OVERVIEW: Human Resources for Health
Context
At the center of every health system are health workers. Their knowledge, skills and motivation play a crucial role in delivering health services to those in need. Many countries are grappling with enormous human resources for health policy challenges, such as how to address shortages or surpluses and how to improve the skills, geographic distribution and performance of health workers. Improving the health workforce situation remains an important pillar of the World Bank's health systems strengthening agenda.
Strategy
The Bank assists countries in implementing evidence-based human resources for health strategies in selected thematic areas (labor market, fiscal and costing analysis, pre-service training costing, as well as political economy of human resources for health reform). We help countries carry out analytic work to inform human resources for health policy, such as designing a census of health workers, or wage and compensation studies. These products provide key information to guide policy decisions.
Results
The following examples illustrate how country-level work has led to important human resources for health reforms:
- Results-based financing (RBF) for Health in Nigeria: An analysis was designed to inform the design of an RBF pilot. The analysis provides a comprehensive assessment of the total revenues (formal and informal) earned by health workers and provides insight on adequate levels of RBF incentives.
- Regional Strategy to Manage Nurse Migration in the Caribbean: In 2008, at the request of the ministers of health, the World Bank initiated a stream of work to strengthen the nurse workforce in the English-speaking Caribbean. The first phase of work provided a comprehensive picture of the nurse education and labor markets of the ES CARICOM, demonstrating both a supply insufficient to meet a growing demand as well as tremendous losses of human capital at multiple points in the markets. The work highlighted three priorities for policy action: strengthening workforce monitoring, improving and expanding training capacities, and managing migration.
- Health Worker Performance Analysis in Tanzania: This study assesses the performance of outpatient health workers in Tanzania. The study applied innovative analytical tools to measure motivation, observe quality of care, and test multiple interventions to improve quality. The evidence produced will inform future RBF investments in Tanzania.
- Discrete Choice Experiment to Inform Health Worker Recruitment and Retention policies in Liberia, Vietnam and India: This novel analytic technique provides policymakers with information on the predicted effectiveness of alternative policies. Analyses have been completed in Liberia (nurses and midwives), Vietnam (medical doctors and final year medical students) and in India (doctors).
Partnerships
The Bank's activities on Human Resources for Health (HRH) have received valuable support from the government of Norway, the government of Japan, GAVI and Bill and Melinda Gates Foundation. Currently, with the support from the government of Japan ("Japan-Partnership Program for Universal Health Coverage") and the government of Norway, HRH studies are being conducted in several developing countries in the context of the universal health coverage strategies. The Bank is also a member of the Global Health Workforce Alliance, a partnership of national governments, civil society, international agencies, researchers, and professional associations dedicated to identifying solutions to address the acute shortages of health workers around the world.