A major report from the Joint Learning Initiative suggests that donors can support the growth and better performance of health workforces in developing countries by providing technical support and mobilising adequate financial resources.

Donors committed to the health Millennium Development Goals (MDGs) are responsible for helping to build the health workforces needed to meet the needs of developing countries. This means not only adding to and better distributing available staff, but also:

• improving the quality of initial education and lifelong training
• creating a motivating work environment
• putting in place a policy framework that sustains a stable and performing workforce.

Donors must first recognise the problems, as most have done recently, and commit to helping countries to address the multiple and interconnected workforce problems facing the health sector.

There is a danger that donors' actions will harm health workforces further, for example, through the promotion of programmes that:

• drain staff from health services or add to already heavy workloads
• recruit, or poach, scarce national staff from general services
• resist contributing to recurring funding needs, such as salary increases.

Also, donor countries should not try to solve their own recruitment problems by importing developing countries' best trained staff.

Instead donors should coordinate their interventions, such as training and production of technical guidelines, as well as reporting and accounting procedures, as they have committed to in adopting the Rome Declaration on Harmonisation of Aid in February 2003. A recent OECD report suggests that progress is slow but that coordination improves as donors move from a project to programme approach, like sector-wide approaches (SWAP) increasingly preferred in the health sector.

Source(s):
id21 insights health #7, August 2005, Responding to the health workforce crisis Full document.
'Human resources in health: overcoming the crisis', report of the Joint Learning Initiative, 2004
'Incentives for harmonization in aid agencies', report by ODI for OECD, 2005

Funded by: Atlantic Philanthropies, USA; Bill and Melinda Gates Foundation; UK Department for International Development (DFID); Swedish Sida; Rockefeller Foundation; Canadian International Development Agency; Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ); Global Equity Initiative, Harvard University, USA; JSI Research & Training Institute, Inc., USA; Open Society Institute; World Health Organisation; World Bank

id21 Research Highlight: 12 July 2005

Further Information:
Gilles Dussault
World Bank Institute
1818 H Street, NW
Washington D.C. 20433
USA

Tel: +1 202 473 8709
Fax: +1 202 614 1137
Contact the contributor: gdussault@worldbank.org

World Bank Institute

Other related links:
'Responding to the health workforce crisis'

'Stopping the migration of Ghana's health workers'

'Filling the gaps: introducing substitute health workers in Africa'

'The crucial contribution of overseas volunteers'

'The Joint Learning Initiative Report: overcoming the crisis'

'Finding the answers to Chad's health workforce crisis'

'Global monitoring report 2005: from consensus to momentum', World Bank, 2005