Despite political struggles that resulted in the loss of many health workers, Eritrea, one of the poorest countries in Africa, has managed to improve its HRH situation, particularly during the past decade. During this period HRH planning has focused on re-orienting and re-training health workers. Priorities include standardizing the skills of different categories of health workers and re-orienting them to the decentralization of administrative zones (zobas), which created new resource requirements. Resources during this period were also used to increase training capacity, which resulted in the creation of new schools of nursing, medicine, and dentistry. During the past 7 years, the number of physicians has doubled from 3 per 100,000 population to 6 per 100,000, and the number of nurses and midwives increased from 20.5 to 75 per 100,000 population (Eritrea MoH, 2005; WHO AFRO, 2010).
Even though there has been rapid growth, HRH remains far below estimated needs and targeted goals to be met by 2014 as set out in the last HRH strategic development plan.
- increasing the number of trained health workers;
- equitable distribution, quality, and performance of health workers; and
- improved capacity of the MoH and others in the health sector to plan for, develop, and train health workers (Human Resources Strategy for the Health Sector in Eritrea: 2006-2010).
A 2010 consensus building workshop supported by WHO and the World Bank, which included representatives from collaborating organizations such as the Alliance, Italian Cooperation, and national training organizations, focused on a new HRH strategic plan.
Goals, described in the current National Health Policy (Eritrea MoH, 2010), include:
- increasing the number of health workers;
- addressing issues such as retention, skill mix, and attrition;
- the challenge of distribution of health workers in an environment where the population can be highly mobile and dispersed;
- responsiveness to prevailing heath needs and disease burden - particularly of non-communicable diseases that require a high level of skilled health workers;
- quantity/quality of available resources;
- technological developments such as distance learning for health workers; and
- staffing patterns at all levels taking into account expansion and restructuring of the health care delivery system, and other government policies (such as decentralization).
COUNTRY COORDINATION AND FACILITATION (CCF) IN ERITREA:
Eritrea has completed all steps of the CCF process up to establishment of an HRH committee and technical working groups; capacity building; involving the HRH committee and technical working groups in developing an evidence-based, comprehensive HRH plan; stakeholder analysis; and creation of an HRH coordination structure.
As of 2011, the country is in the process of engaging stakeholders for resource mobilization, implementation, monitoring, and evaluation of the new HRH plan which is being developed. Eritrea is currently implementing its HRH plan with donor support to complement the low level of domestic resource allocation (KD/AGA Progress Report, GHWA, 2011).