Determining skill mix in the health workforce: Guidelines for managers and health professionals

Abstract

Most health systems are coming under increasing scrutiny with a view to cost containment, often as a direct or indirect result of health sector reform. Health care is labour intensive, and the level and mix of staff deployed is a central element in determining the cost of care and the quality of care. It is important that managers and health professionals in any health care organization strive to identify the most effective mix of staff achievable within available resources and organizational priorities. This report builds on the work already undertaken for WHO in this area, which developed a typology of approaches to skill mix (Buchan, Ball & O’May, 1996; see also Buchan, 1999). It examines the context in which decisions on skill mix are made,drawing from country case studies, and provides practical guidelines for health professionals and managers.