An approach to classifying human resources constraints to attaining health-related Millennium Development Goals

Table 2 Estimated size of HRH-related constraints for typical low-income countries in Africa

Level	Constraint	Estimated size of the constraints in the context of scaling-up in low- and middle-income countries
Individual characteristics
	Gender	++
	Social class and ethnicity of staff	+++
	Demand for medical training	+
	Disease*	++
Health service level
	Team building and interaction	++
	Surpluses, shortages and skill mix at health service level	++
	Physical working environment	+
Health sector level
	Salary level and monetary incentives	++
	Performance management and productivity	+++
	Composition of workforce and skill mix	++
	Geographical imbalances	+++
	Retention policy	++
	Health sector reform	++
	HRH policy	+++
Training capacities
	Initial training	+++
	Re-training	+++
Sociopolitical and economic context of a country
	Multisectoral approaches	++
	Migration	++
	Governance and overall policy framework	+++

* Heavily influenced by the epidemiological situation of HIV/AIDS for a given country +++ = very important; ++ = important; + = moderate

ISSN: 1478-4491