Abstract
Optimizing the management of the health workforce is necessary for the progressive realization of universal health coverage. Here we discuss the six main action fields in health workforce management as identified by the Human Resources for Health Action Framework: leadership; finance; policy; education; partnership; and human resources management systems. We also identify and describe examples of effective practices in the development of the health workforce, highlighting the breadth of issues that policy-makers and planners should consider. Achieving success in these action fields is not possible by pursuing them in isolation. Rather, they are interlinked functions that depend on a strong capacity for effective stewardship of health workforce policy. This stewardship capacity can be best understood as a pyramid of tools and factors that encompass the individual, organizational, institutional and health system levels, with each level depending on capacity at the level below and enabling actions at the level above. We focus on action fields covered by the organizational or system-wide levels that relate to health workforce development. We consider that an analysis of the policy and governance environment and of mechanisms for health workforce policy development and implementation is required, and should guide the identification of the most relevant and appropriate levels and interventions to strengthen the capacity of health workforce stewardship and leadership. Although these action fields are relevant in all countries, there are no best practices that can simply be replicated across countries and each country must design its own responses to the challenges raised by these fields.
Highlights
There is growing recognition that the progressive realization of universal health coverage (UHC) is dependent on a sufficient, equitably distributed and well performing health workforce.[1]
We identify and describe illustrative examples of effective practices in health workforce development according to these six action fields, highlighting the breadth of issues that policy-makers and planners should consider
We have discussed the six different action fields under the purview of health sector policy-makers, planners and managers, focusing on the system-wide or organizational environmental factors that relate to health workforce development
Summary
There is growing recognition that the progressive realization of universal health coverage (UHC) is dependent on a sufficient, equitably distributed and well performing health workforce.[1]. Calls have been made to transform education programmes and learning strategies to ensure that future health workers have the required competencies for the changing burden of diseases and technological environment.[21] Desirable competencies must be identified and aligned with population health priorities and any identified skills gaps In many countries, this means a shift in focus towards education and training that prepares the workforce to deliver effective primary care and meet the increasing challenge of noncommunicable diseases.[22,23] There are good examples of education for primary care practice in medicine and nursing in Portugal,[24] South Africa[25] and Thailand.[26]. Hungary adopted a series of measures such as pay increases and scholarships for specialty training in exchange for 10 years of work in public services, but with only limited success.[49]
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