HRH Overview Documents

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 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.

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]

It is widely acknowledged that Africa’s insufficient health workforce will continue to be a major constraint in attaining the millennium development goals (MDGs) for reducing poverty and disease. The High Level Forum (HLF) in January 2004 also recognized the challenges posed in developing Human Resources for Health (HRH) and the need for actions and strategies to accomplish this. At an international meeting on HRH in Cape Town in September, 2004, the need for an urgent action was highlighted to scale up HRH which requires a concerted action of countries and all other partners and an avenue for action emerged building on a number of efforts in the recent years.

This technical brief discusses the shortage of human resources for health (HRH) that threatens the health care delivery system in many countries, particularly in Africa; and promising practices to strengthen HRH including: workforce planning, task shifting, strengthening HR information and management systems, promoting retention and gender equity, and establishing partnerships. [adapted from author]

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.

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.

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]

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]

Addressing the current state of human resources in health, the paper highlights the critical situation of the health workforce in sub-Saharan Africa. It examines the most recent workforce statistics and trends, including geographical distribution. The factors that have and are influencing the availability of human resources are briefly reviewed, focusing on the workforce motivation, the serious brain drain of health professionals, and the increasing impact of HIV/AIDS. The paper suggests that without renewed emphasis on the health workforce crisis, it will be hard for African countries to attain the health-related Millennium Development Goals.

While the scale of the [health worker shortage] crisis is huge, solutions do exist. Many countries and communities around the world have begun to develop and implement innovative initiatives to sustain and build the health workforce. Several such examples are highlighted here. They address such issues as retention in rural areas, AIDS treatment for health workers, and the deployment of paraprofessionals to extend health care access deeper into communities. Many of these examples focus on rural areas, which typically have only a fraction of the number of health workers as urban areas due to more difficult living conditions, social and professional isolation, and weaker health infrastructure. [publisher's description]

This conference aimed to address the global health care workforce shortage: what has been done and what steps are still needed to solve this critical problem. The meeting linked research, policy and action for global human resources for health. [publisher's description] Video and transcripts from both days of the conference are available.

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 presentation was part of the ECSA Workforce Observatory Meeting in Arusha. It provides charts and data for the health workfoce in Africa, including statistics for: the distribution of health workers and health care cadres, estimated critical shortages, skill mix, and training institutions.
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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 document contains 4 background briefs, a paper entitled "Reality Demands Some Breaks with Traditions," and a summary and outcomes of discussions about human resources for health from the 2001 Health Summit. The main areas of discussion were the migration of professionals strengthening the work ethos, representivity of the professions and scopes of practice.

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]

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]

This consultation was convened jointly by the Global Health Workforce Alliance, the World Health Organization and the Swedish International Development Agency to discuss issues relating to the current crisis in human resources for health. The objectives of the Consultation were: to provide information on the global and regional crisis in human resources for health and propose activities based on the main recommendations of the World Health Report 2006; to share experiences in human resources for health, including issues related to priority programmes such as HIV/AIDS in the countries represented; and to present the African Human Resources for Health Platform and discuss possible solutions to the alleviation of the crisis in the African region.

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.

Fifty-seven countries, most of them in Africa and Asia, face a severe health workforce crisis. WHO estimates that at least 2,360,000 health service providers and 1,890,000 management support workers, or a total of 4,250,000 health workers, are needed to fill the gap. Without prompt action, the shortage will worsen. [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 is a glossary of terms commonly used in the field of Human Resources for Health.

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]
The volume contains studies from France, Germany, Lithuania, Malta, Norway, Po

In specific terms, the report recommends that: a clear determination of the region’s supply of health human resources be undertaken; a code of practice for the management of the internal recruitment of health care professionals be collaboratively developed and implemented; community-based workforce recruitment and retention mechanisms be supported that are responsive to local workforce needs; total enrollments and student mix in professional schools be closely linked to identified community needs and that policies and incentives be introduced to reduce student attrition and to enhance the geographic distribution of the health workforce; primary health care delivery teams, that emphasize an increase in both nursing numbers and their competency ranges to maximize service delivery flexibility should be supported and promoted at the community level; and, an inter-regional expert team be struck to develop a human resource planning framework, to identify regional planning priorities, to conduct country assessments in the areas of highest need, and, to promote the development of a health human resource minimum data set to support the region’s current and long-term planning processes.

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.

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]

The report of the Africa Working Group (Joint Learning Initiative) is in 4 main parts covering a situation analysis, opportunities that arise and the preconditions for effective strategies.

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 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]