Human Resources : The Political and Policy Context

At the request of WHO, this paper incorporates eight issues: donor agencies and their contribution in shaping the HR agenda; national & international agency facilitation of identifying good HR practice and facilitating networks to disseminate it; national & international successes and failures in implementing change in HR policy and practice in health sectors over last 5 to 10 years; the appropriate role for effective national level involvement in HR in a decentralised system; identification of recent trends in introduction and implementation of ‘new’ ideas and theories in HR; what role should be played by international agencies and national governments in appraising the relevance & applicability of new approaches to HR in the health sector; what can be done to facilitate better integration of HR policies into national level health systems planning; and what currently are the major constraints on achieving appropriate recognition of the importance of HR at this level? The influence of the global context is briefly analysed, preceded by clarification of assumptions, based on the literature and the author’s experience. The conclusion drawn is that health leaders, managers and others do not well enough understand the strategic importance of HR to strengthening health system capacity. It seems to be still perceived by some as being at the “soft and fluffy” end of the spectrum in health (other than perhaps some formal and continuing education programmes), instead of something that is as essential to a strong health system as sound health financing, and which requires a similarly rigorous approach. There is little evidence that enough key players understand the key role of strategic HR approaches in achieving sustainable organizational change. While there are case histories of innovation and system change experiences using HR strategies, there is little evidence