Americas & Caribbean

This text presents the context and background, the methodology and some of the main results of the regional consultation on the critical challenges for human resources in health in the Americas. This consultation hopefully documents how the countries in the Americas are facing the main challenges to the development of the health workforce. The main results and suggestions by the actors consulted with regard to the role of international cooperation in the countries of the Region are presented, so that the countries and international agencies can better formulate common strategies of development and strengthening of the work force in health.

Many countries in Latin America and the Caribbean have too many specialists and too few primary care providers and community health workers. These countries need to overhaul their training and payment practices to address this imbalance, say human resources experts. [author’s description]

Ensuring high performance of health care delivery systems is a challenge facing all governments. Dealing with the incentive problems underlying public health care delivery to improve productivity, quality, and performance is a common theme of health sector reforms in many countries. However, the impact of these reforms is often hard to establish. This book presents a series of case studies of health systems innovations by the Central American republics in the 1990s. The cases have a common theme of efforts to improve specific aspects of health system performance through the introduction of innovative and alternative financial, organizational, or delivery models…The case studies in this book report on the results of these experiences, encompassing a range of issues from the expansion of primary care to the use of public-private partnerships and the establishment of a social security-financed delivery system.

This speech contends that a well performing workforce is the most critical determinant of the performance of services. Well functioning infrastructures and equipment do not serve if the people who deliver the services are not there (be it that there are none available, that they are absent from work, or that they are on strike). Well trained health workers, without the appropriate tools and supplies cannot do much either. And even when all ingredients are there, if workers are not motivated, services underperform. Advocacy to convince policy and decision-makers, as well as international agencies and donors to do something to improve the performance of the health workforce (HW) has been fervent these last 3-4 years, and it has been quite successful.

This study provides initial information about current nursing issues that have arisen as a result of health care reform initiatives. Regardless of differences in service models or phases of health sector reform implementation, in all the countries the participating nurses identified many common themes, trends, and changes in nursing practice. The driving forces for change and their intensity have been different in the five countries.

Even though the situation of human resources in health varies between the countries of the Region of the Americas, all of them are confronted by deep imbalances in the availability, composition, and distribution of the work force. These imbalances can be present as acute shortages of health personnel, chronic and persistent problems of inappropriate distribution of the work force with regard to needs, or inequities in composition of health providers in relation to the population served.

This report is the result of the meeting of the 47th Directing Council and 58th session of the Regional Committee in Washington DC. It is a summary of actions and proposals for a plan of action on human resources for health in the Americas submitted for the consideration of the Directing Council. This document summarizes the activities carried out to date in the countries and in the Governing Bodies. It provides an overview of the situation and the predominant trends in the Region, as well as a vision of the technical proposals and agreements for activities that are being developed.

This document aims to facilitate the development of quality-oriented health sector reforms by providing a clear conceptual framework that can serve as a roadmap for policymakers and senior managers. By taking advantage of opportunities to integrate quality assurance activities into health sector reforms, healthcare leaders can maximize the effectiveness of reform and move toward optimizing health outcomes for the citizens of Latin America and the Caribbean. [author’s description]

Human resources become increasingly relevant in this context. Health human resource (HHR) is currently experiencing a three-fold problem, which encompasses old issues, together with the effects of reform, and the consequences of globalisation. This includes the workforce crisis in nursing which, facing all kinds of difficulties, requires complex in-depth analysis, synergies and alliances in order to ensure quality nursing services.

This article discusses the reasons that led health workers to oppose reform; the institutional and legal constraints to implementing reform as originally designed; the mismatch between the types of personnel needed for reform and the availability of professionals; the deficiencies of the reform implementation process; and the regulatory weaknesses of the region. The discussion presents workforce strategies that the reforms could have included to achieve the intended goals, and the need to take into account the values and political realities of the countries. [from abstract]

This document summarizes the human resources management situation in the region, its determinants, and the projects for its development. To promote improvements in the human resources management function as part of the sectoral changes under way at the national and regional level, the Pan American Health Organization is proposing a series of strategies, actions, and operational tools through the Observatory of Human Resources in Health Sector Reform initiative. [adapted from author]