FRONTESPIZIO - Cooperazione Italiana allo Sviluppo

Ethiopia falls among the “low-density / high-mortality” countries.60 Carlo Resti, Yohannes TadesseHuman Resources and health clustersHuman Resources and health clustersSource: WHO, 2004Source: WHO, 2004Challenges and constraints to the development of HRHBuilding up of the health workforce necessary to achieve internationalMDGs targets faces a number of constraints. The most important challengesfor a typical low-income country in Sub-Saharan Africa, as it is the case forEthiopia, are likely to include the following factors:• addressing the proportional representation of staff with a distinct socialand ethnic background in the workforce and addressing the issue of an appropriateskill mix of health personnel;• tackling geographical imbalances in the distribution of health sectorworkforce;• building qualitative and quantitative capacities of medical and paramedicaltraining institutions simplifying entry points in the educationalsystem and career ladder;• addressing the necessity to delegate some key skills (task shifting) tolower health cadres of workers to reach the grass root level in health servicesdelivery;• designing and implementing national HRH policies and ad hoc strategies;• carrying forward good governance for a conducive work environmentand a well conceived and balanced overall policy framework.Obviously, the size and the extent of these main constraints varies across differentlow- and middle income countries, but they will largely determine thepace of any effort to increase health service coverage of the population.