Understanding the labour market
Not enough there, too many here: understanding geographical imbalances in the distribution of the health workforce
Improved salaries alone will not affect human resource distribution
Authors:
G. Dussault; M.C. Franceschini
Publisher:
Human Resources for Health, 2006
This paper, from Human Resources for Health, argues that the health-related Millennium Development Goals (MDGs) cannot be achieved if vulnerable populations do not have access to skilled personnel. The authors explore how geographical imbalances of qualified health personnel are a major barrier in access to health services. They find that accessibility of health services is multidimensional where geographical, economic (affordability), organisational and cultural (acceptability) factors that can facilitate or hinder use of services. Workforce issues are likely to become increasingly crucial and acute as health sector reforms focus on decentralisation, and new public-private partnerships as commitment to achieving the MDGs brings more funds to health sector, like the debt alleviation process. Coherent and well-formulated HRH policies and strategies, as well as the ability to implement and monitor them, are therefore crucially needed.
The paper concludes that the geographical distribution of the health workforce cannot be dealt with in isolation. Strategies must be multifaceted, integrated and coordinated in relation to the health sector and its environment. While improved salaries and working conditions are important strategies to attract and retain personnel to remote areas, they are difficult to implement: problems of low salaries and bad working conditions have their roots in complex organisational and social problems that must be attacked simultaneously and in other sectors.
