Deploying an Integrated Human Resources for Health Approach to Achieving the Millennium Development Goals

Sara Pacque-MargolisThe global health workforce crisis demands a strategic investment in a long-term solution. Given the limited human resources for health (HRH) available in many countries, an integrated, systems-based approach is necessary if countries are to achieve all the health-related Millennium Development Goals.

The Center for Global Development’s (CGD’s) recent report argues that donors must evolve from the emergency approach required to scale up vertical HIV/AIDS programs to a more sustainable approach that plans for, develops, deploys, and retains a health workforce responsive to the population as a whole.

A call to donors
Based on research conducted in Mozambique, Uganda, and Zambia, the CGD report examined how AIDS programs leveraged health workers, their financial and programmatic inputs into health worker training and deployment, and the effects of these actions on health services.

The report concludes that AIDS donors should:

  1. Invest in training, task-shifting, and performance incentives to support the health system, rather than disease- or donor-specific programs
  2. Plan long-term for hiring and retaining health workers
  3. Pay to produce new health workers, particularly doctors and nurses
  4. Define the long-term role of community health workers.

Crystal NgThis is a call for a new age in health development thinking. Donors have the resources to take deliberate efforts to expand, strengthen, and support the global health workforce. By investing in HRH management, education, productivity, support, and retention initiatives, donors can advance governments’ capacities to develop health workforces able to respond to population needs over the long term. CapacityPlus’s framework reflects this goal, with activities to foster global HRH leadership and advocacy, enhance HRH policy and planning, improve health workforce training and development, strengthen health worker support to improve retention and productivity, and build and disseminate the evidence base for successful HRH interventions.

Strategic investment in a long-term solution

With the launch of the Obama Administration's Global Health Initiative, which incorporates integrated service delivery and health systems strengthening as key principles, the CGD’s recommendations come at a critical juncture in international aid for global health. The GHI has set a target of “Increased numbers of trained health workers and community workers appropriately deployed in the country.”
A health workforce strategy for the GHI could “make optimal use of the funds available for HRH, create a model for addressing the other health systems issues included in the GHI, and help ensure that this pillar of health systems is available to support the USG contribution to achieving the Millennium Development Goals,” writes our colleague Maurice Middleberg. In order to reduce child mortality (MDG 4), improve maternal health (MDG 5), and combat not only HIV/AIDS, but also malaria and tuberculosis (MDG 6), donors must change their strategies and funding priorities.