Shortages of trained health staff are a crisis of epidemic proportions in the developing world.

» Every year, 66% of graduating doctors emigrate from developing countries.

» Hospitals report vacancy rates among nursing positions of more than 60%.

» 44% of nurses in southern Africa are estimated to be HIV positive while 80% of hospital beds are occupied by patients dying of AIDS.

In some of the poorest countries of the world, the health system is in danger of collapse due to a lack of health staff to deliver services. Human resources are essential to planning, managing, and delivering life-saving health services; research has shown that more mothers and babies die when there is an acute shortage of health staff.

Many of the causes of such shortages are chronic problems, familiar to health managers and providers everywhere: migration of health personnel, poor distribution of staff, and lack of resources to recruit, train, and support health workers. These problems are being intensified in many countries by the prevalence of HIV/AIDS among the workforce and the extra demands the disease and its treatment impose on already overburdened health systems. These changing demands require changes in thinking about how to help governments and organizations sustain an adequate supply of qualified, motivated health staff.

In December 2005, MSH participated in a WHO- and USAID-sponsored conference with a group of representatives of multilateral and bilateral agencies, donors, partner countries, NGOs, and academics. The result of this meeting was a simple but comprehensive technical framework for addressing the crisis in human resources for health (HRH).

HRH Framework