Journal Article

IDS Bulletin Vol. 36 Nos. 3

Reaching the Health MDGs with Human Resource Reforms: Financial, Educational and Management Capacities

Published on 1 July 2005

There is growing recognition of the severe human resource constraints on the achievement of national and international priorities established by the Millennium Development Goals (MDGs)(Hongoro and McPake 2004).

While there seem to be major new initiatives to provide vastly increased funds, especially for addressing the HIV/AIDS epidemic, there is relatively little serious attention given to investing in human resources and the systems needed to make them effective in achieving the development objectives. In the past, much of the attention on human resources focused on thematch between the skills needed to address development problems and the different types or classes of human resources and their distribution and densities. International agencies assisted in developing rigid planning tools to determine an optimal populationto-human resource category that seldom took into account whether there were sufficient funds, educational facilities and organisational capacities to provide and support these types of workers. These approaches in most cases failed to provide realistic guides to develop effective human resource strategies, especially in low- and middle-income countries.

This article discusses new initiatives for developing appropriate strategies for human resource capacity development in one critical sector – health, which is currently receiving major new funding to address HIV/AIDS; funding that has first targeted the provision of expensive drugs for chronic care and only belatedly begun to address the broader system capacity issues.

Like other sectors, human resource policy in the past was dominated by the ‘population-to-human resource’ planning models which were used in poor countries to plan for the recruitment, education, geographic distribution and promotion of human resources in centralised public health systems. This model generally showed that less developed countries had far fewer human resources than the technically optimal models which tended to be based, at least in the early years, on national standards in more developed countries. The planning models also failed to account for the private sector growth in most countries that has been occurring over at least the last 30 years. Some attempts to develop demand and supply planning models (Huddart 1989; Hall 2001) nevertheless remained relatively static and formulaic in their approach, unable to capture the dynamism of the human resources markets, the capacities of financing, and the education and management systems needed to support human resources.

There has been a renewed interest in human resources for health led by the Joint Learning Initiative (JLI), sponsored by the Rockefeller Foundation, World HealthOrganization (WHO), theWorld Bank and the JSI Research and Training Institute Inc. with Harvard University and other participants (Joint Learning Initiative 2005). The JLI raises fresh concerns about human resource issues – the migration of health personnel to more developed countries, the threat to health workers posed by the HIV/AIDS epidemic, and the growing disparity between public and private sector remuneration.

This initiative has rekindled innovative thinking in the human resources field, with new research efforts and with policy prescriptions calling for greater attention to and investment in human resource development and support.

Related Content

This article comes from the IDS Bulletin 36.3 (2005) Reaching the Health MDGs with Human Resource Reforms: Financial, Educational and Management Capacities

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Bossert, T. (2005) Reaching the Health MDGs with Human Resource Reforms: Financial, Educational and Management Capacities. IDS Bulletin 36(3): 74-82

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Thomas Bossert

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Institute of Development Studies
Bossert, Thomas