Assessment of human resources for health programme implementation in 15 Latin American and Caribbean countries.
BACKGROUND
The health systems in the Americas region are characterized by fragmentation and segmentation, which constitute an important barrier to expanding coverage, achieving integrated primary health care, and reducing inefficiency and discontinuity of care. An assessment of the human resources for health (HRH) programmes that have been implemented at the country level was developed as part of the measurement of the 20 HRH regional goals for 2007-2015, adopted in 2007 by the Pan American Sanitary Conference (CSPA).


METHODS
The exercise was a combination of academic research and the development/application of an advocacy tool involving policy makers and stakeholders to influence the decision-making in the development, implementation, or change of HRH programmes while building evidence through a structured approach based on qualitative and quantitative information and the exchange and dissemination of best practices.


RESULTS
This paper covers the methodological challenges, as well as a summary of the main findings of the study, which included 15 countries: Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua and Panama in the Central America, Dominican Republic in the Caribbean, Chile, Colombia, Ecuador and Peru in the Andean sub region, and Argentina, Paraguay, and Uruguay in the South Cone. Despite the different contexts, the results showed that the programmes evaluated faced common challenges, such as lack of political support and financial unsustainability.


CONCLUSIONS
The evaluation process allowed the exchange and dissemination of practices, interventions, and programmes currently running in the region. A shared lesson was the importance of careful planning of the implementation of programmes and interventions. The similarities in the problems and challenges of HRH among the participating countries highlighted the need for a cooperation programme on the evaluation and assessment of implementation strategies in the Americas region.
Institute of Social Medicine, University of the State of Rio de Janeiro, Rua São Francisco Xavier, 524, Pavilhão João Lyra Filho, 7 andar / bloco D, Maracanã, Rio de Janeiro, CEP 20550-013, Brazil. dalpozm@uerj.br.
Mario Roberto
MR
Dal Poz
Human Resources for Health Programme, Pan American Health Organization, Washington, USA. sepulveh@paho.org.
Hernan Rodrigo
HR
Sepulveda
Institute of Social Medicine, University of the State of Rio de Janeiro, Rua São Francisco Xavier, 524, Pavilhão João Lyra Filho, 7 andar / bloco D, Maracanã, Rio de Janeiro, CEP 20550-013, Brazil. costacoutomh@gmail.com.
Maria Helena
MH
Costa Couto
Human Resources for Health Programme, Pan American Health Organization, Washington, USA. cgodue@gmail.com.
Charles
C
Godue
Human Resources for Health, Pan American Health Organization, San Salvador, El Salvador. Padillpadillamo@paho.org.
Monica
M
Padilla
Cameron Health Strategies Group, Halifax, Nova Scotia, Canada. rickcameron.chs@gmail.com.
Rick
R
Cameron
Institute of Social Medicine, University of the State of Rio de Janeiro, Rua São Francisco Xavier, 524, Pavilhão João Lyra Filho, 7 andar / bloco D, Maracanã, Rio de Janeiro, CEP 20550-013, Brazil. thais.a.v.franco@gmail.com.
Thais de Andrade
Tde A
Vidaurre Franco
D017691:Caribbean Region; D002489:Central America; D003695:Delivery of Health Care; D003906:Developing Countries; D006282:Health Personnel; D006296:Health Services; D006801:Humans; D013020:South America; D000078329:Workforce