HRH Overview

This document discusses the issues surrounding human resources for health and how they impact health system performance.

The Capacity Project helped to organize and facilitate a regional Human Resources for Health (HRH) Action Workshop in Accra, Ghana, September 23-28, 2007. Participants came together with the overall purpose of exchanging knowledge and best practices in planning, developing and supporting the health workforce in order to improve health workforce management capacity and strategic development at the country level.

This article is an overview of the major HRH issues facing the health system in Zambia, including out-migration, an outdated medical-training infrastructure, faulty government management, and the effects of HIV/AIDS.

This article outlines different efforts at making strategic HRH plans in the developing world. The article focuses on the financial aspects of HRH planning and provides some general guidelines on the best way to make these plans.

This document outlines the issues for human resources for health in the Americas and what the Pan American Health Organization resolves should be done to address them.

Liverpool Associates in Tropical Health has been teaching, researching and consulting in HRH throughout the changing global and country contexts for almost two decades. This overview paper highlights the changes that we have observed over time, in both the attention paid to workforce issues and the types of activities that we have seen. [from author]

This document outlines three major human resources for health challenges related to family planning and reproductive health. Several possible solutions are suggested, including: increasing task shifting, workforce planning, and partnerships. [adapted from publisher]

This article discusses the gaps exist between the potential of health systems and their actual performance. Best practices from various countries are discussed. The author concludes that the crisis can be tackled if there is global rsponsibility, political will, financial commitment and public-private partnership for country-led and country-specific interventions that seek solutions beyond the health sector. [adapted from abstract]

This report first reviews the policy and programmatic challenges of weak health systems, health care worker shortages, and related issues in HIV/AIDS affected countries, and concludes by outlining three key options for strengthening health systems during PEPFAR’s next five-year phase. [from introduction]

To foster a global exchange of human resources for health (HRH) evidence, tools and innovation, the Capacity Project created a searchable collection of HRH resources with librarian support. Launched in May 2006, the HRH Global Resource Center now has over 1,500 resources to support HRH in developing countries and help the health community address workforce challenges. [author's description]

The disparity is staggering. Africa bears one-quarter of the burden of disease around the world yet has barely 3 percent of all health workers. Millions of people across the continent thus suffer needlessly because they cannot obtain medical care from trained personnel. In sub-Saharan Africa, where the crisis is most acute, fully 820,000 additional doctors, nurses, and midwives are needed to provide even the most basic health services. To meet this shortfall, most of the region’s countries would have to increase the size of their health workforce by 140 percent. [author's description]

A worldwide shortage of health care workers, coupled with a disproportionate concentration of health workers in developed nations and urban areas, stands in the way of achieving such key public health priorities as reducing child and maternal mortality, increasing vaccine coverage, and battling epidemics such as HIV/AIDS. [author's description]

This report reviews the literature, published and unpublished, available on HRH in Mozambique. It also carries out some secondary data analysis and presents data from interviews and focus group discussions with key informers and stakeholders. The study of the human resources situation in Mozambique followed a frame of reference that addressed key issues related to the context, professional policies, labour market, management of human resources, and performance and coping. [from executive summary]

The focus of McKinsey's research effort is on the HRH constraint, faced by many developing countries, in absorbing development aid and scaling up urgently needed health programs. HRH in this context is defined as the health workers at the front line of healthcare service delivery. The field work necessary to diagnose the problem and identify possible solutions has been initiated in Tanzania. We believe these findings, accounting for certain differences, will be broadly applicable to several developing countries.

This section describes the dire shortage of human resources (HR) in the health systems of low and middle income countries and the special challenges posed by this crisis. It touches on ways of addressing shortages of qualified staff and gives several examples of how countries can use technical support to build stronger a health workforce. [author's description]

This report provides an overview of the public health situation across the 46 Member States of the African Region of the World Health Organization. The report charts progress made to date in fighting disease and promoting health in the African Region. It reviews the success stories and looks at areas where more efforts are needed to improve people’s health. [author's description] Chapter 6 includes a discussion of the human resources for health crisis and approaches to filling the gap as well as health information systems.

This edition covers topics such as: migration of skilled health workers, investing in human resources for health, strengthening human resources for health in Africa, and the economic cost of health professionals brain drain in the African region. [author's description]

This document briefly describes HRH-related issues common to many countries and proposes ways to address them. It gives examples of strategies applied successfully in specific local contexts, as well as constraints and challenges often encountered. [from introduction]

Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of each health care system and of reform and policy initiatives in progress or under development. [publisher's description] Each report contains a section on human resources for health including an overview of the situation and specific health workforce statistics.

The starting point for this online database was a comprehensive health workforce survey conducted by the WHO Regional Office for Africa in collaboration with WHO department of human resources for health in Geneva in 2004/2005. All 46 member states of the African Region have contributed to this data collection. The data base presented here is the best available information base on the health workforce in the African Region to date and it will be continuously updated. Data is provided for 23 different types of health care cadres, both as total numbers and densities per 1000 population. For many health care cadres, additional data e.g.

The data presented here in 46 country fact sheets for all countries in the African Region was collected in a comprehensive HRH data collection exercise in 2005. The HRH country fact sheets presented here are intended to give a brief summary of the HRH situation in each country. [publisher's description]

This chapter of the Global Health Watch focuses on the global dimension of health migration, although it recognizes that the agenda for coherent and comprehensive health systems development must place human resources at its centre. [author's description]

Section 6, "Developing Human Resources for Health," describes the dire shortage of human resources in the health systems of low and middle income countries and the special challenges posed by this crisis. It touches on ways of addressing shortages of qualified staff and gives several examples of how countries can use technical support to build stronger a health workforce. [author's description]

The health worker crisis is particularly acute in rural and hard to reach areas, where 80% of the population in Africa live. The resultant low capacity at the peripheral level of the health system is a crucial barrier to good health. AMREF believes that developing capable, motivated and supported health workers at all levels of the health system is essential in ensuring the delivery of accessible and effective health care across Africa... This briefing draws on AMREF's experience to look at three key issues: the importance of appropriate training, task-shifting to lower cadres of worker, and training and supporting community health workers (CHW) in order to bring health care closer to communities.

The importance of human resources in health systems needs not to be over-emphasised. Expenditure on health workers forms a significant proportion of total health expenditure in many countries. In order to effectively implement cost-effective interventions, health workers must have the appropriate skills, competencies, training and motivation to do so. However, current evidence suggests that health systems in developing countries are understaffed and exhibit maldistribution of health workers. Health workers are generally demotivated and less productive due to inappropriate incentive environment.

The quality and quantity of health care services delivered by the Malawi public health system is severely limited, due to, among other things the shortage of adequate numbers of trained health care workers. In order to suggest policy changes and implement corrective measures, there may be need to describe the perceptions of the legislature on how they perceive as the cause of the problem, which could be the solutions and an evaluation of those solution. In this paper, I present the finding from a qualitative study of Hansards (official verbatim record of parliamentary speeches) analysed by discourse analysis.

Health workers are at the core of health systems everywhere. Where there are health worker shortcomings, health systems suffer, resulting in insurmountable preventable deaths and disease. Such is the case now in sub-Saharan Africa where the health worker shortageof over 1 million is truly the bottleneck in AIDS care delivery. [author's description]

Whether one is ill, in need of urgent care but denied access to essential services due to the absence of a health worker – or looking from the perspective of an over-stretched health worker who is inadequately equipped and supported, and brings barely poverty-level wages back to the family – the crisis in human resources for health (HRH) is an old problem which has developed right in front of us, and has now been exposed and accentuated by fresh forces. [author's description]

The webcasts and transcripts from the 2006 Annual Meeting of the Clinton Global Initiave address the issues of "Extending Physical and Human Capacity" for global health and "Maximizing Returns Through Increased Public/Private/NGO Coordination."

Too often capacity building becomes merely a euphemism referring to little more than training. This paper argues that it is more important to address systemic capacity building, identifying a pyramid of nine separate but interdependent components.