The Health Workforce in Latin America and the Caribbean

The health workforce is the foundation of care and affects quality and outcomes; human resources for health (HRH) constitutes the largest portion of the health care budget of most countries. Latin America and the Caribbean has been challenged by imbalances in workforce composition, distribution, and skill mix, as well as by variations in productivity and quality. The Health Workforce in Latin America and the Caribbean: An Analysis of Colombia, Costa Rica, Jamaica, Panama, Peru, and Uruguay provides an update on HRH in these six countries. The discussion is structured around five key areas of the workforce: financing, organization, management, regulation, and performance. -- Financing: The authors present the variety of contracting mechanisms, salary levels, and financial incentives, and their roles in attracting and retaining health workers. -- Organization: The countries have made progress toward achieving HRH targets and making education more accessible. However, the absorption capacity remains limited for graduates, the primary health care focus of training programs needs to be strengthened, and the strategies to encourage rural service have not effectively addressed the distribution gap of health workers. -- Management: All six countries have adopted the World Health Organization's Global Code of Practice on the International Recruitment of Health Personnel to recognize foreign-trained professionals to help address shortages and fill gaps in rural and remote areas. However, the countries continue to struggle with implementing self-sufficiency policies to build the capacity to meet needs. Such policies include promotion plans, nonmonetary incentives, and personnel for recruitment and eventual placement. -- Regulation: The countries are working to reduce precarious and unprotected employment, introduce safety policies to decrease occupational diseases and workplace accidents, and enact legislation to resolve disputes. -- Performance: Mixed results have been achieved in health outcomes, access and availability, quality of care and patient satisfaction, professional practice, and productivity and efficiency.