Human Resources in Health As Indicator of Good Governance – the Case of Republic of Macedonia

The progress towards achievement of Millennium Development Goals and other health goals that countries set to achieve over certain period depends mainly on health systems capacity to provide health services. In that sense, health system performance greatly relies on combination of basic inputs (financial, technical, human, material) and their appropriate management.

Analysis of human resources (HR) for health has been performed as a part of assessment of good governance in public health system, using WHO/CDC instrument for assessment of essential public health functions (EPHF); analysis has been performed on 3 groups of respondents – government officials at central level, officials at local level and representatives of civil society. HR as EPHF#8 has been assessed through set of 5 indicators, with a subset of 11 main questions and 84 sub-questions for measures in the area.

Results show that there are no visible results of the policy for human resources development in RM, if such policy exists at all; all 3 groups of respondents have scored this function as with minimum performance – 0.25 by central level, 0.27 by local level and only 0.18 by civil sector. Despite numerous strategic documents for human resources planning and development, as well as certain changes in curricula for undergraduate and postgraduate medical studies, all respondents think that there is no visible and stable concept for continuous professional development that will solve numerous cadre problems, while at the same time there is complete absence of cultural aspects while creating such policies.  

Recommendations for urgent intervention include improvement and strengthening of the initiated process for capacity building of health professionals to provide quality health services that will take into consideration cultural determinants of health, mainly at local level.