%0 Journal Article
%T Human resources: the Cinderella of health sector reform in Latin America
%A N¨²ria Homedes
%A Antonio Ugalde
%J Human Resources for Health
%D 2005
%I BioMed Central
%R 10.1186/1478-4491-3-1
%X This article is based on fieldwork and a review of the literature. It discusses the reasons that led health workers to oppose reform; the institutional and legal constraints to implementing reform as originally designed; the mismatch between the types of personnel needed for reform and the availability of professionals; the deficiencies of the reform implementation process; and the regulatory weaknesses of the region.The discussion presents workforce strategies that the reforms could have included to achieve the intended goals, and the need to take into account the values and political realities of the countries. The authors suggest that autochthonous solutions are more likely to succeed than solutions imported from the outside.Health reforms that aim at increasing efficiency, quality and users' satisfaction need to take into consideration human resource issues, because the health sector is labor-intensive and the performance of health systems depends on qualified and motivated workers [1-4]. At the same time, the support of the workforce is crucial to ensure successful implementation of reforms.In Latin America, the need to improve the performance of the workforce had been pointed out in many health sector assessments conducted in the 1970s and 1980s by the United States Agency for International Development (USAID), the World Bank (WB), other agencies and independent researchers. (See for Argentina [5-7], for Bolivia [8-10], for Brazil [11], for Chile [7,12], for Colombia [12-14], for Costa Rica [15], for the Dominican Republic [16-18], for Ecuador [19,20], for El Salvador [21], for Guatemala [22,23], for Mexico [12,24-26], for Nicaragua [27], for Panama [28,29], and for Uruguay [7].)From these reports and studies, and notwithstanding the differences among the countries in the region, we can summarize the problems present during the 1970s and 1980s as follows:£¿ The skill mix of health personnel was often inadequate to meet the needs of the communities, and highly q
%U http://www.human-resources-health.com/content/3/1/1