Introduction

The 2006 World Health Assembly (WHA) and the publication of the 2006 World Health Report, Working together for health, constitute the most important events in human resources for health (HRH) of the last decade and have brought global HRH issues to the top of the international agenda. From the first meeting of the High Level Forum in Geneva and the launching of the Joint Learning Initiative in Mexico , there have been a series of international events looking specifically at HRH. These events culminated with the adoption of important resolutions on HRH by the WHA: Resolutions WHA59.23 and WHA59.27, and the presentation of a ten years plan to tackle the health workforce problems at global level.

The World Health Report 2006 assesses the current crisis in the global health workforce, highlighting an estimated shortage of almost 4.3 million doctors, midwives, nurses and support workers worldwide. This shortage is most severe in the poorest countries, especially in sub-Saharan Africa , where health workers are most in demand. Focusing on all stages of the health workers' career lifespan, including entry to health training, job recruitment, professional development and retirement, the report outlines a ten-year action plan in which countries can build their health workforces, with the support of global partners.

The World Development Report 2006: Equity and Development identifies poor service delivery as a major factor contributing to increase inequities in health and to hinder development. According to the report, poor service delivery is related to weak management and incentives within public health systems, ineffective technical and structural backup, lack of professional career structures and inadequate financial incentives.

The shortage of doctors, midwives and nurses is most severe in the poorest countries, especially in sub-Saharan Africa

The Global Health Watch Report 2005, an alternative health report from civil society organisations, details the global health worker crisis. The authors illustrate the importance of the health workforce within health systems and highlight the history of neglect that the issue has suffered in the last decades.

The report shows that, although maternal, child and infant survival rates increase with density of health workers, it is not only the right number of workers that is important. The distribution of health personnel is often inequitable. Developing countries bear the highest burden of disease but have the lowest access to health professionals, and the brain drain of health workers from low-income to more industrialised countries contributes to this. Within countries, the most deprived areas tend to have fewer health professionals than more affluent areas.

The distribution of human resources between private and public services is also imbalanced, as there is often a higher concentration of private health services, which are generally not accessible to the poor. The report suggests a range of positive policies to address shortages of HRH in poor countries. It recommends redefining professional roles, improving the motivation of health workers and coordinating these efforts with effective ethical recruitment policies.

In the paper Human resources for health policies: a critical component in health policies, Gilles Dussault aims to sensitise decision and policy-makers and their advisers to the role of workforce policies in supporting health sector reform. It argues that the production and the management of the workforce play a determinant role in achieving the objectives of reforms.

Intelligence is paramount in tackling workforce problems. Information availability constitutes one of the main hindering factors for monitoring and decision-making in HRH. The WHO Department of Human Resources for Health gathers information on the number of health workers and their employment status, gender and age, among other characteristics.

The Global Atlas of the Health Workforce presents the estimate of numbers and densities – the ratio per 100 000 population – of health workers.