Human Resources for Universal Health Coverage: From Evidence to Policy and Action

By Sales, Mozart; Kieny, Marie-Paule et al. | Bulletin of the World Health Organization, November 2013 | Go to article overview

Human Resources for Universal Health Coverage: From Evidence to Policy and Action


Sales, Mozart, Kieny, Marie-Paule, Krech, Ruediger, Etienne, Carissa, Bulletin of the World Health Organization


The seminal role of human resources for health (HRH) in the attainment of health-related goals has long been recognized and was recently reaffirmed by the United Nations General Assembly, which identified the need for "an adequate, skilled, well-trained and motivated workforce" to accelerate progress towards universal health coverage (UHC). (1) Yet, under existing affordability and sustainability constraints, countries at all levels of socioeconomic development are confronted with challenges in trying to match health worker supply and demand. Against this backdrop, the Third Global Forum on Human Resources for Health, which will take place in Recife, Brazil, from 10 to 13 November 2013, seeks to set out a contemporary and forward-looking HRH agenda and to bolster political commitment to support its implementation.

Health workforce development is partly a technical process and, as such, it requires expertise in human resource planning, education and management. It is also, however, a political process requiring the will and the capacity to coordinate efforts on the part of different sectors and constituencies in society and different levels of government. This theme issue on human resources for UHC covers both of these aspects by providing examples of how countries have aligned political will and sound technical strategies and by presenting new analytical tools and evidence surrounding successful or promising innovative approaches.

Several success stories--from Brazil to Sudan, (2) from Cameroon (3) to Thailand, (4) from Ghana to Mexico (5) and Indonesia (6)--have sprung from efforts to improve the availability, accessibility, acceptability and quality of the health workforce, with corresponding improvements in health outcomes. The pathways chosen have varied in accordance with the needs, contextual factors and opportunities specific to each setting. But as Padilha et al. point out, without high-level political commitment we will not be able to progress beyond piecemeal and short-term approaches and ensure the alignment and coordination of different sectors and constituencies in support of long-term human resource development efforts. (6)

Other articles in this theme issue contribute to strengthening the policy frameworks and evidence base surrounding HRH by: (i) helping us to understand the market forces affecting HRH; (7,8) (ii) highlighting best practices and lessons learnt in relation to the retention of health workers in rural areas (9) and the international migration of health workers; (10) (iii) providing new evidence and recommendations on the effectiveness of mid-level (11) and community-based (12) health workers and on the system support they require; and (iv) identifying opportunities for innovation in HRH education and management support through the use of emerging technologies. (13)

As countries aspire to achieve UHC, new demands will be placed on health workers. …

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