Human Resources for health policy mapping in Francophone African countries

Objective: To identify all training, recruitment, deployment and retention programmes for healthcare human resources in five Francophone African countries in order to analyse progress in the authorities' efforts to resolve the problems of human resources for health. Methods: Analysis of policy processes was based on the University of Wisconsin logical framework approach to identify and describe programmes detailing missions and objectives, and outcome indicators. Data were derived from document analysis and interviews with key resource persons (N = 69). Results: Four main processes were identified: (1) training policies; (2) recruitment interventions; (3) strategies to improve governance by the creation of professional boards; (4) interventions on financial and non-financial incentive mechanisms. Two main groups of countries can be distinguished. One group presents a coherent succession of strategy integration (Burkina Faso, Mali) focusing on training policies to gradually move towards recruitment policies, deployment and incentive mechanisms. The other group presents a rupture of this political process with a return to training policies (Chad, Cote d'Ivoire) and recruitment and deployment policies (Cote d'Ivoire). Conclusion: This study highlights the absence of structural reforms to improve health care performance to achieve Universal Health Coverage. A lack of policy impact evaluation and evidence-based data was also observed.