Conclusions of a Policy Forum article in PLoS Medicine have shown that an analytical framework, called "house model", which focuses equally on health workers deployment, production and retention could assist in strengthening and developing health systems in post-conflict countries, including Afghanistan, Cambodia and the Democratic Republic of Congo.
The study authors, Noriko Fujita, Mari Nagai, and Hidechika Akashi from the National Center for Global Health and Medicine in Tokyo, Japan and Anthony Zwi from the School of Social Science and International Studies at The University of New South Wales in Sydney, Australia question the fact that development partners' and governments' efforts are usually focused on human resource system elements, mainly on educational institutions and in-service training for health workers, whilst neglecting other significant elements together with their essential connections.
According to the authors' description of recruiting and contracting local students for deployment in Afghanistan and Cambodia, it is more effective to use innovations that build on and support link across different elements of the human resource system. They also state that it is difficult to balance the emphasis placed on quantity and quality of human resources without taking other contextual factors into account, which affect the entire health system, such as health sector reforms and education in Cambodia.
They highlight that National Health Ministries and related ministries usually only have limited capacity whilst external agencies procure substantial resources alongside their own agendas. However as seen with the Human Resource Task Force in Afghanistan and the engagement of national stakeholders in DR Congo, coordination strategies that involve all players are vital to reconstruct, develop and monitor the human resource system.
The authors conclude:
"A meaningful, comprehensive, and visual framework that is easy to understand and identifies key components of the human resources system is of value. While the 'house model' contains elements similar to the World Health Organization [Human Resources for Health] Action Framework, some functions are extracted in order to draw more attention to them. Issues such as the legal and regulatory framework, coordination, and monitoring are often neglected. We also place particular emphasis on the linkages among elements by highlighting some core functions of human resource management (production deployment-retention), or by separating the foundation components (policy and planning, finances, legal) as primarily the responsibility of the government."
Written by Petra Rattue