Investing in human resources for health: the need for a paradigm shift

Abstract

Increased international resources have flowed towards HRH over the past decade, either directly through targeted HRH funds or indirectly through programs for disease control or health system strengthening. In some countries, development partners have contributed to the achievement of tangible results. Rwanda’s performance-based payment to health workers and Ethiopia’s health extension program have both been heralded as successes. In spite of these efforts, however, global investment in HRH has suffered setbacks that have undermined its effectiveness and impact. Such investment remains uncoordinated and fragmented. International programs sometimes compete for the few existing HRH, which exacerbates the HRH crisis. Furthermore, investment in HRH has been largely focused on short-term solutions to the crisis rather than on building sustainable HRH systems. The global health community needs to think strategically about how to make investments in HRH more efficient, effective and relevant to country needs. Development partners then need to jointly align their resources with the country strategies while building on the experience of the International Health Partnership. Development partners need to invest in building sustainable HRH systems through measures such as pre-service training. The recent labor market analysis lends support to a comprehensive approach to integrating supply and demand, the public and private sectors, and health and other critically important sectors. Shifting disease burden and strides in information and communication technologies make reforms in health education mandatory. A knowledge base to inform HRH policies and strategies must be created. The global health community must embrace these paradigm shifts if it is to deal effectively with the critical issues surrounding HRH.