Achieveing A Sustainable Workforce

The Human Resources for Health Action Framework

Adapted from the USAID Capacity Project

The framework makes a fundamental and important point: tackling the human resources crisis requires a comprehensive, multi-dimensional approach and working at different levels with a wide range of stakeholders. Long standing human resource issues, especially in the public sector, will take a long time to resolve. But it is also clear that most countries are experiencing severe HR shortages and attrition, and are looking for quick, emergency-type fixes to maintain or expand existing services.

The Human Resources for Health (HRH) challenges many countries fact – inadequate numbers of health care workers, high turnover and migration, maldistribution, low job satisfaction and ineffective workforce planning – can only be solved by using a holistic approach.  The HRH Action Framework (HAF) is designed to assist health leaders and practitioners to develop and implement strategies to achieve an effective and sustainable health workforce.  By using a comprehensive approach, the Framework is helping to address staff shortages, uneven distribution of workers, gaps in skills and competencies, low retention and poor motivation, among other challenges.

The Development of the HAF

Work on the HAF began during a technical consultation in Washington, DC, on December 14-15, 2005, among multilateral and bilateral agencies, donors, partner countries, NGOs and the academic community, sponsored by the World Health Organization (WHO) and USAID.  The initial Framework draft, produced at the consultation, contains six integrated components and fits into the overall health system context.   

Progress continues on the HAF and tools, and a Framework Web site has been developed as an initiative of the Global Health Workforce Alliance (GWHA).  The Web site presents a collaborative effort between USAID and WHO, as well as among a number of other partners. 

The HAF is a global effort to bring a shared approach and resources to bear on complex HRH issues at the country level.  It reflects general agreement among global and country stakeholders on a comprehensive approach to HRH. It includes a growing list of key tools and resources to foster action in countries and promote collaboration among donors. The HAF should be applied in as many countries as possible in order to gather lessons learned that will inform succeeding versions of the Web site and its integrated set of tools, guidelines and resources.

Benefits of the HAF

	Human Resources for Health Spotlight
	HRH Global Resource Center For Human Resources for Health policy makers and practitioners in the field, having on hand the latest research and information is invaluable. That is why USAID supports the HRH Global Resource Center, maintained by the Capacity Project, a Web-based portal which centralizes access to critical Human Resources for Health research, data, tools, job aids, journal articles, meeting and conference reports, country-level HRH documents and strategic plans, as well as interview transcripts with HRH practitioners. USAID’s goal is to support stakeholders in developing countries, many of whom are on the front lines of HRH action and decision-making, supporting both planning and implementation efforts. Most importantly, the HRH Global Resource Center fosters learning, knowledge sharing and dialogue across sectors, geographical barriers and cultural boundaries; and strengthens national capacity and accelerates the implementation of evidence-based HRH solutions. Learn more

The key benefit – described above – is that the HAF and tools provide the foundation for using a comprehensive approach to address HRH challenges at the country level.  Because the problems are complex, interrelated and multisectoral, sustained progress can only be achieved through a holistic approach.  In addition, there are other key benefits of applying the HAF at the country level and continuing the HAF development process:

• It will define the key dimensions of technical competence needed, given a particular country context, to develop and implement a strategy for sustainable HRH.
• As the HAF is disseminated more widely, it will help inform the growing number of health professionals interested in HRH about the complexities of building a sustainable health workforce—and this can help prevent the sread of simplistic and limited views on what is needed.
• It will provide a common reference point and shared set of tools and resources for all health workforce stakeholders and save policy makers, implementers, donors, academics and others the effort of “reinventing the wheel.”

Next Steps

Work continues on the HAF to link proven tools and guidelines that will help analyze the issues that need to be addressed in each of the six components of the HRH Framework and also assist with developing comprehensive HRH operational plans at the country level.  The GHWA Working Group on Tools and Guidelines intends to lead a process of applying the HAF at the country level, documenting progress, identifying lessons learned and refining the HAF based on actual usage.  As this work continues, all HRH practitioners, experts and researchers are invited to contribute additional tools, guidelines and resources in an open and participatory way.

July 2009

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