Abstract

Human Resources for Health (HRH) constitute the most vital component of health systems. However, the HRH picture of Ethiopia has remained critically low and characterized by geographic mal-distribution. This brief aimed to show the major causes for poor health workforce distribution and to suggest possible policy options. We reviewed relevant evidence describing the problem and feasible options to address the problem, the barriers to implement those options, and implementation strategies to address these barriers. We searched electronic databases of systematic reviews and supplemented with local evidences. In our review, we found different options that help to improve health workforce distribution in the remote and rural areas of the country. Systematic reviews on impact of task shifting, clinical rotations in rural areas during studies and financial incentives have shown favourable results that may lead to increase the number of health workforce working in rural and underserved areas. But none of the studies assessed the costs and cost effectiveness of the suggested options. Therefore, given the limitations of the currently available evidence, there is a need for rigorous evaluative research on the cost effectiveness of each option prior to widespread implementation.

Highlights

  • Human Resources for Health (HRH) constitute the most vital component of health systems

  • Effective and equitable health service provision depends to a large degree on the availability, competence, motivation and distribution of human resources for health

  • We searched global research evidence from systematic reviews and local evidence to find the causes for poor health workforce distribution and the available options to solve the problem

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Summary

Introduction

Human Resources for Health (HRH) constitute the most vital component of health systems. It is one of the six building blocks of the WHO framework for health systems [1]. Effective and equitable health service provision depends to a large degree on the availability, competence, motivation and distribution of human resources for health. Worldwide the geographical distribution of health workers is skewed towards urban and wealthier areas [2]. 37% of the world’s health workforces work in the WHO region of the Americas, which accounts for only 10% of the global burden of disease. With 24% of the global burden of disease the WHO African Region, is served by only 3% of the world’s health workforces [3]

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