Abstract
SETTING: Since the year 2003, most countries of the Region of the Americas have experienced sustained economic growth and inclusive development policies. In the health sector, achieving universal access became the overarching goal. However, the structural limitations of the health workforce represented a formidable obstacle to change. National Health Authorities were confronted with the challenge of developing critical capacities to redress entrenched inequalities in access to qualified health personnel.
INTERVENTION: Under the auspices of the Pan American Health Organization, the Ministers of Health of the Region adopted, in September 2007, twenty regional goals for Human Resources for Health 2007–2015, aligned with the renewed strategy of Primary Health Care. Subsequently, a set of indicators and a methodology were developed to assess the goals and to monitor progress at the country level.
OUTCOMES: Fifteen countries carried out a baseline assessment in 2009 or 2010 and conducted a second assessment in 2013. Although differences were noted across goals and between countries, the results suggested improvements in all twenty goals overall. The goals linked to the distribution of personnel, the management of migration, and the cooperation with education institutions appeared to be more resilient to change.
IMPLICATIONS: The twenty Regional Goals for Human Resources for Health provided a common vision for action and a framework for cooperation within and among countries, and was a catalyst for change. Faced with evolving challenges, the countries should consider adopting a new shared agenda that builds on progress made and further supports intergovernmental policy alignment and capacity building in health workforce development, governance and management.
Résumé
LIEU: Depuis 2003, la plupart des pays de la Région des Amériques connaissent une croissance économique soutenue et ont adopté des politiques de développement axées sur l’inclusion. Dans le secteur de la santé, l’accès universel est devenu l’objectif primordial. Les contraintes structurelles des personnels de santé ont cependant représenté un obstacle formidable au changement. Les autorités sanitaires nationales ont été confrontées à la difficulté de renforcer les capacités critiques pour redresser les inégalités enracinées face à l’accès aux personnels de santé qualifiés.
INTERVENTION: Sous les auspices de l’Organisation panaméricaine de la Santé, les ministres de la Santé de la région ont adopté, en septembre 2007, vingt objectifs régionaux liés aux Ressources humaines pour la santé 2007–2015, qui correspondent à la stratégie des Soins de santé primaires renouvelée. Par la suite, on a élaboré un jeu d’indicateurs et une méthode pour évaluer les objectifs et surveiller les progrès accomplis dans chaque pays.
RÉSULTATS: Quinze pays ont mené une évaluation préliminaire en 2009 ou 2010 et une seconde évaluation en 2013. Malgré les différences constatées entre les objectifs et d’un pays à l’autre, les résultats suggèrent une amélioration pour l’ensemble des vingt objectifs. Ceux qui étaient liés à la répartition des personnels, à la gestion des migrations et à la coopération avec les établissements d’enseignement se sont avérés plus réfractaires au changement.
IMPLICATIONS: Les vingt objectifs régionaux liés aux Ressources humaines pour la santé ont offert une vision commune des mesures à prendre et un cadre de coopération à l’intérieur des pays et entre eux; ils ont de ce fait été des catalyseurs de changement. Confrontés à des défis mouvants, les pays devraient considérer l’adoption d’un nouveau plan d’action commun qui s’appuie sur les progrés accomplis et qui promeut l’harmonisation des politiques intergouvernementales et le renforcement des capacités de développement, de gouvernance et de gestion des personnels de santé.
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Godue, C., Cameron, R. & Borrell, R.M. Capacity building in human resources for health: The experience of the region of the Americas. Can J Public Health 107, e347–e354 (2016). https://doi.org/10.17269/CJPH.107.5564
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DOI: https://doi.org/10.17269/CJPH.107.5564
Key words
- Human Resources for Health
- capacity building
- Latin America
- health policy
- governance
- evaluation and monitoring