Narrowing the gap between eye care needs and service provision: a model to dynamically regulate the flow of personnel through a multiple entry and exit training programme

BACKGROUND: The purpose of this paper is to present a complex yet transparent, computable model to simulate the regulation of the flow of personnel through a previously described multiple-entry, multiple-exit eye care training scheme linked to the health workforce. This methodology should be a useful tool for the planner; it can address changes and feedbacks over time and be sensitive to any unexpected consequences of the interactions. The same model template can be applied to calculate the finances associated with the personnel flow. PRESENTATION OF THE HYPOTHESIS: The worth of any model or set of concepts of human resources for health is considerably enhanced by actual field application. However, implementation involves the selection of one set of parameters and a large, long-term commitment of resources. A far less expensive and time-consuming, yet still effective, method of testing assumptions and ideas would be to simulate their application using a variety of possible inputs, structural configurations and/or desired outcomes. To that end, this paper presents a computable, dynamic model of personnel flows within a health system. TESTING THE HYPOTHESIS: Some testing of the model has been demonstrated in a previous paper. However, the value of the model is that all stakeholders can enter their own data and parameter assumptions and readily review the outcomes. IMPLICATIONS OF THE HYPOTHESIS: The complex yet easy-to-use model presented in this paper opens the debate on current and future policy to any stakeholder. A very wide range of scenarios can be considered and a selected option can be monitored and changed dynamically over time.