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Comprehensive assessment of human resources for health in Côte dIvoire.

Many countries are exploring ways of mobilizing large number of physicians nurses counselors midwives laboratory technicians and other health workers in order to meet service targets of their governments and of international initiatives while simultaneously maintaining basic health care services. Despite knowing that lack of human resources (HR) will impede their reaching targets few countries have conducted comprehensive assessments to estimate the existing stock of health care workers and project HR needs into the future. Therefore Partners for Health Reformplus conducted a comprehensive assessment of the public health sector in Cote d’Ivoire to quantify HR available and what is needed to maintain basic health services while scaling up HIV/AIDS services to reach targets at the national level and at the global level through initiatives such as the President’s Emergency Plan for AIDS Relief the World Health Organization’s 3 by 5 Initiative and the Millennium Development Goals. In Cote d’Ivoire civil conflict and worsening socio-economic conditions have increased the demand for public health services and exacerbated the shortage of HR in the public sector. Data show that HR levels decreased across all health worker types from 2002 to 2003 although levels rose slightly in 2004. Limited public budgets impede recruitment of health workers into the civil service. Attrition rates are high among social workers generalized doctors and nurses and medical school graduation rates have declined. The assessment shows that meeting targets will require substantial HR mobilization. It recommends that Cote d’Ivoire support the development of a long-term HR plan and HR database and make better use of its trained health professionals. An assessment of HR in the private sector is suggested to provide a comprehensive picture of the entire health sector. Similarly it must protect existing services from collapsing due to an HR shortage. (authors)