Human Resources for Universal Health Coverage: Leadership Needed

By Padilha, Alexandre; Kasonde, Joseph et al. | Bulletin of the World Health Organization, November 2013 | Go to article overview

Human Resources for Universal Health Coverage: Leadership Needed


Padilha, Alexandre, Kasonde, Joseph, Mukti, Ghufron, Crisp, Nigel, Takemi, Keizo, Buch, Eric, Bulletin of the World Health Organization


Global leaders have recently reaffirmed their commitment to the principle of universal health coverage (UHC). (1) The experience of the health-related Millennium Development Goals (MDGs) has taught us, however, that to translate such a principle into reality, health systems must be strengthened. Key to such strengthening and to improving health service coverage and health outcomes is the availability of a sufficient, equitably distributed, skilled and motivated workforce. (2) Yet in many countries health workforce shortages and poor worker distribution, training and performance hinder the attainment of the health-related MDGs and UHC.

Human resources for health (HRH) challenges are complex. Piecemeal solutions, such as short-term in-service training initiatives, abound. However, strategies to systematically address deep-rooted human resource problems require a long-term perspective and collaboration among many stakeholders and constituencies, brokered and led by national governments. (3) Several different paths towards strengthening the health workforce are possible, as the following examples illustrate.

In Brazil, the Unified Health System, grounded in the national constitution, has brought improved HRH policy-making and management. It took intersectoral and interagency collaboration to secure the required thrust and resources. No single HRH plan was developed, and yet Brazil succeeded in achieving sustained growth and more equitable worker distribution. Between 1990 and 2007 physician density rose from 1.17 to 1.74 per 1000 population and family health teams were deployed to rural areas. (4)

In Indonesia, the HRH agenda was bolstered by the decentralization reforms of 1999, whereby almost 2.4 million central government civil servants were successfully reassigned to local governments. (5) To overcome persistent worker shortages, maldistribution and dual practice, the government has enacted measures for improving health workforce education, equitable deployment and performance. HRH information systems have been strengthened. Coordination of national stakeholders has improved and resource allocation from both domestic and international sources has increased. (6) The national density of physicians, nurses and midwives has risen from 1.25 per 1000 population in 1997 to 2.06 in 2012. (7,8)

In Zambia, important innovations took place in HRH development, including initiatives to upgrade the training of existing staff, create new cadres to formalize task delegation and provide direct access to mid-level specialist training. (9) A new national HRH strategy, built on lessons learnt in the last decade, complements the traditional focus on producing new health workers with improved worker management, performance, distribution and retention.

Brazil and Indonesia are on track to achieve MDG 4 and are making progress towards MDG 5 targets. (10) Zambia has seen an important reduction in child mortality. In all three countries sustained, high-level political commitment across several sectors, including the health sector, accounts for these achievements. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

Human Resources for Universal Health Coverage: Leadership Needed
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved from this article
  • Highlights & Notes
  • Citations
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.