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The Future of Managing Human Resource for Health (HRH) in Africa

  May 29, 2020

The healthcare industry all over the world has been thrust into the spotlight by the COVID-19 pandemic, now all the weak links in the health sector are under scrutiny.

According to the World Health Organization (WHO), human resources for health (HRH) refers to all people engaged in actions whose primary intent is to enhance health. These include clinical staff such as physicians, nurses, pharmacists, and dentists, as well as management and support staff – those who do not deliver services directly but are essential to the performance of health systems, such as managers, ambulance drivers, and accountants.

Sub-Saharan Africa faces a myriad of problems when it comes to HRH, more so in the public sector. The gravity of the problems may vary on a country by country basis, but in general, the continent has similar HRH problems.

  1. Shortage of health workers. The HRH in sub-Saharan Africa was in recent years referred to as the ‘crisis in human resources for health. A key contributor to the crisis has been employee attrition. Some causes for attrition may be retirement, death, dismissal and voluntary resignation by health workers who leave the public health sector to work in the private sector, for more attractive occupations in the home country, or to emigrate to work in health facilities in richer countries, in search of better pay and working conditions (Chankova et al, 2009).The Coronavirus pandemic worsened the situation by dramatically increasing the workload of staff, further adding pressure to a frail African Healthcare system.WHO recommends a doctor-patient ratio of 1:300, this is however not the case in Africa. In Kenya for instance the doctor-patient ratio is 1:16,000, in Tanzania it is even higher at 1:20,000, and Nigeria is better off at 1:6000. 
  2. Inequitable distribution of health workers. An urban-rural imbalance of healthcare workers is seen throughout Africa. In Kenya for instance, northern Kenya has the weakest healthcare system with the lowest percentage distribution of health professional cadres with the number of Doctors, Nurses, and Clinical Officers being 2%, 2%, and 5% of the national total respectively. Some of the contributors to this include geographical challenges, poor telecommunication, infrastructure, and insecurity.
  3. Shortage of skilled professionals. With more diseases cropping up, you would expect more specialists trained. This is not the case however, Africa has a serious shortage of specialists. Speaking during a webinar hosted by Strathmore University Business School, Dr. Tossef Din CEO, Mp Shah Hospital emphasized the need for healthcare training institutions to step up their offering in terms of training and multi-skilling to ensure they produce the healthcare professionals that the sector needs. “The cadre of healthcare workers is not consistent with the public need,” she said.

Human resources for health form the foundation of any healthcare system and play a major role in improving health outcomes. COVID-19 has brought out the gaps in the healthcare sector and how private health practitioners can step in to fill those gaps. When managing human resources for health in Africa, there must be strong linkages between the public and private sectors.


  1. Kenya Ministry of State for the Development of Northern Kenya and Other Arid Lands (MONDKAL) and IntraHealth International. 2012. Human Resources for Health (HRH) Assessment in Northern Kenya: An overview of health workforce distribution across 10 counties. Nairobi, Kenya: MONDKAL
  2. Chankova, S., Muchiri, S. & Kombe, G. Health workforce attrition in the public sector in Kenya: a look at the reasons. Human Resource Health 7, 58 (2009).

Strathmore University Business School is hosting a free webinar series dubbed Navigating the Pandemic that aims to bring together Thought Leaders to discuss important topics across all sectors. For more information click here

SBS aims to equip leaders with the knowledge they need to help them overcome the challenges they are facing in this uncertain climate. For more information on our Executive Education programmes, click here

Article by Juliet Hinga


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