Managing the health workforce after a conflict: a review of research and knowledge gaps
During conflict, health systems can break down, with clinics and hospitals destroyed and medicine in short supply, leaving people at high risk of disease. Health workers can be targets and many leave the conflict zone. Managing human resources well can help overcome shortages in the health workforce, as well as other challenges such as workers’ skills which do not match health service needs, patchy human resource data, inadequate medical training and weak management. This area is complex, and understanding how human resource management (HRM) contributes to rebuilding health systems after conflict is valuable. The knowledge can be used to inform national and international policy-makers: this is important as decisions made immediately after a conflict can influence the development of the health system in the long term. Research in this field is, however, limited, with few reviews providing an overview of the evidence. Therefore the ReBUILD consortium has carried out a review of publications in the area of HRM in health systems in countries affected by conflict. It was structured using a framework which looks at three areas of the health workforce: supply, distribution and performance, as well as some overlapping areas, such as finance and gender. We know most about workforce supply issues, such as training, pay and recruitment, but less about workforce distribution and performance. The review stresses the need for more primary research, with a longer term perspective. Further research will increase awareness of how effective HRM can develop the health workforce and help build strong health systems after conflict has ended.