Africa
The health sector human resource crisis in Africa: an issues paper
Donor neglect of African health-sector human resource crisis
Authors:
J. Huddart; O. Picazo
Publisher:
Support for Analysis and Research in Africa, USAID, 2003
This paper outlines the severity and complexity of the Human Resources (HR) crisis in sub-Saharan Africa and criticises donor neglect of the issues. The document was prepared as a background document for a World Bank/World Health Organization meeting on Building Strategic Partnership in Education in Health in Africa. The document outlines three reasons why donors have not addressed HR issues. Firstly, it is seen as too big and complex for one donor to address alone. Secondly, traditional donor projects provide for capital costs, such as drug imports, rather than recurrent costs, including salary support or enhancement. Finally, continuing fragmentation of African health systems result from lack of harmonisation between donor projects.
The paper recommends adopting a ‘systems approach’ to diagnose HR problems. It also suggests improving the HR information base and conducting HR country case assessments that can highlight the critical gaps in the system. Other recommendations include reducing the rigid professional practice barriers to allow health workers to take on more function, increase and improve service delivery and reduce costs; adopt more flexible employment and provider arrangements, including contracting and private management; move gradually towards results-oriented performance management; and provide better informed local managers for personnel management and employee relations. [adapted from author]
