HRH Overview Documents

This working paper is from the African regional consultative meeting on human resources for health (HRH) in Brazzavile, Congo. It describes the issues in health systems and HRH in the region and outlines the strategies and actions required for improvement. The document also discusses the Observatory of Health Human Resources for Africa, which was proposed as a cooperative network initiative among the countries and different partners of the region to produce the information and knowledge necessary for improving human resources policy decisions, and to share the country experiences in order to improve human resource development in the health services. [adapted from author]

The shortage of health workers with the right expertise and experience has reached crisis levels in many developing countries. The ability of health services to deliver care depends on the knowledge, skills and motivation of health workers. Without enough skilled staff in the right place at the right time health systems cannot function effectively and populations are left without the treatment and support they need. [author’s description]

This note provides a brief overview of the scope and nature of health workforce challenges in low-income countries; provides a simple framework for organizing the analysis of problems and responses; and outlines possible priority actions at country and international level.

Various constraints are being experienced in the health delivery systems, namely weak health infrastructure, limited tools, inadequate human resource capacity, limited public financing to the health sector as a whole (and not only to disease specific programs), poor management and planning and lack of integrated health systems and misapplication of human, technical and financial resources. In order to improve health in Africa, inequalities to health service access between and within countries should be addressed within the health system. [author’s description]

The case studies contained in this volume provide a means of exchanging information on the challenges that countries face and the solutions that they are exploring. A companion volume by the European Observatory, Human resources for health in Europe, looked in detail at the key issues affecting the health workforce in Europe. It drew on a series of detailed case studies undertaken to assess the situation in a range of European countries. This volume brings those case studies together. [from foreword]

This presentation is from the director of the Department Human Resources for Health of the World Health Organization. It presents information on health workforce issues including shortages and distribution problems, provides a summary of the major projects and initiatives addressing the crisis, and discusses the role of WHO in HRH.

The purpose of the Regional Strategy is to provide Member States with a range of policy options and strategic actions from which to choose. The strategy’s framework for action is comprised of five interrelated strategic objectives organized around three key result areas, with suggested national actions to achieve them and WHO enabling responses. The key result areas are:a health workforce that is responsive to population health needs, or demand; effective and efficient workforce development, deployment and retention, or supply; and workforce governance and management.

This document attempts to review the HRH situation in the WHO European Region. Section 2 addresses the problems associated with varying definitions to ensure a common understanding of the issues involved. In section 3, a number of key methodological issues (the relevance of HRH, education, management, regulation, etc.,) are analyzed. Section 4 summarizes the key HRH facts and figures for the region. In conclusion, section 5 describes the way forward and the main EURO policy proposals for supporting member states in this complex sphere. [author’s description]

This book examines some of the major challenges facing health care professions in Europe and the potential responses to these challenges. The authors document how health care systems in Europe are confronting existing challenges in relation to the health workforce and identify the strategies that are likely to be most effective in optimizing the management of health professionals in the future. [from publisher]

One Million More presents some of the interventions, debates, discussions and conclusions of a conference held in London.

This communication will serve to outline the European Union’s and the European Commission’s coherent and coordinated response to the planned decade of action on human resources proposed by the 57th World Health Assembly (Resolution WHA 57.19), which begins in 2006. [from introduction]

For decades, discussions on human resources in health have ended with a ritual call for more and better manpower planning. But this traditional wisdom has been discredited by unrealistic or vague targets, based all too often on information that was inaccurate, outdated and unrelated to the policy agenda… Policy-makers and donors concerned with human resources problems may want to request those proposing a major new project or policy to make a systematic and formal human resource impact assessment during its preparation. Such assessments would examine the likely effects of the proposed project or policy on the health workforce.

Only a few studies have investigated the link between human resources for health and health outcomes, and they arrive at different conclusions. The authors tested the strength and significance of density of human resources for health with improved methods and a new WHO dataset on maternal mortality rate, infant mortality rate, and under-five mortality rate. [from summary]

This report contains an expert assessment of the current crisis in the global health workforce and ambitious proposals to tackle it over the next ten years, starting immediately. The report reveals an estimated shortage of almost 4.3 million doctors, midwives, nurses and support workers worldwide. The shortage is most severe in the poorest countries, especially in sub-Saharan Africa, where health workers are most needed. Focusing on all stages of the health workers’ career lifespan from entry to health training, to job recruitment through to retirement, the report lays out a ten-year action plan in which countries can build their health workforces, with the support of global partners. [from publisher]

In this analysis of the global workforce, the Joint Learning Initiative (JLI) - a consortium of more than 100 health leaders - proposes that mobilisation and strengthening of human resources for health, neglected yet critical, is central to combating health crises in some of the world’s poorest countries and for building sustainable health systems in all countries. Nearly all countries are challenged by worker shortage, skill mix imbalance, maldistribution, negative work environment, and weak knowledge base.

For any wide-ranging effort to scale up health-related priority interventions, human resources for health (HRH) are likely to be a key to success. This study explores constraints related to human resources in the health sector for achieving the Millennium Development Goals (MDGs) in low-income countries. [adapted from author]

Over the past few years, the human resources situation in the Zambia public sector has reached a point of severe crisis and inability to provide basic health services, primarily due to three interrelated factors. First, the country is losing substantial numbers of health workers to countries that offer better conditions of service, or are changing professions to ones that offer more attractive opportunities. Second, Zambia’s medical and professional schools have a limited capacity to train additional staff.

The human resource (HR) problem in the health sector in sub-Saharan Africa has worsened to an extent that it has reached crisis proportions in some countries. Although the gravity of the problem varies across the continent, the situation in some of the countries is so grave that urgent action is needed. A complex set of factors has contributed to this problem, some exogenous, such as the austere fiscal measures introduced by structural adjustment, often resulting in cutbacks in the number of health workers.

The papers presented here cover the main dimensions of HRD (Human Resource Development) in health: planning and managing the workforce, education and training, incentives and working conditions, managing the performance of personnel and policies needed to ensure that investments in human resources produce the benefits to which the investing populations are entitled.