This function exhibited low performance, with a median of 0.38 for the Region. In general, most countries revealed low or intermediate performance, although a small group performed better.
The following areas are critical for the Region: improving human resources quality, promoting continuing education and graduate training in public health, and training personnel to promote delivery of health services that are culturally appropriate.
In general, this function exhibited a smaller degree of variation in the results obtained for indicator 3 (continuing education) and 2 (improvement of quality). Other indicators (1, 4, and 5) exhibited greater dispersion, which indicates that some countries performed better in comparison with the rest of the Region.
The primary factors determining this function’s performance are:
• Although the countries evaluate their workforce, only half assess the needs of their personnel in delivering public health services, which include the number of workers, their profiles, and the required competencies. Consequently, this hinders efforts by the NHA to develop adequate human resources. The lack of criteria to estimate future needs is one of the most prominent areas of weaknesses seen throughout the Region.
• Although accreditation guidelines exist to improve the quality of personnel, adherence to these standards during the hiring process is not evaluated. In only a few of the countries, strategies for selecting and retaining workers are evaluated, and 19% of countries stated that their training programs include ethics as a field of study. There are no incentives for promoting leadership of public health officials, and only 11% of the countries have created incentives to retain leaders. Although half of the countries have performance evaluation systems, only 32% establish measurable indicators, and even fewer use the results to assign responsibility and create incentives for merit-based worker retention.
• In most countries, continuing education is encouraged, training is offered to less experienced personnel, and partnerships with training centers for professional development are established. However, none of the countries have clear policies and standards to guarantee adequate training. There are also no systems to evaluate the results obtained from personnel training and no mechanisms to retain the most qualified staff. All of these deficiencies result in the loss of any benefits that are obtained through education and training efforts.
• With respect to support for the sub-national entities, less than one-third of the countries support the identification of the human resources that are appropriate to the socio-cultural and linguistic characteristics of users. Fifty-one percent of countries lack strategies to improve human resources management according to the needs of the intermediate and local levels.