Health Sector Human Resource Crisis in Africa: An Issues Paper

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. But endogenous factors are also to blame, including misdirected human resource and training policies, weak institutions, and possibly even inappropriate structures. Section I of the paper lays out the key features of the HR crisis as gathered from a review of available data and reports and interviews with health program managers, health officers and project task managers in east and southern Africa. Section II of the paper gathers a few good practices and mechanisms that have been tried to ease the HR problems in the region. It highlights some opportunities for reform and cites the continuing challenges and risks. [adapted from author]