Research

The health workforce crisis in TB control: a report from high-burden countries

José Figueroa-Munoz¹ , Karen Palmer¹ , Mario R Dal Poz² , Leopold Blanc¹ , Karin Bergström¹ and Mario Raviglione¹

¹  Tuberculosis Strategy and Operations, Stop TB Department, World Health Organization, Geneva, Switzerland

²  Department of Human Resources for Health, World Health Organization, Geneva, Switzerland

author email corresponding author email

Human Resources for Health 2005, 3:2doi:10.1186/1478-4491-3-2

Published:	24 February 2005

Abstract

Background

Human resources (HR) constraints have been reported as one of the main barriers to achieving the 2005 global tuberculosis (TB) control targets in 18 of the 22 TB high-burden countries (HBCs); consequently we try to assess the current HR available for TB control in HBCs.

Methods

A standard questionnaire designed to collect information on staff numbers, skills, training activities and current staff shortages at different health service levels was sent to national TB control programme managers in all HBCs.

Results

Nineteen HBCs (86%) replied, and 17 (77%) followed the questionnaire format to provide data. Complete information on staff numbers at all service levels was available from nine countries and data on skill levels and training were complete in six countries. Data showed considerable variations in staff numbers, proportions of trained staff, length of courses and quality of training activities. Eleven HBCs had developed training materials, many used implementation guidelines for training and only three used participatory educational methods. Two countries reported shortages of staff at district health facility level, whereas 14 reported shortages at central level. There was no apparent association between reported staff numbers (and skills) and the country's TB burden or current case detection rates (CDR).

Conclusion

There were few readily available data on HR for TB control in HBCs, particularly in the larger ones. The great variations in staff numbers and the poor association between information on workforce, proportion of trained staff, and length and quality of courses suggested a lack of valid information and/or poor data reliability. There is urgent need to support HBCs to develop a comprehensive HR strategy involving short-term and long-term HR development plans and strengthening their HR planning and management capabilities.