Africa

Health systems have reached the breaking point in many countries in sub-Saharan Africa . With increased commitments from international donors and other global initiatives such as the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM) and the Global Alliance for Vaccines and Immunization (GAVI), more money is available now than ever before to improve health systems in Africa. And there is a growing consensus that human resources are a vital part of improving African health systems and making progress towards the MDGs.

The World Health Organization African Regional Office (WHO-AFRO) highlights the importance of the health worker in Placing health workers at the heart of health services delivery in Africa. This brochure outlines how health workers are central to making the best possible use of other resources and investments in the health sector.

The NEPAD (New Partnerships for Africa's Development) Health Strategy also highlights the importance of human resources and identifies it as a priority in its strategy. Its action plan aims to strengthen and improve training programmes for health care workers, as well as improving and increasing the capacity of public health training in Africa more generally.

However in the editorial Human resources for health in Africa, Adetokunbo Lucas argues that training alone is not enough. Lucas calls for strong African leadership to direct debate and discussions to establish national and local needs for health workers. Lucas also highlights the need for countries to develop human resources for health policies that are relevant, affordable and sustainable, and that are realistic about the migration of trained health workers.

With this increased international, national and regional focus on HRH in Africa comes the need for better HRH data and information. In order to effectively respond to the HRH crisis, information on the key issues such as international migration, international recruitments and trends, distribution imbalances, production of health workers, freezing on recruitment due to Structural Adjustment Programmes (SAPs), impact of HIV and AIDS on the health workforce, scaling up of priority interventions, motivation and retention challenges, among others is needed. This has led to the creation of the Observatory of Health Human Resources for Africa. This observatory will be a cooperative network initiative among the countries and different partners of the region promoted by African Regional Office of the World Health Organization (WHO AFRO) . It will produce information and knowledge necessary for improving human resources policy decisions, and sharing the country experiences in order to improve human resource development in the health services.

Human resources for health are not just an issue for Ministries of Health to deal with. Often factors affecting recruitment and retention in the public sector are linked to wider public sector problems and need to be addressed through public sector reform.

Reasons for human resource problems in African health systems are complex. F actors such as the financial cutbacks as a result of structural adjustment, as well as misdirected human resource and training policies, weak institutions, and inappropriate structures all contribute to these problems. Moreover, they vary greatly between and within countries. This means that solutions will be complex and are dependent on the political, economic, historic and social context of each country.