Human resources for health reforms

Overview

A large increase in the number of primary health care units in the past decade resulted in a doubling of health posts and five times more health centres in Ethiopia. The health workforce required to meet the increase in demand did not keep pace, and the emerging imbalance raised concerns related to aspects of both technical and allocative inefficiency. On the one hand, there was clearly an inefficient mix of inputs between capital and labour that limited productivity. On the other hand, the distribution of the limited health workforce among and within districts was uneven, and they were poorly trained, resulting in gaps in the delivery of essential services in rural areas. In order to augment human resources for health, a new cadre of health extension worker was trained and deployed to health posts to meet family and community demands. The paper discusses the reforms in Ethiopia that successfully scaled up the health workforce to provide high impact primary care and community based services by creating health extension workers, shifting tasks, and expanding primary health care units.

Synthesis report

The Ethiopia case study is part of a synthesis report that applied a causal framework to synthesize lessons from ten case studies of various health system reforms which aimed to improve the efficiency in health systems.