Policy makers face challenges to ensure an appropriate supply and distribution of trained health workers and to manage their performance in delivery of services, especially in countries with low and middle incomes. We aimed to identify all available policy options to address human resources for health in such countries, and to assess the effectiveness of these policy options. Quality health care depends on policies to ensure that health workers who are capable of delivering such care are available in sufficient numbers. Challenges related to human resources for health are particularly acute in countries with low and middle incomes. These challenges include an absolute shortage of qualified staff, especially in sub-Saharan Africa; an inequitable distribution of health workers, with too few in remote rural areas; and staff   absenteeism and poor motivation that are probably caused by low pay, poor supervision and support, and unsatisfactory working conditions. 

Mickey Chopra, Salla Munro  et al ; 2008