution (RHD).
There is an office
responsible for HHR
strategic planning and
financing management
monitoring. There is staff
dedicated exclusively to
HHR management;
however, some UEs don´t
have this staff.
There are technical and
management documents
and HHR legislation.
There is an Excel
application and trained
staff to determine HHR
gaps at the three levels of
care.
Trained and experienced
staff in operational
research (RHD).
Most UEs do not have staff
who are responsible for
managing HHR
development; planning HHR
needs and financing;
operating the information
system; and designing,
monitoring, and analyzing
HHR indicators.
There is not information
about HHR from other
institutions that provide
health services in the
Region.
Limited budget and no
designated office to create
staff positions related to HHR
strategic planning and
monitoring of HHR indicators.
No budget allocated for the
strengthening of HHR
capacities.
No qualified staff to evaluate
results of trainings.
HHR operational research
has not been prioritized due
to the demand for and
prioritization of health
interventions
Poor coordination among
UEs and RHD.
Poor coordination with other
institutions that provide
health services in the region.
Poor planning and little
knowledge of HHR needs
prevent a true estimate of
needed financing and capacity
strengthening.
Over- or underestimation of
HHR in health networks, micro-
networks, and health facilities.
There are no job profiles, which
causes duplication of functions,
internal user dissatisfaction
(wages), and internal labor
disputes.
No available regional HHR
indicators or results for decision
making.
Develop HHR management proposal to
incorporate key processes.
Set a budget goal for implementing the
HRMS.
Set up a unit to formulate and evaluate
regional policies; plan and develop
budgets; monitor and analyze; and
develop research in HHR. Or establish
new sections in existing areas.
Train responsible personnel to improve
performance of their functions. Propose
financing and development of the
corresponding positions.
Design systematized tools to collect
information from other institutions.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 88
Huánuco RHD
Strengths Problem Description Restrictions Consequences Proposals for Improvement
Design of HHR policies.
There is HR Observatory.
Some information systems
and criteria exist to define
HHR requirements.
Some employees are
motivated by a desire to
serve their communities,
and they have been
trained.
Implementation of HHR
module.
Inconsistent HHR data.
Understaffing of HHR and
specialist physicians in Level
1-4 health facilities.
Insufficient budget to cover
HHR gap.
Not all staff is committed.
No operational research is
done.
Limited budget to reduce
HHR gap.
HHR planning only considers
specific aspects related to
natural growth of the
population.
Information management is
considered to consist mainly
of managing the names of
workers, staff files, etc.
No equity in achieving goals
and objectives.
Low staff skills and high staff
turnover.
There are new executive
units.
HHR policies have not been
designed.
Insufficient budget for human
resources.
Belated information flow, and
HHR information delayed.
There are no indicators.
New personnel in Level I health
facilities possess few skills to
provide care.
There is little health care
coverage.
Consider the processes required to design
policies; information management; and
strategic human resource planning.
Increase UEs budget for adequate HHR
management.
Hire more personnel and train them.
Budget availability for operational
research.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 89
Pasco RHD
Strengths Problem Description Restrictions Consequences Proposals for Improvement
RHD has formulated and
approved 08 HHR regional
policies of HHR
Development
Management.
RHD has selected and
approved regional
research priorities and the
regulation of research
management.
RHD/Daniel Alcides
Carrion Hospital have
started entering data in
INFORHUS.
There are information
systems (Human
Resources MEF Module
and PLAME Module) that
serve to filter and control
HR management.
There are population
density gap indicators that
RHD has used for HR
provision.
Increased funding to hire
HR and have initiated
designation processes.
DL 1153 establishes
remunerative
improvements.
No HHR regional policies have been
implemented, and few personnel are
familiar with them. There is little interest
in their implementation at the national
level.
A Research Management Unit has not
been implemented.
Operational research has not been
correctly developed.
Lack of interest among professionals to
develop research.
HHR data is outdated and incomplete;
personnel displacements are not
recorded.
INFORHUS does not include goals and
productivity indicators. Entry and
reporting data from INFORHUS is more
limited than within SIRHUS.
Control actions are limited. RHD has
little control over networks, hospitals,
and micro-grids.
There is no HR strategic planning
policy nor have HR strategic plans
been developed.
No increased funding for staff
remuneration improvements for CAS
contracts, administrative staff, and staff
of DL 728.
Small staff in the
HR office which
limits HHR
management. No
units to develop
HR strategic
planning.
There is high staff
turnover.
Many HRM
processes require
national regulatory
arrangements.
Little importance is
given to HR
information
management.
Research function
has not been
incorporated into
institutional
management
documents.
No budget for
compliance.
Limited availability
of financial
resources to
improve staff
remuneration for
CAS contracts.
Inadequate HR management
and no strategic planning.
Inadequate HR rationalization.
HR gap has not yet been closed.
Research function has not been
adequately developed.
HR control regulations
implemented in health facilities
are distorted.
High staff turnover for CAS
contracts.
Personnel is not motivated.
Implement regional development HR
policy.
Designate responsible staff for HR
management.
Incorporate the role of health research in
management documents and assign a
budget for this task.
Establish monitoring, evaluation, control,
and productivity of HR indicators.
Designate a responsible unit for the HHR
information system.
Establish a unit for HR strategic planning.
Unit staff should be trained.
Suggest a policy remuneration
improvement for CAS contracts,
administrative staff, and staff of DL 728.
Approve remuneration scale.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 90
Lambayeque RHD
Strengths Problem Description Restrictions Consequences Proposals for Improvement
Support of senior
management.
Budget availability to hire
HR in some UEs.
There is available staff,
predisposed to the work.
SIGA and INFORHUS
systems have been
updated in each EU, and
they are customizable.
There are management
documents that
demonstrate the need for
HHR.
HHR gap analysis in
primary care.
HR estimated
requirements and
financing needs exist for
some UEs.
Information is available as
a guide in the
development of indicators.
Salary increase for
permanent staff.
There is no responsible
instance for planning HHR.
Outside authorities
developed plans.
Lack of procedures for
strategic policy formulation or
developing management.
Lack of HHR
trained/specialized in various
processes.
HHR management indicators
do not exist. HHR is not
trained or specialized in the
development/formulation of
personnel management
indicators.
Outdated management tools;
information entered is not
analyzed.
Human resources gap
analysis has not been done
for the second and third
health care levels.
The staffing table, which
includes requirements, has
not been implemented due to
insufficient budget.
A Research Unit has not
been implemented.
A research unit only exists in
Las Mercedes Hospital, but
HHR operational research is
not carried out within it.
There is weak organization.
Inadequate infrastructure and
insufficient HR with the skills
required to develop policies
and strategic planning.
HR office has limited
autonomy for decision
making.
There is insufficient budget
for recruitment.
Lack of a research unit in the
organizational structure of
the Office of Human
Resources.
Human resource gap studies
have not been carried out.
No HR policies are formulated.
Lack of human resources
management
Development of low-level skills
Delay in reporting human
resource needs, thus limiting
analysis and decision making.
Incorrect HR allocation that is
not based on existing criteria
needs.
Complaints of workers.
Low efficiency of organizational
units.
Inadequate and inefficient health
care is provided to users.
Design and implement HR management
policies in line with reality
Create the instance for HR strategic
planning within the Human Resources
Unit.
Recruit and select qualified/skilled
personnel, and train staff available.
Create a research unit in the
organizational structure of the entity and
develop HHR operational research.
Develop management documents and
assign roles to a team.
Formulate and define indicators for HHR
management.
Update management tools in line with
computer system innovations and
improved tools (reports, applications, etc.).
Develop HHR gap studies.
Allocate budget according to regional
needs and CAP requirements.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 91
Piura RHD
Strengths Problem Description Restrictions Consequences Proposals for Improvement
Staff is available to
implement policies,
strategic planning, and
HHR information
management.
There is an office in
charge of planning HHR
policies and strategies
(Chulucanas - Morropón
Health Network).
Updated health policies
focused on public health.
ROF points out
systematization and
updating of HR information
for decision-making and
development planning.
Employees can assess
their performance,
including tardiness, status,
salary, and payroll record,
through official reporting
systems.
Recruiting processes have
been implemented based
on profiles for HHR hiring.
A monthly analysis of the
HHR situation within the
institution is performed.
Staffing requirements have
been met based on WHO
rates and the projection of
service needs.
Maintenance of production
HR planning is not promoted
by the State.
No responsible unit or trained
personnel exists to formulate
management and develop
staff policies.
Personnel selection is not
based on HR merits.
Organizational units with
insufficient personnel.
Personnel not meeting
expectations
Processes to capture,
develop, and maintain HHR
quality does not exist. More
specifically, job performance
is not evaluated; staff profiles
are not updated; there are no
incentives to improve or
motivate staff; and safety
and occupational health
procedures do not exist.
Absence of HHR information
management policy. No
support for making decisions
based on evidence. While
there is data, current
systems do not record or
report non-remunerative
concepts such as
attendance, tardiness,
absences, public competitive
examinations, or current
location of the worker. There
is no database that contains
Inefficient budget allocation
and use of resources.
Staff members do not
establish management
guidelines; HR policies and
strategies are not
established; and there are no
specific functions in ROF.
There is no policy or
personnel training plan, and
there are no HR
management manuals. There
is limited budget for health
and administrative personnel
training.
Inadequate staff selection
and constant changes.
Staffing requirements are not
determined through
appropriate criteria like
"operational need"; there is
no real needs assessment.
Inadequate performance
evaluation policy. Staff
disagrees with evaluation.
Resistance to change.
There is no policy for staff
incentives.
An occupational safety and
health plan has not been
developed.
No research policy. Lack of
staff capacity for
development of research.
Staff does not possess
appropriate labor competencies
for optimal performance of the
functions assigned. Lack of
competitiveness among
workers.
There is no real diagnosis of
staff performance.
Work is not planned or
evaluated based on job profiles
and competencies.
Decisions taken do not
correspond to the real needs of
the institution.
There is no research policy,
which makes it impossible to
cultivate good management,
development, and planning of
activities.
Health and administrative
personnel train themselves (or
are trained) and then seek to
use this investment in other
positions, thus leavings UEs
without trained professionals.
Staff does not know the rules
because they are not trained.
Staff files are outdated.
There is no management
information system. Decisions
are then based on insufficient
information.
No real information about worker
specialties, potential skills, and
Assign non-historic budget from central
and regional levels to UE to strengthen
HR.
Incorporate the following specific functions
in institutional ROF: management and
development of policy formulation; and
long-term planning and tools for workforce
development.
Implement a HR management control
system and restructure the current
management information system,
including a information system.
Form a team to develop HHR
management and development policies.
Develop an innovation capacities plan that
includes functions associated with
management and control of human
resources as well as document
management.
Perform induction and training to
personnel entering work after evaluation.
Develop guidelines for evaluating staff and
reward those staff members who exhibit
good job performance.
Introduce incentives to improve work
performance and for staff working in
remote areas as well as those who have
not been considered in the RM 190-2013.
Staff should be evaluated for
qualifications.
There should be an only pay scale so as
not to discriminate against staff.
Form a committee for occupational safety.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 92
Strengths Problem Description Restrictions Consequences Proposals for Improvement
policies according to
service needs. Personnel
are engaged to improve
care for the external user.
All personnel positions are
funded within the budget
formulation.
Despite low wages,
personnel are seeking to
improve their health care.
all HR processes.
No information system to
update personnel files. Files
updated only through data
sheet (Excel).
Periodic measurement of
performance indicators is not
performed.
Only remuneration data is
updated and maintained; this
is done through the PLH
system (spreadsheet assets).
There is no estimate or
assessment of HR needs.
Insufficient financial
resources for comprehensive
improvement of HHR. Not all
positions required by UE are
financed.
No development of
operational research nor is
there a unit with personnel
trained to perform this. The
support unit, which is
responsible for training and
research, does not perform
its functions.
Low budget for training in
research.
The information provided by
the current information
systems is insufficient for
decision making. There is no
budget to purchase software,
and only SIAF and SIGA are
used. This is evidence of the
lack of interest in controlling
HHR management.
Personnel files outdated, and
there is no shared
information between the
personnel area and the files
area. Also lack of staff to
update files.
Weak coordination between
employers and training
institutions in designing
curriculum according job
profiles.
Low salaries generate high
turnover.
knowledge means that the
institution cannot benefit from it.
Inadequate recruitment, which is
reflected in work deficiencies.
Actual staffing needs are not
met; poor quality customer
service is a result of staff
shortages.
No improvement in quality of
services, systems, or health
programs.
Delayed money transfers.
Finance operational research for HHR
situational diagnosis. Appoint qualified
staff to develop it.
Create a file registration system as well as
worker awareness about its importance.
Improve salaries of health workers.
Define existing HHR in the region and
establish real staff needs by identifying
HHR gap.
Establish funding requirements for better
redistribution in different units.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 93
8.2 Analysis of performance evaluation results in the work organization sub-system, in selected regions
Loreto RHD
Strengths Problem Description Restrictions Consequences Proposals for Improvement
There is a responsible unit
within RHD to design job
profiles and identify
competencies in selecting
health professionals.
Management technical
documents exist; ROF
approved that specifies the
responsible unit in
identifying institutional
competencies.
Knowledge of the
importance of job rating.
Each position, according
to the hierarchy, has a job
profile.
No personnel are dedicated
exclusively to designing and
evaluating job profiles within
UEs.
Staff with multiple functions
is unable to determine
competency profiles and
selection of professionals.
ROF does not specify which
units are responsible of staff
development training
Management documents and
job profile classifier is
outdated.
Lack of job profile
implementation. Lack of
technical criteria for job
evaluation.
No permanent staff to
schedule and coordinate
trainings or select job
profiles.
Lack of interest within staff
members to train personnel.
Given the prioritization of
other activities, staff does not
exclusively perform with
functions.
Lack of decision from the
national government
regarding regional proposals.
Staff has geographic
limitations which hinder their
work.
No information regarding
competency profiles.
Staff working in positions that do
not match their competencies.
Lack of specialized staff.
Few health professionals in
remote and border areas.
Human resources are not
properly managed.
Goals, schedules, and activities
are not developed.
MoH support needed.
Restructuring of management documents,
including ROF and MOF.
Implement unit with exclusive and trained
personnel to develop competency profiles
and job rating.
Designate appropriate personnel
according to job profiles.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 94
Huánuco RHD
Strengths Problem Description Restrictions Consequences Proposals for Improvement
CAP, MOF, and PAP are
used as references in
designing job profiles.
Staff commitment to
achieving goals.
There are health care
competencies for staff who
work on growth and
development in children
under 5.
Very limited staff availability.
No MAPRO or standardized
processes.
Lack of initiative from
personnel and senior
management.
Little financial support.
Institutional goals are not
met.
Excessive workload.
Incomplete management
documents for proper
functioning of the institution.
Suboptimal care.
Hire more staff.
Technical workshops to include all
functional areas in order to develop
MAPRO.
Internships in skill development centers.
Pasco RHD
Strengths Problem Description Restrictions Consequences Proposals for Improvement
RHD and Daniel Alcides
Carrion Hospital have
identified three job skills:
prenatal care; growth and
development; and
demonstration sessions.
Job profiles and job rating
have not been designed or
developed.
Competencies have been
assessed only at health
facility pilot sites.
No skills have been identified
in all staff functions.
No HR competencies
identified for the design of
profiles and job rating.
Little interest in defining job
competencies.
Few professionals trained in
the methodology of
identification and
standardization of labor
skills.
Job profiles do not exist.
No job rating exists.
Develop the skills and competencies to
design job profiles.
Train UE HR managers in labor
competencies and job rating methodology.
Reactivate the Regional Competency
Standards Committee on Health.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 95
Lambayeque RHD
Strengths Problem Description Restrictions Consequences Proposals for improvement
Support of senior management and staff.
Human resources willing to participate in change processes.
Most management documents as well as a methodological guide to develop job profiles in public institutions are available.
Reference documents on the design and definition of labor competencies are available from other institutions like MoH and professional associations.
No designated office or specialized staff to design job profiles.
No defined HHR labor competencies according to areas or services. Job rating has not been carried out.
Inadequate personnel selection and no specialized personnel.
Staff in jobs that do not correspond to their academic training, experience, or capabilities; therefore, job functions do not correspond with MOF, MAPRO, and CAP.
Available management documents are not used.
Weak organization. HR has not been trained or is not specialized to design job profiles, labor competencies, and job rating.
Insufficient budget for optimal HHR development management.
Little importance is assigned to personnel unit.
Inadequate staff distribution.
Misallocation of job functions.
Staff with limited competencies and low performance, which affects users.
Differences in salaries among workers.
Create a work organization unit within the personnel unit and designate appropriate personnel according to job profile.
Design and use a job profile manual.
Design a job rating chart.
Recruit specialized personnel.
Set up multidisciplinary teams to identify labor skills and train staff.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 96
Piura RHD
Strengths Problem Description Restrictions Consequences Proposals for improvement
Over 80% of units have management documents, including MOF, ROF, and CAP, which are used as references in job design.
Staff is able to perform their duties given a positive and efficient work atmosphere
Decision making is coordinated to achieve positive results.
Each job has a profile. Personnel know the functions to be performed within their job.
MAPRO has been updated. There are qualified personnel to develop it.
No designated unit or sufficient personnel to design job profiles or identify labor competencies.
Lack of funding for training.
Due to lack of staff, job profiles are not respected.
Institutional CAP and MOF are not aligned with current reality.
As a consequence of the lack of knowledge, there are areas within the hospital that have not developed their MAPRO or other administrative manuals.
Staff does not certify labor competencies to increase their labor productivity level.
Tools for developing competencies are not used.
Repetitive or routine tasks hinder good performance in the workplace.
No job rating policies nor is there a responsible unit for evaluating jobs.
No responsible unit for designing labor competencies; MoH established labor competencies are used, which do not meet expectation Lack of minimum criteria and tools for assessing and defining labor competencies (job profile, experience, training, etc.). According to the planning unit, the Piura Regional Government has not approved the institutional CAP and MOF; it is using outdated documents. Due to staff shortages, some staff who are currently in positions are not according with his job profile. Due to the lack of staff has not achieved that 100% is in the position according its job profile. Constant staff turnover in some positions interferes with the long-term institutional plan. Health personnel are not trained to prepare MAPRO or other administrative manuals. No training plan to improve staff performance and competitiveness levels. Lack of budget for training.
Staff recruitment and selection processes are not efficient. Personnel profiles do not match positions, which lead to job misallocation and weakened performance. There is no health career; path positions are not valued; and there is a lack of knowledge of job functions. Functions performed are not properly classified, and there is duplication of functions; consequently, there is no basis for setting salaries. Personnel are not satisfied with salaries. Staff turnover hinders performances. Objectives and/or goals included in the institutional operating plan are not achieved. There is no real or official information about the jobs budget, expected jobs, jobs filled, etc. This would help assess real personnel needs. Some units do not have procedure manuals, and they operate without standardized protocols. No personnel assessment exists.
Coordination of the management team with the regional government for increased budgetary allocation. Implement job design program with trained personnel according to diagnosis and HHR gap studies. The institution must guide their investment in human resource capacities development. Train staff and perform periodic evaluation to measure performance and strengthen work. Annual update of job profiles. Develop job profiles for managerial or administrative levels, and update MOF. Reiterate the need to approve the institutional CAP and MOF to the regional government. Train personnel in the development of MAPRO and other administrative manuals. Train and appoint a responsible unit for job rating policy.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 97
8.3 Analysis of performance evaluation results in the employment management sub-system, in selected regions
Loreto RHD
Strengths Problem Description Restrictions Consequences Proposals for improvement
There is a designated unit for recruitment, selection, incorporation, and induction processes.
There are standards and tools for these processes.
There is a responsible unit for attendance control, staff mobility, and management of staff files for permanent and contract staff.
Radiogram is used as an information tool to communicate the updating of staff files.
There in a responsible unit to manage the institutional disciplinary process.
Staff performs multiple functions. No dedicated personnel to manage employment management processes; staff mobility; and staff termination and retirement. The staff is not fully trained to recruit HHR according job profiles. The size of the region makes training development difficult. Undue and excessive payments to staff. No computer application exists to manage staff files. Staff is not able to submit their staff reference file, like experience, education, etc. Weak coordination between offices. No disciplinary process committee.
Limited financial resources to fund staff exclusively for each process. Not all UEs have or know the approved rules, laws, and regulations for staff recruitment. By prioritizing other activities, the staff does not carry out their specific functions according to their position but instead focuses on immediate office needs. Turnover of trained staff and staff relocation to different areas or units. Lack of tools to coordinate activities or personnel training. No timely information regarding attendance control, subsidies, retirements, and licenses. Absence of approved rules, laws, and regulations for administration of disciplinary proceedings. Lack of planning with regards to the disciplinary processes.
Lack of adequate staff to take responsibility for job profile requirements. Staff capabilities are unknown. Staff do not know their job functions or evade the responsibilities of the designated job. No timely personnel information is available, and there is a risk of losing staff file information. Non-compliance regarding disciplinary processes. Accounting, tax, and administrative problems in HHR management, which could lead to improper payments.
Train responsible network units on the different management processes. Given the size of the region, implement mechanisms to facilitate coordination with staff. Procure funding to hire/appoint and train personnel responsible for the management of recruitment, selection, incorporation, and induction processes. Update centralized registration forms. Procure funding to modernize job file management; develop a software to record personal and work HR data; and update information. Staff documents should be filed promptly. Implement strategies for personnel in remote zones to update their staff files. Plan disciplinary processes and disseminate them to committee for timely implementation and compliance. Implement and train a committee. Monitor compliance with provisions about staff termination and retirement. Monitor compliance of approved standards.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 98
Huánuco RHD
Strengths Problem Description Restrictions Consequences Proposals for improvement
There is qualified staff in critical areas. Staff is committed to achieving goals. There is a responsible unit for managing the recruitment, selection, incorporation, and induction of staff. There are responsible personnel for updating staff mobility, updating staff files, and managing staff termination and retirement.
The need for staff recruitment is not done based on a gap study. Lack of human resources. Qualified staff is scarce for higher level health facilities. No system to record, to maintain, and update staff information.
Necessary aspects are not considered for recruitment, selection, incorporation, and induction processes Lack of skilled and committed staff. No budget to contract staff. Lack of software for registering and updating staff information and staff retirement by occupational group and labor regime.
Work overload results in low quality care in health facilities. Institutional goals are not met. Delayed information dissemination. Job management processes are not optimal for all steps.
Strengthen recruitment and induction staff process and provide ongoing training to improve performance of higher level health facilities.
Develop a gap study to define HR recruitment needs.
Have a system to record and maintain updated staff information, performance evaluation reports, attendance control, and staff retirement.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 99
Pasco RHD
Strengths Problem Description Restrictions Consequences Proposals for improvement
Pasco RHD and Daniel Alcides Carrion Hospital have a human resources selection process committee for various budgets. Staff mobility is not a management policy; it occurs through institutional and personnel interest. There is a responsible unit for attendance control in all health facilities and micro-grids. Pasco RHD and Daniel Alcides Carrion Hospital have a disciplinary process committee established through a directorial resolution.
New contracted personnel do not receive induction. Vacant positions are not immediately filled; they are not attractive due to low salaries. Some newly hired professionals and technicians have been mobilized but not in accordance with established standards. Staff files are incomplete and outdated. Institutional sanctioning capacity is almost nonexistent. Personnel who are subject to the disciplinary process are still working. There is no staff termination process. There is no personnel welfare service.
There is no directive governing the recruitment, selection, and incorporation of HR. There is no induction policy for new contracted and appointed personnel. No accredited skills development centers. DL 1057 establishes conditions and restrictions for contract personnel. DL 276 and SERUMS establish personnel mobility terms. Few HR staff with staff file administration skills. Personnel with low attendance compliance. Limited availability of attendance control system. Lack of human resources, including social workers and organizational psychologists. Internal audit unit does not perform prior and concurrent monitoring for administrative and disciplinary proceedings.
Dissatisfaction with poor skills of newly recruited staff.
New staff has poor problem-solving skills.
Personal and professional development of HHR is not improved, which leads to low productivity and motivation of staff.
Attendance control and staff files are incomplete and unreliable.
Ethical standards and labor rules are not followed by staff.
Labor rights are not always recognized.
Staff and users (patients) are dissatisfied.
Establish health policy and develop labor skills and competencies of staff according to their functions.
Assess and accredit skills development centers.
Develop selection process directives.
Reformulate induction directive and extend its scope.
Develop and establish a policy to govern staff shifts as a way of promoting human development.
Improve attendance information systems.
Train responsible personnel in management of staff file regulations.
Reorganize the disciplinary process committee with appropriately selected members.
Develop and establish policy to regulate staff termination processes.
Hire social workers and/or psychologists for three UEs.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 100
Lambayeque RHD
Strengths Problem Description Restrictions Consequences Proposals for improvement
There are guidelines for selection processes. There is a permanent commission for HHR recruitment and selection. Increased RHD budget. Official documents for staff mobility processes exist. There is an office responsible for staff file administration, affidavits, and attendance control. There is a disciplinary process commission and internal regulations for disciplinary processes. There is a General Administrative Procedure Law (Law N° 27444) and General Act of Ethics Code. There is an office responsible for updating staff termination data. Updated regulations for staff termination exist. Staff termination data is updated.
Insufficient and unqualified personnel for managing recruitment, selection, hiring, staff files, attendance control, staff mobility, and staff termination. Staff files management and attendance control are not properly performed. Political interests related to staff termination.
Limited job offers, low remunerative levels, and better offers from the private sector. Insufficient induction for new personnel. Insufficiently trained personnel for managing staff files, disciplinary processes, staff attendance control, staff termination, and staff mobility. Insufficient logistical supplies like record books. No competent legal advisors. Lack of software for registering and updating staff termination by occupational group and labor regime.
The job position remained vacant. Limited supply of human resources for units. Low efficiency of units in managing staff files. Documents and staff data are lost. Lengthy processes. Delay in disciplinary proceedings. Staff with multiple functions and high turnover
Train UE personnel.
Procure funding for recruiting processes.
Increase incentives offered to personnel.
Disseminate recruitment processes through various communication channels.
Implement information systems to improve unit efficiency.
Maintain updated internal job regulations.
Implement an information system for updating staff termination by labor regime.
Qualified and competitive human resources needs for filling vacancies.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 101
PIURA Sub-system: Employment Management
Strengths Problem Description Restrictions Consequences Proposals for improvement
There is an office and staff
dedicated to HHR
recruitment, selection,
incorporation, and induction.
Staff is hired through a
recruitment process in
accordance with DL 276, and
selection steps are
performed according to
regulations.
UE directors are members of
the selection committees.
The selection process
committee is responsible for
the recruitment, selection,
incorporation, and induction
of staff. The internet is used
todisseminate the process to
the public.
Recruited personnel for
service and administrative
tasks have started work in
their positions.
Staff mobility occurs
according to EESS needs;
there is an office and staff
who are responsible for
maintaining updated
information on HHR mobility
within and outside the
institution.
There is sufficient staff to
Personnel who are assigned to
various employment management
processes lack proper training and
are overloaded with multiple
functions.
During the staff selection and hiring
process, some steps detailed in the
regulation are omitted due to lack of
time. RNSDD is not consulted during
selection and recruitment process;
also, unqualified candidates are not
filtered out early on.
There is no regulation on CAS
contracts, and unassigned CAP
positions are not used.
Recruitment and selection processes
are done only at the request of the
user unit and only if there is
allocated budget. Candidates’
knowledge is not taken into account.
The induction process for new staff is
not performed.
There is no designated personnel to
maintain information on staff
mobility.
Inadequate infrastructure: there is
no space for file storage.
The unit responsible for maintaining
files lacks software to register and
systematize personnel information.
Attendance unit does not report staff
attendance, tardiness, or absences.
The creation of a permanent office
to manage recruitment and
selection processes has not been
prioritized.
There is a lack of knowledge
concerning the selection process.
Steps in the selection and
recruitment process have
inappropriate deadlines. Call
spreading is not done properly.
There is no induction stage for
newly recruited staff; additionally,
there is no designated or trained
staff to perform the induction
process.
Few applicants meet the required
profile for the available positions.
Staff working in an institution for
at least three months are allowed
to work in budgeted CAP positions
if they have gone unfilled; these
positions may also be filled by
agreement between
administrative and assistance
unions.
Staff is evaluated based on
references and not on relevant
knowledge. Staff information is
not readily available due to lack of
storage space and files.
Staff mobility is not properly
managed because there is no
There are no proper staff
recruitment and selection
processes.
Selected staff is poorly
trained, and that not
possess the necessary skills
they are not able to fulfill
their duties because they
are not familiar with job
tasks.
Salaries are below the
expectations of applicants,
and there is no information
about it in selection
processes.
Staff registered in RNSDD is
hired against regulation.
Mobility requirements are
not met on a timely basis.
Personnel are relocated
without considering
technical job criteria.
Intellectual capital is lost
when staff move to other
organizations.. budget
assigned to the position
cannot be used towards
the replacement.
There is no attendance
register; established
schedules are not kept, and
man-hours are lost.
Improve infrastructure of the HR office.
Training and designation of a staff to manage
different processes according to regulations.
Increase budgetary allocation to cover the
shortfall in staff by increasing CAS contracts.
Define guidelines and procedures for
selection, hiring, and incorporation of
personnel. Add a knowledge section to
assessments.
Establish a permanent committee that will be
properly trained in recruitment processes for
either CAS positions or DL 276 .
Establish an induction policy for newly
recruited staff to optimize performance.
Train personnel to manage the RNSDD
website.
Improve coordination between staff who are
responsible for file management and
attendance.
Implement computer applications for: control
of staff attendance and permanence in CLAS;
registration of personnel relocations; and
planning, adaptation, and control of
personnel files.
Improve legal advice entities to avoid rule
violations.
Strengthen the disciplinary proceedings
committee by implementing schedules;
appointing staff to update information; and
training staff on MoH disciplinary proceedings
and the use of the RNSDD register.
Establish a regulation or internal rules to
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 102
Strengths Problem Description Restrictions Consequences Proposals for improvement
manage files, affidavits, and
attendance registers.
Some UEs use an computer
to update files.
A digital system (SYNASYS)
exists to register staff
attendance. Some UEs have
fingerprinting devices to
monitor attendance.
There is a designated office
and personnel to manage
disciplinary processes.
Members of the permanent
committee are appointed by
a executive resolution.
Some staff members do not have an
updated file although it is an
institutional. Affidavits are not
updated according to the fiscal year.
Some physicians avoid the
attendance registration process.
Attendance registry needs support:
Designated attendance registry staff
are overloaded with various tasks..
The disciplinary proceedings
committee rarely meets. Members
of the committee lack training and
cannot offer full-time commitment.
There are no updated files on
administrative proceedings. RNSDD
(National Register of Dismissal and
Sanctions).
There is no internal policy for
employing management.
There is no internal regulation
regarding dismissal proceedings, and
there is no assigned office for this
task.
designated personnel to manage
it. No software exists to record
staff mobility. Workers do not
update their files or affidavits.
It is difficult to recorder staff
attendance. Control register and
attendance in far health facilities
is done manually
Some physicians do not sign
attendance based on orders from
institutional managers. This
situation creates discomfort, and
it is against MoH and SERVIR
regulations.
Administrative proceedings are
delayed as committee members
do not have enough time due to
their assigned tasks and lack
training.
The RNSDD register is not
updated. There is no office,
trained personnel, or system to
manage staff dismissal
proceedings.
The budget is insufficiently
allocated.
File information is not
updated and systematized.
manage employee dismissals the
disengagement cases to avoid relying only on
DL 276.
Designate staff to manage dismissals and
update information accordingly.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 103
8.4 Analysis of performance evaluation results in the performance management sub-system, in selected regions
LORETO Sub-system: Performance Management
Strengths Problem Description Restrictions Consequences Proposals for improvement
Within ROF and MOF, there
is a designated office to
implement performance
improvement evaluations in
some UEs.
There is staff to manage HHR
performance evaluations.
Senior management has
prioritized the planning and
implementation of
performance evaluations for
professional groups.
There are technical tools to
aid staff for supervising.
There are no job profiles.
In many cases, UEs do not have
offices or staff to manage:
planning and organization of
performance plans; monitoring
and supervision in the
workplace; and evaluation,
feedback, and design of
individual performance plans.
There are no job profiles.
The performance evaluation
function is not prioritized. The
process itself is not well
understood.
There is no office or trained
personnel to plan, organize,
monitor, evaluate, provide
feedback, or design individual
performance plans.
There is insufficient budget to
supervise each health facility.
Senior management shows little
interest in supporting training
activities.
Designation of an office for
planning, organization, monitoring,
evaluation, feedback, and design of
individual performance plans is not
prioritized.
There are no targets set within
evaluations nor are there technical
instruments to measure goals and
results.
Supervision processes are not
implemented.
Staff is generally not evaluated;
when they are, the evaluation is
subjective. Actual, objective
performance is not measured.
The lack of individual performance
plans and objectives leads to
unmotivated staff who are often
untrained and not able to
accomplish job functions and
targets.
The staff promotion policy does not
exist.
Establish an office with trained staff to manage
design, evaluation, and feedback of performance
plans.
Train responsible staff in this functions for Provide
legal consultation to UEs for elaboration of HHR
profiles and implementation.
Procure budget for increased staff supervision to
better enforce staff tasks and goals.
Incentivize staff by offering training opportunities to
improve commitment and encourage them to
achieve results.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 104
HUÁNUCO Sub-system: Performance Management
Strengths Problem Description Restrictions Consequences Proposals for improvement
Staff is committed to
achieving goals.
There is no office or staff
responsible for the following:
planning, organizing,
implementing, evaluating, and
monitoring the performance
evaluation process; and
supervising and managing
feedback of the assessed staff
to design individual
performance plans.
Personnel are unmotivated.
Falta de conocimiento para el
desarrollo de los procesos de
gestión del desempeño.
Lack of knowledge for
performance management
processes.
Goals are not accomplished.
The planning and performance
evaluation process as well as the
supervision, feedback, and design
of individual performance plans are
ineffective.
Develop a plan and design tools to aid in
planning, organization, implementation,
evaluation, supervision, feedback, and design
of plans to improve employee performance.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 105
PASCO Sub-system: Performance Management
Strengths Problem Description Restrictions Consequences Proposals for improvement
Mandatory goals are set
through performance
budgeting and budgeting by
signed agreement.
There are instruments to
measure the performance of
EESS level one.
DIRESA Pasco/HDAC has
developed performance
evaluations in pilot sites for
two functions: prenatal care,
and growth and
development.
There is no policy to encourage
HHR staff performance
improvements. There are no
institutionalized instruments to
aid in performance evaluation.
There are no tools to help
supervisors incorporate
performance evaluations into
their offices There are
institutional goals, but they are
not individualized for
employees.
There are no performance
evaluation standards for most
functions.
No feedback processes have
been developed nor have plans
been designed to improve
individual performance.
There are no validated models
for performance improvement
plans.
The design of job profiles at the
national level is slow.
Managers do not have the
capacity to plan and set skills
performance standards
(including performance
assessments).
Supervision plans should be
linked to performance
evaluations.
Monitoring and evaluation of
strategic budget outcomes
should be linked to goals and
service quality.
There are noset performance goals
and plans at any organizational
level.
Performance evaluations are not
performed.
There is no supervision at the
intermediate level, which includes
networks and micro-networks, or
first level (EESS).
There are no improvements in the
quantity or quality of health service
provision.
There is no feedback on
performance gaps or plans for
individual performance
improvement.
Develop and validate a proposal for plans to
improve performance.
Train HHR managers in all UEs to develop
performance plans.
Train professionals in the identification and
standardization of labor skills.
Establish supervision plans and develop
monitoring tools linked to performance.
Validate performance assessment instruments
for the prenatal and growth and development
areas. Set competencies standards for other
key functions.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 106
LAMBAYEQUE Sub-system: Performance Management
Strengths Problem Description Restrictions Consequences Proposals for improvement
There is support from senior
management There is
sufficient budget due to
support from the regional
government.
Instruments have been
officially approved to
monitor and evaluate staff
performance.
The necessary requirements
are in place to carry out
performance evaluations.
There is staff available to
monitor and evaluate
performance.
Recruited CAS personnel are
subject to periodic
evaluation.
There is an approved PDP.
HHR has a desire to excel.
There is no designated office or
qualified staff to plan
performance goals, supervision,
evaluation, feedback, and
design of performance
improvement plans.
There is no plan for
performance evaluation.
Performance goals have not
been defined.
Staff performance is not
monitored or supervised, and
there is no methodology for
this.
Performance evaluation
instruments are based on a
traditional approach and do not
evaluate the required
competencies for the position.
There is no trained or
specialized staff to manage HHR
processes, including planning
performance management,
supervision, evaluation,
feedback, and design of
individual performance plans.
There is low supply of potential
employees in the local labor
market.
There are no reports or
information available for
decision making.
There is no objective evaluation
of performance linked to
competencies.
There are no instruments to
evaluate competencies.
HHR management is inefficient and
functions poorly. As a result, goals
are not achieved.
There is no plan for staff
performance evaluation.
Staff refuses to be evaluated.
. After the evaluations, staff
performs functions as usual, and
there is no improvement or change
in attitude.
Poor health service provision.
Create an office responsible for the different
processes associated with assigning and
training staff.
Create a separate unit to set objectives and
goals for staff based on their functions and
activities.
Design and validate methodology and tools
for monitoring and supervision of staff for
heads of organizational units.
Design tools, including a competency profile,
to enable precise evaluation in order to
achieve institutional goals and improve
institutional performance.
Develop PDP to strength the competencies
required in different job positions.
Design methodology to provide efficient
feedback to improve individual performance.
Develop plan to monitor compliance with
individual performance improvements plans.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 107
PIURA Sub-system: Performance Management
Strengths Problem Description Restrictions Consequences Proposals for improvement
There are mechanisms to
record monitoring processes.
Employees are given
advanced notice of
evaluation.
The objective of the
evaluation process is for staff
to improve performance
according to a plan.
The supervisor’s role is to
improve work performance.
There is no policy for
performance evaluation plans.
Performance evaluations are
not scheduled or carried out.
There is no office or unit
responsible for planning,
organizing, implementing, and
recording performance
evaluation processes. There is
no feedback mechanism
between supervisors and staff
in designing individual
improvement plans. The
performance evaluation
process, methodology, design,
and tools are not well
understood.
There is no comprehensive plan
for monitoring and providing
feedback to staff, including
EESS. There is no defined
methodology nor are there
instruments for the heads of
units to utilize.
There is no office or unit
responsible for planning,
organizing, implementing, and
monitoring processes.
Supervision is almost inexistent.
Personnel fear being evaluated
as they associate it with
dismissal.
There is no plan nor are there
tools for measuring and
evaluating job performance.
There is no office or personnel
assigned to this task. Due to
this situation, processes to
manage feedback and design
individual performance
improvements plans do not
exist.
There is no defined
methodology to evaluate by
occupational group; there are
no defined goals for
occupational groups.
Unions are not providing
information to their members
on the benefits of evaluation.
There is a lack of staff
cooperation related to
performance evaluations.
Supervision is limited due to a
lack of methodology. There is
no designated office to manage
these processes.
Department heads have not
been adequately trained in
employee supervision.
There is limited budget
allocation for performance
management.
There are no performance targets,
and there is no estimated or
updated information related to
employee performances. This
situation hinders progress in
improving institutional
performance. Staff performance is
subjectively evaluated.
Correct assignment of staff to
positions is not monitored. Staff
training needs are unknown.
There are no plans for individual
performance improvement
Institutions provide only mínimum
performance improvement
opportunities for staff
Staff does not want to be
evaluated for fear of the results.
Administrative procedures are not
properly carried out and goals are
not achieved due to low
productivity. Institutions expect
employees to perform their work
but do little to enforce standards.
Monitoring activities do not
improve performance and do not
lead to good decision making.
There are no promotion or
compensation policies. There are
no staff incentives, which cause
dissatisfaction.
Implement a plan backed by budget for the
measurement and evaluation of job
performance.
Establish an office with trained personnel to
plan, measure, and evaluate staff job
performance; provide office with
methodology and tools to set individual
performance goals and to perform objective
evaluation and feedback for performance
improvements.
Elaborate a comprehensive supervision plan
backed by a budget.
Train unit heads for performance managing
and provide the necessary tools, including
report models and others, to support
monitoring.
Promote constant job performance evaluation
and staff training.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 108
8.5 Analysis of performance evaluation results in the development and training management sub-system, in selected regions
LORETO Sub-system: Development and Training Management
Strengths Problem Description Restrictions Consequences Proposals for improvement
There is an office responsible
to manage staff proceedings
for promotion and career
path.
There is an approved training
policy and a designated
office with qualified and
experienced personnel to
manage trainings.
Agreements to have short
trainings in other institutions
have been initiated Although
there was little support for
capacity building, the staff
expanded their knowledge.
The Health Graduate
Regional Committee
(COREPRES) was approved by
directorial resolution.
Some agreements have been
signed with training
institutions.
There is no approved job
promotion policy.
There is a lack of funds to
develop abilities, and not all
staff is qualified to do their
jobs.
COREPRES does not regularly
meet.
There is no designated unit to
manage agreements.
Staff is overloaded with
multiple tasks.
Promotion is based on years of
service.
Functions are not prioritized in
policy making. Training is not
prioritized as a key factor in
institutional development.
There is no meeting scheduled
to develop the reaching-service
regulation.
Staff are not motivated.
Staff claim that their files are not
updated, and thus, they are not
eligible for promotions or wage
increases.
Unqualified staff hinders
achievement of targets and success
of programs.
Coordination with training
institutions is ill-defined
Prioritize the establishment of a promotion
policy. Create regulations, laws, and directives
for staff promotion.
Take action to secure budget for a capacity
building policy; secure budget for elaboration
and execution of a staff development plan.
Incorporate outcomes of performance
evaluations to elaborate a staff development
plan.
Establish alliances with universities for better
operation of COREPRES.
Establish agreements with institutions and
universities.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 109
HUÁNUCO Sub-system: Development and Training Management
Strengths Problem Description Restrictions Consequences Proposals for improvement
Staff is committed to
achievement of goals.
Some criteria are taken into
account to identify staff
training needs.
Outcomes of knowledge and
performance evaluations are
not taken into account to
identify staff training needs.
There are no regulations for
management of development,
training, and teaching.
Lack of trained staff and criteria
to carry out knowledge and
performance evaluations to
determine training needs.
Promotion is delayed.
Capacity building is not tailored to
institutional goals and realities.
Staff works for many years without
promotion.
Take into account necessary inputs to develop
and implement capacity building.
Assign qualified personnel to manage
different aspects of capacity building.
PASCO Sub-system: Development and Training Management
Strengths Problem Description Restrictions Consequences Proposals for improvement
DIRESA/HDAC has a PDP,
although its contents need
improvement, and it is
insufficiently funded.
There is good coordination
with teaching institutions.
A framework agreement has
been signed between the
university, the regional
government, and MoH.
Clear career paths have not
been established nor are they
regulated; there are no
established mechanisms for
promotion based on merit.
On capacity building: training is
not aligned with institutional
needs; there is no reliable
database to manage and track
training; and there are no
medium- or long-term plans for
capacity building.
Clinical fields are insufficient
due to the lack of specialized
hospitals interns (obstetricians,
nurses, nutritionists,
psychologists, etc.) are not
being paid.
A very strict regulation in HHR
promotes stability.
The training office is allowed a
limited leadership role in
planning academic events.
No budget has been allocated
to fund PDP.
Universities are not
communicating well with
service providers.
.
Promotions do not regularly occur
. Professionals and administrative
technicians are given little
opportunity for capacity building.
Low productivity related to health
services.
Deregulation of internship
practices.
The teaching-service process does
not meet basic regulations.
Develop a proposal to improve HHR
development administration and incorporate
a promotion process. Establish competitive
career paths based on merit.
Reformulate the PDP to incorporate the three
UEs according to SERVIR methodology.
Formulate a training policy to emphasize
internships..
Reformulate agreements to involve training
institutions; encourage regional and local
authorities to establish a training policy.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 110
LAMBAYEQUE Sub-system: Development and Training Management
Strengths Problem Description Restrictions Consequences Proposals for improvement
Staff is committed.
A promotion regulation has
been implemented.
There is increased budget for
training (supplied by the
regional government).
There is a designated office
and qualified and
experienced staff to manage
training.
There is a regulation
governing budget allocation
for training.
Agreements have been set
up with educational
institutions.
There is a growing demand
for hospitals that offers
educational opportunities.
There is an office responsible
for managing the teaching-
service process. This office
has evaluation criteria.
There is no internal promotion
policy.
Training policies have not been
designed, and there are no
methodological guidelines for
capacity building.
There are no internships.
There is no evaluation on the
impact of training.
Staff training needs have not
been identified.
Universities do not respect
agreements
Time periods for tutors and
students are not specified.
There are no criteria to to
assess the office responsible for
the teaching-service process
Trained and specialized staff to
manage training is not available
for every UE.
There are a limited number of
job positions.
There is no IT system to
manage staff training.
Lack of procedures to ensure
fulfillment agreements with
universities.
Staff has unfulfilled expectations.
Job vacancies take a long time to
fill.
HHR is not trained in the whole
GERESA. There is no equity
regarding staff access to training
opportunities and capacity
building.
Personnel are not efficient.
Patients are observed by a large
number of student, which causes
discomfort.
Create new job positions.
Assign and train personnel to manage
promotion.
Promotions must occur on a regular basis.
Implement a training program that is
accessible to staff on an equitable basis.
Increase budget for training.
Set up agreements with prestigious
educational Institutions.
Identify training opportunities.
Periodic monitoring and evaluation of
agreements to ensure fulfillment.
Elaborate and approve criteria to assess the
office that manages the teaching-service
process.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 111
PIURA Sub-system: Development and Training Management
Strengths Problem Description Restrictions Consequences Proposals for improvement
Some UEs have an office to manage
human development (promotion)
and training.
There is a welfare and training
section within the personnel unit
that is responsible for managing
training.
The administration has granted
career promotions based on years
of service and evaluation of
personnel files.
Several criteria are used in
recruiting personnel: candidates
must not have incurred disciplinary
sanctions; they must have public
sector experience and experience
with the functions to be
performed; and they must have
professional experience and
training.
Training needs are identified
according to office objectives.
Some training programs have taken
place: short courses, lectures, and
workshops according to specific
section and employee demands.
Some UEs have an office to support
teaching and research.
There is an agreement to set up
practices with technological
institutes.
There is no capacity building policy nor is there assigned
personnel, a training unit, or methodological guidelines
associated with capacity building.
The HHR unit is not carrying out its role and functions in
managing staff training.
Few training opportunities. There are no internships or
certification programs.
Training is not programmed or carried out according to
adequate criteria, i.e. regional health needs, training
offered by MoH, or other regional institution training.
Assessments results from training measuring knowledge
or performance are not collected.
There is no staff promotion policy, and there are no
assigned personnel or permanent committee to manage
these processes.
Certain criteria, including performance evaluations, merit-
based competitions, interviews, knowledge tests, and
group dynamics, are not taken into account when
promoting staff.
Files are not updated.
The job profile, performance evaluations, and training
plan guidelines are not used when selecting and
recruiting staff.
DIRESA and UEs are not educational institutions, and
therefore, there is no staff responsible for teaching. There
are training agreements with educational institutions, but
students are being trained only in administrative
activities.
There is no information system database to track
students trained in the institution.
There is no promotion
policy nor is there assigned
personnel or allocated
budget.
Promotion is not a
function of the UE but is
directed from MoH.
No capacity building
policies have been
designed.
The office responsible for
capacity building cannot
accomplish its tasks due to
lack of budget and HHR
personnel.
There is a lack of training
for the heads of UEs.
There are no signed
framework agreements
with training institutions.
There are no accredited
health professionals
assigned to lead training
activities.
There is little allocated
budget for development
and training management,
There are no inter-
institutional agreements
or strategic alliances with
other institutions such as
NGOs.
Personnel assigned to
positions that do not
correspond to their
professional profile do
not fulfill all job duties.
There is little staff
capacity building, which
has caused
dissatisfaction.
Staff claim that job files
are not updated.
Financial resources
related to capacity
building come from MoH
and other centralized
sources.
There are no framework
agreements with other
institutions to train staff.
There is no updated
information about the
student population
trained at the hospitals.
Implement a promotion
policy based on staff capacity
and performance as well as
professional profiles.
Develop a promotion plan
that is tied to budget
allocation.
Develop a plan to encourage
performance improvements;
plan should be tied to budget
allocation and include a plan
for promotion.
Keep updated personnel
files.
Develop a training policy
based on staff and
institutional needs.
Implement training plans to
align with these needs.
Consider, as a priority at the
MoH, the capacity building of
public sector staff in the
provinces.
Sign framework agreements
with training institutions.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 112
8.6 Analysis of performance evaluation results in the compensation management sub-system, in selected regions
LORETO Sub-system: Compensation Management
Strengths Problem Description Restrictions Consequences Proposals for improvement
There is a regulation on
remuneration scales that
covers benefits, bonuses,
and incentives. There is
designated office responsible
for this task.
There is trained staff who are
responsible for managing the
salary scale system. Despite
an unfavorable geographical
location and lack of
upgraded tools, staff
receives all appropriate
compensation and benefits
(DATEM).
There is no full-time staff to
manage remuneration
processes.
There is no quick way to update
the system.
RM190 does not take into
account the EESS Putumayo
basin, which borders Colombia,
or Lagunas and Shucushyacu
districts.
Incentives are not granted
according to performance
evaluation results. Incentives
are constantly changing.
No objective performance
assessment is performed.
Not all UEs are in ZAF.
It has been noted that there is
no equity in the management
of payroll and salaries using the
job rating for remote and
undeveloped areas Not all UEs
support pensioners.
Lack of information hinders
decision making related to
incentives.
Personnel are dissatisfied and
unmotivated.
Request timely information from MoH.
Update the salary structure.
Negotiate with MoH to incorporate ZAF bonus
payments to Putumayo basin establishments
and the Shucshyacu and Lagunas districts.
Increase staff and train them to form teams
specialized in administration of benefits,
bonuses, and compensation.
Implement performance evaluations and take
them into account when granting incentives.
Comply with regulations.
HUÁNUCO Sub-system: Compensation Management
Strengths Problem Description Restrictions Consequences Proposals for improvement
Staff is committed to
achieving goals for
Management of salaries and
payroll in the institution.
Staff are not promptly
compensated.
There is no assigned staff to
manage non-monetary and/or
monetary incentives, including
benefits and bonuses.
Policies are not consistent with
reality. There are no approved
rules or policies for the
implementation of incentives.
Limited staff and space to
establish office to manage
compensation activities.
There is no staff or office to
manage incentives.
Personnel are unmotivated.
Untrained personnel are
implementing activities related to
compensation management.
Inquire about rules allowing development and
implementation of compensation and
incentive policies.
Ensure appropriate physical space for the
development of activities for compensation
management.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 113
PASCO Sub-system: Compensation Management
Strengths Problem Description Restrictions Consequences Proposals for improvement
Salary scales are approved at
the national level.
Staff is trained in payroll
management.
Allocation of benefits and
bonuses is done in
compliance with regulations.
Availability of resources and
expertise for the
implementation of monetary
and non-monetary
incentives.
Adequate and available
budget for administration of
pensions.
CAS worker scale is not
standardized.
Trained staff for payroll
management is underused.
Non-compliance with the
payment schedule set out in
legal regulations due to
untimely information from
networks and micro-networks.
Payment of benefits and
bonuses is not done in a timely
manner.
There is no budget to satisfy
requirements of DU 037-94,
Law 25303, and other legal
provisions.
There is plan for incentives.
There are no incentive
directives for workers.
Limited budget available to
standardize pay scales.
Payment scales for HHR and
SERUMS are the responsibility
of MoH.
There is limited personnel who
are trained to manage the
payroll system and process.
Information is not provided on
a timely basis by networks. The
payment of benefits and
bonuses is delayed.
MEF sets the conditions and
schedule for transferring
benefits and bonuses despite
limited budget for this.
Incentives are not well
managed.
Pay scales do not correspond to
regional realities.
The pay scale for CAS recruits
differs from staff and SERUMS pay
scales.
Staff payments are delayed.
Payment of benefits and bonuses is
delayed.
Workers are dissatisfied and
therefore exhibit low productivity.
Set up technical meeting with staff to outline
responsibilities and improve key processes for
compensation management.
Suggest and set pay scale for CAS contracts
based on DL 1153.
Provide payroll unit with trained and
experienced personnel.
Formulate and implement an incentive
directive; develop and implement the
incentive plan.
Establish a training rotation plan and
permanent training policy.
Establish social welfare programs for
pensioners.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 114
LAMBAYEQUE Sub-system: Compensation Management
Strengths Problem Description Restrictions Consequences Proposals for improvement
There is a different pay scale
for High Andean Zone CAS
staff.
There is a bonus for
employees working in
remote and dispersed zones.
There is an office responsible
for managing payroll and
wages; bonuses and benefits
administration; and incentive
management.
There are trained HHR that
are able to develop a site-
specific payroll. The pay
sheet is updated monthly.
Compliance with existing
directives for the
management of bonuses and
staff pensions.
Monetary incentives are
granted, and all workers
have the opportunity to
receive them.
There is assigned staff and an
information system for the
administration of staff
pensions.
Vacancies remain vacant due to
low wages; personnel are
unmotivated.
There is a lack of training for
human resources.
There is no office responsible
for designing salary scales.
MoH does not have an updated
payroll system. PLH is an old
DOS system. Lambayeque has a
separate system, which is slow
when the system is updated
with changes (SIGA). The
implementation of new
standards is not immediate.
CAS professionals have low
salaries.
Staff is not aware of the latest
regulation regarding benefits
and bonuses.
CAS personnel are not eligible
to receive incentives.
No non-monetary incentives
are granted.
Under Law 20530, a pension is
not granted when personnel
are dismissed upon cessation of
personnel.
Payment to AFPs is delayed.
Limited budget for
implementing a salary scale
system.
No official permission exists to
allow development of
differentiated pay scales.
There is a lack of trained or
qualified personnel and a lack
of funds for training.
There is a high possibility that
payments cannot be made in
accordance with the
regulations.
Lack of budget to fund
incentives.
There is no legislation related to
incentives for the CAS system.
There is no policy for non-
monetary incentives.
Lack of budget to pay out
pensions at the end of the year.
AFPs do not report employee
transfers between AFPs in a
timely manner.
Staff lacks information about
pension systems.
There is no differentiated salary
scale, only the national wage scale.
Low staff productivity is reflected
in health indicators.
Pay and pension formats are not
updated according to the new
directive. Delayed information
from MoH generates payment
delays.
Poor understanding of certain
processes in the administration of
staff benefits and bonuses.
Staff perceive that the work
environment is unsatisfactory,
especially CAS staff and other
employees who perform their jobs
adequately but do not receive
incentives.
Pensioners are unsatisfied because
they are not receiving their full
pensions. AFP levies fines or
penalties on the institution.
Train responsible staff to carry out processes
related to management of compensation.
All staff and CAS personnel must have fair
remuneration arrangements. Design a pay
scale structure and prioritize CAS staff.
Secure budget to improve infrastructure.
Manage implementation of PLH and assign
trained personnel.
Grant incentives taking into account the
available budget, and base incentives on staff
productivity.
Design policies and strategies to utilize non-
monetary incentives to recognize and
motivate workers.
Ensure full pensions at the time of
termination.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 115
PIURA Sub-system: Compensation Management
Strengths Problem Description Restrictions Consequences Proposals for improvement
The salary scale is based on
national legislation. Pay
scales for all types of staff
have been developed and
approved. Pay scales are
used in new contracts
according to budget
availability and functions of
the position.
There is an office responsible
for managing wages and
payroll. According to the
current ROF, there is a
designated unit responsible
for administering wages and
payroll.
There is also a computer
spreadsheet application that
updates pay lists according
to regulations.
There is designated staff in
the Planning Office to
monitor pay scales.
There is a current directive
and an office with assigned
staff to manage benefits,
bonuses, and incentives.
There is designated staff
which is responsible for
monetary incentives.
Budgetary allocations to
cover benefit and bonus
There is no office or
methodology to design and
monitor pay scales; there are
no standards for compliance
and maintenance.
While there is an approved pay
scale, it is not used.. There is no
one salary scale for all staff.
Salary increases are not allowed
for public servants according to
MoH.
There are applications within
the DOS platform to manage
obsolete forms based on an
MoH design.
Staff has not been trained in
payroll management; they only
execute instructions given by
MoH.
MoH does not provide timely
replies to emails concerning
remuneration issues (bonuses)
Benefits and bonuses are
determined at the central level
regardless of performance.
There is no designated unit to
manage benefits and bonuses;
staff is trained on its own
initiative or through work
alone.
There is no equity in the
administration of benefits and
The Annual Budget Act restricts
salary increases even though
there is available budget.
There is a lack of methodology
for designing salary scales.
Proposals to improve salary
scale from the sub-regional
level are not welcomed; only
ftp-MoH computer manuals are
used.
UEs receive requests from
employees requesting salary
increases.
The pay slip is not available via
internet.
Differences in employee job
performances are indiscernible;
there is no designated staff
responsible for performance
evaluations.
Incentives are not applied in
relation to the level of
performance.
There is no trained and
responsible staff to manage
benefits and bonuses; there is
no software to quickly calculate
benefits and bonuses.
There is a budget deficit and
staff is unavailable to work on
procuring it.
There are no requirements for
The policy for designing salary
scales is inadequate. Employees
are dissatisfied with wage
differences.
Strikes occur.
There have been no increases in
salaries.
When there are changes in the
salary structure, the payroll
operation application slows down.
Personnel must go to the
administrative office to receive pay
slips.
There is a lack of responsible
personnel, and the training policy is
inadequate.
Performance improvement is not
encouraged; personnel are
unmotivated.
Calculation of benefits and bonuses
is done manually.
The granting of monetary
incentives is not based on job
performance.
Pensions are not well managed,
and there has been no
management decision to address
this.
Design of a salary scale according to job
profiles, functions, and hierarchy of each
worker; increase must be proportional to the
rising cost of living.
Standardize wages based on work experience
and studies.
Redesign UE application for payroll and salary
management to address technological
limitations.
Designate and train staff to design pay scales;
develop salary payroll management; and
manage administration of benefits and
bonuses.
Design a proposal for a law to define and
implement benefits, bonuses, and incentives
related to performance.
Designate an office to manage not only
monetary incentives..
Acquire software to improve the management
of benefits and bonuses.
Designate personnel responsible for non-
monetary incentives. Recalibrate work
incentives using the central level as a
reference point.
Recruit qualified professionals to manage
administration of pensions.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 116
Strengths Problem Description Restrictions Consequences Proposals for improvement
payments are managed in a
timely manner.
Non-monetary incentives are
granted to the "worker of
the month."
MoH provides advice about
remuneration; application of
monthly remuneration
manuals and consolidation of
pension information.
bonuses. Payment of monetary
job incentives is a fraction of
what is paid at the central level.
Only benefits regulated by law,
including AETAS and other legal
benefits, are paid.
Staff which has not been paid is
disgruntled and have filed
claims. There is no designated
unit responsible for non-
monetary incentives.
Incentives are not provided
based on performance
evaluation results. Not all UEs
grant incentives.
There is no designated unit or
assigned staff to manage
administration of pensions.
managing staff pensions.
There is a lack of funding to
train or hire qualified
personnel.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 117
8.7 Analysis of performance evaluation results in the managing human and social relations sub-system, in selected regions
LORETO Sub-system: Managing human and social relations
Strengths Problem Description Restrictions Consequences Proposals for improvement
There are designated offices
with trained personnel
responsible for the different
processes, including
managing the organizational
climate; labor relations; and
welfare and safety at work.
Duplication of functions
between the Department of
Quality and the Department of
Social Welfare.
Lack of an integrated office to
manage human and social
relations..
There are no instruments to aid
in implementing the process.
Lack of coordination with other
offices regarding safety and
health at work.
Dissatisfaction of the union and
the institution related to
agreements.
Functions are not defined in
MOF and ROF management
tools.
No decisions have been made
regarding safety and health at
work.
Unmet expectations and
disagreements on decisions
related to labor relations and
health and safety at work.
Dissatisfaction of personnel and
patients.
Unmotivated personnel;
interpersonal and labor disputes.
Disagreement over decisions.
Possible increased risks related to
occupational accidents and
occupational diseases.
Restructure ROF and MOF management
documents.
Designate an office responsible for managing
the organizational climate and labor dispute
resolution.
Implement security and health-at-work
processes.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 118
HUÁNUCO Sub-system: Managing human and social relations
Strengths Problem Description Restrictions Consequences Proposals for improvement
There is a quality office and a
welfare unit.
Staff is committed to
achieving goals.
The participation of
employees in unions is not
restricted.
There are no documents to
guide management of the
organizational climate; labor
relations; and welfare and
safety at work.
The organizational climate is
inadequate; personnel are
unmotivated and insecure at
work.
There is no defined
methodology to measure
organizational climate; only
remunerative issue
management has
accompanying methodology
Requirements for the
development of welfare and
safety at work are not
considered.
Lack of training budget.
Lack of specific functions for
managing human and social
relations sub-systems.
Lack of methodology to
measure organizational climate.
Changes that could enhance
employee efficiency and
performance are not discussed
No welfare activities are
planned.
Processes related to the
management of the organizational
climate are not developed.
Partial development of welfare and
safety-at-work processes.
Personnel show no interest in their
work.
Inadequate or poor interpersonal
relationships between staff.
Staff interferes in work outside
their positions.
There have been no negotiations
with unions.
Implement and prioritize management
documents.
Apply tools to evaluate and manage the
organizational climate.
Provide training on managing the
organizational climate.
Promote labor relations, and develop social
welfare programs.
Establish a unit to manage labor relations.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 119
PASCO Sub-system: Managing human and social relations
Strengths Problem Description Restrictions Consequences Proposals for improvement
National instruments are
used to measure the
organizational climate.
DIRESA reports few labor
disputes.
There is a social welfare
resolution.
There has been no
measurement of the
organizational climate, and the
related methodology has not
been disseminated.
The organizational climate in
the three execution units is not
adequate.
There are no joint committees
for conflict prevention.
Staff is unaware of their rights
and duties.
Few social welfare activities are
developed.
Workers are not financially or
physically protected against
accidents at work.
Some UEs do not make
contributions towards the
Insurance Risk Work (SCRT) for
CAS staff.
There is little interest in
developing organizational
climate processes at all levels.
There is no stable and exclusive
staff to manage labor relations.
. There are numerous
regulations that govern labor
relations
The union has no legal status.
There is no assigned social
worker for a welfare unit.
Standards and safety-at-work
instruments have not been
developed.
The organizational climate is
inadequate at all levels. There are
no plans to improve the
organizational climate.
Certain labor rights are not
enforced .
Workers are exposed to hazardous
situations.
Development of chronic
degenerative diseases.
Little motivation and commitment
to work.
Implement regular measurement of the
organizational climate.
Provide training in the implementation and
systematization of instruments to measure
the organizational climate.
Managers must develop the capacity to
manage labor relations and conflict
prevention.
Develop promotional activities for workers
centered on prevention of accidents at work.
Develop safety standards in the workplace.
Require contribution to SCRT.
Hire a social worker.
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Abt Associates Inc. Annex ▌pg. 120
LAMBAYEQUE Sub-system: Managing human and social relations
Strengths Problem Description Restrictions Consequences Proposals for improvement
Senior management and
staff are supportive.
There is a budget and
support from the regional
government.
There is a designated unit to
manage the organizational
climate and develop
activities to strengthen this
area. Motivational
workshops are developed
periodically.
Good relations between
unions and institutional
authorities. Authorities are
willing to listen to union
demands.
There is a designated office
and staff responsible for the
management of health and
safety processes.
Approved standards or
policies are followed.
There is a social service unit.
There are social welfare
programs.
There is no office responsible
for climate management and
labor relations.
There is no methodology to
measure and analyze the work
environment; the
organizational climate has not
been measured.
Some staff are resistant to
changes.
Occasionally, labor unions are
opposed to administrative
actions that contained within
laws.
Medical staff disagrees with the
current administration.
A program for occupational
health and safety at work has
not been implemented. Staff is
not protected against work
accidents.
No planning of social welfare
programs.
Research on organizational
climate is not done.
Limited staff that is not trained
to implement and monitor the
organizational climate
improvement plan.
MEF does not favor granting 22
productivities (Law 29912) to
administrative staff.
There is no budget to
implement regulations and/or
formulate welfare and safety-
at-work plans.
A health and safety at work
study has not been carried out.
Lack of knowledge related to
organizational climate.
The organizational climate has not
been measured, and therefore,
there is no starting point for
improvement.
Personnel are dissatisfied with the
organizational climate; as a result,
they are unmotivated and not
committed.
Quality of patient care has not
improved.
Labor relations are not good.
Workers are unprotected against
potentially risky situations.
Inadequate planning of social
welfare programs and limited
activities.
Create an office responsible for training
personnel in management of the
organizational climate.
Implement and strengthen mechanisms for
measuring the organizational climate.
Encourage activities to promote better staff
relations.
Encourage dialogue to prevent conflict and
foster agreements between staff.
Encourage channels of communication
between the various unions, guilds, and
institutional authorities improve coordination.
Designate an office to be responsible for
welfare and safety at work.
Allocate budget for the management of the
organizational climate and staff welfare.
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Abt Associates Inc. Annex ▌pg. 121
PIURA Sub-system: Managing human and social relations
Strengths Problem Description Restrictions Consequences Proposals for improvement
There are unions, guilds, and
associations that represent workers;
these have good relationships with
authorities.
According to the current ROF, Quality
unit is responsible for measuring and
analyzing labor relations; social
welfare; and health and safety at work.
There is willingness for organization
and a climate of solidarity among
workers.
There are personnel responsible for
managing health and safety processes
at work. Workers are familiar with
welfare and safety-at-work standards.
There are measures to protect the
health of workers; prevent accidents;
and promote the care of equipment
and materials.
Activities and mechanisms have been
organized to improve welfare at work:
a workshop on improvement of labor
relations; welfare office staff is in
charge of planning activities such as
celebrating birthdays, anniversaries,
and championships; and provision of
financial support for training.
There is an office for quality
management, but there is no
designated unit responsible for
managing organizational climate
or labor relations.
There is no methodology to
measure the organizational
climate, and no measurement has
been planned.
Inadequate communication
between management and
subordinate staff.
Lack of planning programs to
improve the management,
training of human resources.
Basic rules of safety and health in
the workplace need to be updated
implemented. Conditions do not
currently exist for the
implementation of regulations.
There is no team to manage staff
welfare; the social assistance unit
does not take charge of these
functions. Personnel are not
trained to manage welfare
processes.
There are no welfare programs,
including child care, elderly clubs,
and travel.
There is no office
responsible for
organizational climate.
There is a lack of logistical
resources and a lack of
personnel with suitable
profiles; it is not included in
the current ROF.
There is no willingness on
the part of the staff to
complete the organizational
climate survey.
Staff is not encouraged to
create business synergies.
Interpersonal relationships
are partially damaged.
There is no annual training
plan.
Improving welfare
conditions and job security is
not included in budget
programming.
There is a lack of interest in
social assistance for the
welfare of workers. There is
no assigned unit to manage
social welfare activities.
There is no interdisciplinary
work team for managing
human and social relations.
There is perceived
discrimination among
workers. Polarization and
confrontation with the
management generates
strikes.
No plans have been
made to improve the
working environment;
the organizational
climate has not been
measured which could
improve the quality of life
in the workplace.
; Personnel are not
valued for their
professional experiences.
The work environment is
ambiguous and tense,
and there is poor
communication. Staff is
discontented, and this
affects the quality of
service.
Lack of knowledge
related to the rules and
procedures for worker
health and safety has
consequences: accidents,
infections, and diseases
among workers are more
likely to occur.
Develop a plan to measure the organizational
climate; survey staff to improve HHR policies
and management.
Implement management strategies to foster
an organizational climate that takes into
account needs, motivations, and interests of
workers in performing their duties.
Develop a strategic plan that includes design,
implementation, and evaluation of programs
and activities aimed at continuous
improvement of labor relations within UEs,
both individually and collectively.
Strengthen ties between labor groups with
common objectives and interests, including
cultural, sport, and academic interests.
Designate an official in the current ROF to
manage the organizational climate.
The development of standards and
procedures must ensure safety and health at
work in order to preserve the physical and
mental integrity of workers.
Elaborate an annual work plan and schedule
health and safety-at-work activities.
Create an interdisciplinary team to formulate
and plan social welfare activities to benefit
staff Designate a unit and staff responsible for
welfare activities.
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Report on HH.RR. management system in San Martin and other approved regions Contract #GHS-I-10-07-00003-00
Abt Associates Inc. Annex ▌pg. 122
8.8 HRMS evaluation results by Region and sub-systems.
HRMSPeru
(108/162)
Loreto
(6/6)
Callao
(2/4)
Junin
(5/9)
Cusco
(5/8)
Lima
(9/9)
Apurimac
(6/10)
Caja-
marca
((6/6)
Lamba-
yeque
(4/4)
Pasco
(3/3)
Huanuco
(7/7)
Ucayali
(2/5)
Moque-
gua
(3/3)
Ica
(7/8)
Huanca-
velica
((8/8)
San
Martín
(5/5)
Ancash
(9/9)
Madre de
Dios
(2/2)
Ayacucho
(6/9)
Amazonas
(4/5)
Tumbes
(2/3)
Piura
(7/7)
HUMAN RESOURCES MANAGEMENT
SYSTEM35% 47% 45% 44% 43% 41% 41% 40% 39% 35% 33% 32% 32% 31% 31% 30% 30% 29% 27% 26% 25% 21%
HHR policy and strategic planning 31% 34% 35% 41% 50% 29% 35% 43% 29% 42% 35% 29% 25% 34% 33% 30% 25% 21% 28% 30% 31% 19%
Policies and strategies for HHR management
and development17% 13% 41% 21% 20% 42% 35% 29% 0% 58% 23% 5% 0% 7% 14% 3% 2% 4% 17% 2% 7% 4%
Development of operational research 8% 9% 9% 0% 9% 20% 20% 18% 5% 9% 10% 0% 0% 4% 26% 5% 6% 0% 20% 0% 0% 0%
HHR information management 40% 46% 42% 61% 68% 38% 43% 46% 43% 54% 49% 33% 37% 54% 35% 50% 41% 35% 22% 56% 53% 32%
HHR management control 18% 25% 24% 41% 61% 12% 19% 21% 0% 7% 22% 11% 8% 13% 21% 8% 12% 0% 19% 25% 17% 4%
HHR strategic planning 35% 30% 24% 30% 42% 15% 39% 63% 50% 46% 34% 54% 44% 42% 52% 39% 20% 21% 44% 11% 33% 20%
HHR financing 41% 71% 58% 40% 42% 42% 31% 73% 54% 54% 38% 62% 21% 36% 53% 26% 43% 54% 67% 29% 15% 30%
Work organization 29% 38% 29% 29% 36% 36% 33% 34% 27% 19% 36% 25% 20% 19% 36% 30% 17% 22% 26% 19% 28% 15%
Design of job profiles 42% 58% 38% 42% 43% 52% 45% 44% 50% 31% 43% 42% 37% 29% 52% 35% 27% 41% 39% 26% 43% 28%
Identification of labor competencies 14% 15% 17% 9% 34% 18% 27% 15% 0% 9% 27% 9% 0% 8% 21% 21% 7% 0% 13% 17% 13% 1%
Job rating 12% 13% 20% 19% 19% 17% 8% 31% 0% 0% 29% 0% 0% 5% 16% 30% 2% 3% 7% 4% 8% 1%
Employment management 45% 54% 54% 50% 31% 51% 41% 53% 62% 41% 45% 32% 49% 42% 44% 31% 46% 45% 41% 31% 33% 35%
Recruitment, selection, incorporation and
induction48% 57% 56% 54% 33% 54% 52% 57% 65% 42% 55% 36% 53% 46% 57% 39% 44% 48% 52% 38% 38% 37%
Staff mobility 45% 60% 21% 54% 34% 46% 38% 55% 32% 43% 39% 21% 62% 37% 66% 17% 60% 57% 48% 29% 14% 33%
Management of staff files and attendance
control44% 55% 70% 49% 37% 61% 26% 54% 65% 55% 40% 32% 51% 44% 29% 31% 59% 46% 25% 31% 50% 34%
Administration of disciplinary process 35% 37% 34% 44% 12% 29% 23% 54% 63% 39% 22% 41% 32% 33% 16% 16% 34% 32% 22% 20% 20% 36%
Staff termination and retirement 32% 45% 63% 40% 29% 37% 23% 24% 63% 4% 33% 5% 33% 29% 13% 12% 40% 34% 23% 8% 5% 24%
Performance management 20% 24% 36% 44% 35% 32% 16% 29% 26% 17% 19% 11% 22% 14% 15% 13% 13% 11% 20% 11% 1% 5%
Performance planning 26% 35% 50% 47% 40% 50% 19% 32% 38% 19% 15% 13% 28% 18% 27% 10% 12% 25% 36% 15% 0% 5%
Supervision 16% 23% 0% 29% 30% 19% 13% 23% 0% 3% 21% 0% 20% 14% 17% 12% 10% 0% 23% 11% 0% 11%
Performance evaluation 21% 23% 51% 57% 36% 33% 14% 33% 32% 22% 22% 16% 25% 14% 11% 16% 16% 10% 15% 9% 0% 3%
Feedback and design of plans for individual
performance improvement12% 13% 16% 22% 34% 15% 21% 21% 24% 19% 14% 4% 5% 10% 3% 13% 13% 0% 0% 13% 4% 2%
Development and training management 43% 67% 61% 60% 57% 49% 61% 46% 46% 45% 38% 42% 30% 43% 29% 31% 34% 42% 19% 28% 30% 27%
Labor advancement (promotion and career
path)42% 52% 48% 70% 60% 45% 62% 43% 34% 48% 41% 42% 30% 57% 30% 36% 34% 36% 19% 27% 21% 18%
Capacity building 48% 81% 68% 57% 61% 59% 69% 54% 48% 48% 42% 40% 32% 38% 36% 32% 36% 49% 26% 31% 43% 34%
Regulation of the teaching & service process 33% 55% 65% 50% 38% 30% 41% 27% 65% 30% 24% 47% 25% 31% 7% 20% 26% 35% 1% 19% 12% 27%
Compensation management 37% 60% 46% 41% 40% 38% 45% 40% 38% 50% 26% 49% 38% 33% 31% 39% 41% 26% 34% 37% 13% 27%
Design of salary scales 24% 51% 10% 24% 24% 13% 43% 29% 0% 38% 18% 27% 29% 9% 34% 38% 14% 0% 31% 12% 2% 19%
Management of payroll and salaries 60% 95% 100% 76% 74% 78% 67% 75% 100% 100% 61% 94% 59% 90% 54% 64% 85% 85% 67% 94% 53% 64%
Administration of benefits and bonuses 71% 88% 90% 72% 89% 64% 68% 70% 100% 69% 53% 90% 62% 86% 59% 65% 93% 83% 77% 72% 13% 61%
Incentive management 30% 58% 50% 36% 33% 34% 34% 29% 45% 36% 16% 39% 27% 25% 14% 25% 34% 19% 18% 31% 20% 20%
Pension management 62% 50% 90% 68% 64% 91% 60% 67% 65% 87% 40% 100% 80% 71% 40% 56% 98% 60% 37% 80% 0% 26%
Managing human and social relations 38% 51% 56% 41% 49% 55% 55% 39% 45% 29% 32% 38% 39% 31% 26% 33% 33% 37% 20% 27% 42% 22%
Management of the organizational climate and
culture30% 37% 61% 12% 32% 45% 49% 25% 22% 11% 27% 26% 61% 10% 16% 19% 32% 53% 10% 12% 3% 5%
Management of labor relations 42% 52% 35% 45% 41% 59% 45% 55% 70% 42% 29% 53% 41% 33% 41% 19% 39% 38% 29% 24% 48% 34%
Workplace health, safety and welfare 39% 57% 69% 51% 61% 56% 65% 33% 36% 27% 35% 32% 28% 38% 21% 48% 30% 29% 17% 34% 53% 20%
SOURCE: Technical report on HRMS evaluation results for each RHD.
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8.9 Ministerial Resolutions and Legislative Decree
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