Table 1. Status of human resources for health, Sudan, 2005 and 2012.
| Challenge | 2005a | 2012b |
|---|---|---|
| Data collection and use | – Deficient HRH information | – A comprehensive electronic HRH database built |
| – Weak capacity for data analysis and use | – Improved capacity for data analysis and knowledge translation | |
| – Lack of studies on HRH | – HRH operational research on key workforce issues commissioned – several studies accomplished | |
| Partnerships | – No mechanism to bring HRH stakeholders together | – Stakeholder forum established and operational |
| – Poorly coordinated HRH actions – leading to duplication and conflicts | – HRH analysis, decisions and actions are coordinated, coherent and jointly conducted | |
| Policy and planning | – Lack of documented and coherent HRH policies | – Institution of an inclusive policy process in the domains of pre-service education, the scaling up of CPD and health-worker deployment and distribution |
| – Absence of a national strategic plan for HRH | – Development of a costed national HRH strategic plan for 2012–2016 | |
| Institutional strengthening and leadership development | – Modest capacity for HRH leadership and advocacy | – Emergence of HRH champions – leading to the strategic positioning of HRH issues in higher government forums and, subsequently, supportive deliberations by the Federal Cabinet |
| – Lack of a critical mass of HRH technical staff at the Federal MOH and inadequate HRH-focused training | – Number of HRH technical staff at the Federal MOH raised from 20 to 115 | |
| – Limited capacity of training institutions for mid-level and community health workers | – More than 340 individuals in MOH exposed to HRH training opportunities | |
| – More training institutions for mid-level and community health workers at national and state level – and greater enrolment at older institutions | ||
| Coverage and skill mix to revitalize PHC services | – Critical shortage of health workers and a distorted skill mix | – Number of training institutions for nurses and midwives increased from 18 to 55 |
| – More than 5500 nurses and midwives produced in a year, with majority enrolled in the rural health network | ||
| – More than 3400 individuals enrolled in a new programme for the training of community health workers | ||
| – Number of medical schools increased from 27 to 33, with 3000 doctors produced per year | ||
| – Mechanisms introduced for predicting future HRH needs and levels | ||
| CPD coverage | – Lack of CPD institutional structures and norms | – Establishment of a national CPD programme and a CPD centre – with 15 state-level branches |
| – Sporadic in-service training covering only 24% of the workforce | – Mobilization of additional resources and extension of coordinated and harmonized CPD activities to 67% of the health workforce | |
| Geographical distribution of health workforce | – Seventy per cent of health workers serving 30% of the population | – Over 10 000 new employment positions sanctioned, many of them in rural and other provincial areas |
| – Limited job creation at state and rural level and poor workforce retention | – Improved bonding schemes to strengthen the implementation of training policies | |
| – Introduction of a major “discrete choice experiment” to help in the design of an appropriate and effective incentive package for rural retention | ||
| – Improved staff retention through decentralized education and improved enrolment of students from rural areas | ||
| Emigration of health workers | – Few data on emigration of health workers | – Establishment of migration database – leading to several studies on health-worker migration |
| – Lack of policy attention despite increasing levels of emigration | – Establishment of national Migration Studies Centre | |
| – Emigration issues raised in the political agenda – the problem being discussed by the Federal Cabinet to support a national policy on the subject | ||
| – Movement to sign bilateral agreements with three destination countries – Ireland, Libya and Saudi Arabia – initiated |
CPD, continuing professional development; HRH, human resources for health; MOH, Ministry of Health; PHC, primary health care.
a The situation in 2005 applies to the Sudan before the secession of what is now South Sudan.
b Six years after the establishment of a national observatory and the introduction of the country coordination and facilitation process in the Sudan.