title: Human resources for health and universal health coverage: fostering equity and effective coverage.
abstract: Achieving universal health coverage (UHC) involves distributing resources, especially human resources for health (HRH), to match population needs. This paper explores the policy lessons on HRH from four countries that have achieved sustained improvements in UHC: Brazil, Ghana, Mexico and Thailand. Its purpose is to inform global policy and financial commitments on HRH in support of UHC. The paper reports on country experiences using an analytical framework that examines effective coverage in relation to the availability, accessibility, acceptability and quality (AAAQ) of HRH. The AAAQ dimensions make it possible to perform tracing analysis on HRH policy actions since 1990 in the four countries of interest in relation to national trends in workforce numbers and population mortality rates. The findings inform key principles for evidence-based decision-making on HRH in support of UHC. First, HRH are critical to the expansion of health service coverage and the package of benefits; second, HRH strategies in each of the AAAQ dimensions collectively support achievements in effective coverage; and third, success is achieved through partnerships involving health and non-health actors. Facing the unprecedented health and development challenges that affect all countries and transforming HRH evidence into policy and practice must be at the heart of UHC and the post-2015 development agenda. It is a political imperative requiring national commitment and leadership to maximize the impact of available financial and human resources, and improve healthy life expectancy, with the recognition that improvements in health care are enabled by a health workforce that is fit for purpose.
authors.affiliation: Instituto de Cooperación Social Integrare, Calle Balmes 30, 3°-1, 08007 Barcelona, Spain .
authors.forename: James
authors.initials: J
authors.lastname: Campbell
authors.affiliation: Queen Margaret University, Edinburgh, Scotland .
authors.forename: James
authors.initials: J
authors.lastname: Buchan
authors.affiliation: Global Health Workforce Alliance, World Health Organization, Geneva, Switzerland .
authors.forename: Giorgio
authors.initials: G
authors.lastname: Cometto
authors.affiliation: Australian Agency for International Development, Canberra, Australia .
authors.forename: Benedict
authors.initials: B
authors.lastname: David
authors.affiliation: Universidade Nova de Lisboa, Lisbon, Portugal .
authors.forename: Gilles
authors.initials: G
authors.lastname: Dussault
authors.affiliation: Norwegian Agency for Development Cooperation, Oslo, Norway .
authors.forename: Helga
authors.initials: H
authors.lastname: Fogstad
authors.affiliation: Universidade Nova de Lisboa, Lisbon, Portugal .
authors.forename: Inês
authors.initials: I
authors.lastname: Fronteira
authors.affiliation: National Institute of Public Health, Cuernavaca, Mexico .
authors.forename: Rafael
authors.initials: R
authors.lastname: Lozano
authors.affiliation: Ministry of Health, Accra, Ghana .
authors.forename: Frank
authors.initials: F
authors.lastname: Nyonator
authors.affiliation: United States Agency for International Development, Washington, United States of America (USA).
authors.forename: Ariel
authors.initials: A
authors.lastname: Pablos-Méndez
authors.affiliation: United States Agency for International Development, Washington, United States of America (USA).
authors.forename: Estelle E
authors.initials: EE
authors.lastname: Quain
authors.affiliation: Family Care International, New York, USA .
authors.forename: Ann
authors.initials: A
authors.lastname: Starrs
authors.affiliation: International Health Policy Programme, Ministry of Public Health, Nonthaburi, Thailand .
authors.forename: Viroj
authors.initials: V
authors.lastname: Tangcharoensathien
mesh_terms: D003906:Developing Countries; D014943:Global Health; D059066:Gross Domestic Product; D005102:Health Expenditures; D006282:Health Personnel / Q000193:education / Q000458:organization & administration* / Q000592:standards; D006297:Health Services Accessibility / Q000191:economics / Q000458:organization & administration*; D006301:Health Services Needs and Demand / Q000191:economics / Q000458:organization & administration*; D006280:Health Workforce / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D057766:Policy; D011787:Quality of Health Care / Q000458:organization & administration