There are health workforce imbalances in terms of deficits, shortages or inequitable distribution of workers in all countries (Celletti, et al., 2011; Frenk, et al., 2010). Together with the imperative to deliver more and more effective health services, these imbalances create an urgent need to scale up the number of human resources for health, to adapt the education and training of health providers to the new epidemiological and demographic challenges, and ensure a proper skill mix, and to adopt measures and incentives to make the geographical and organizational distribution of health professionals more equitable (Frenk, et al., 2010). In many countries, this need has to be met in a context of difficult economic circumstances.
The link between education and health systems is close, as the former provides an essential resource to the latter: health professionals. There is consensus that, in most countries, there are insufficient health care providers, and many are deficient in terms of the quality and relevance of their training. New generations of health professionals equipped with appropriate competencies and capable of leading change must be educated and integrated into health systems in a continuous process of adaptation to a new reality in health.
The Lancet Commission has identified a series of reforms of education processes necessary for health systems to effectively answer population needs (Frenk, et al., 2010). These reforms aim at the acquisition of competencies responsive to local needs but connected globally, which include a culture of critical enquiry and the effective use of information technologies. Reforms should also trigger a renewal of professionalism. The ultimate goal is a transformative and interdependent professional educational system for health professionals to provide equity in health. To achieve that goal, it is essential to mobilize leadership within the educational and health systems, to invest more, to develop robust quality control mechanisms and to strengthen global learning.
In the process of building stronger education institutions, policy-makers face key questions such as: How to recruit the right type of students? Which competencies should they equip their graduates with? What profile of educators and trainers and which learning strategies are more appropriate? The Lancet Commission has identified four key policy issues corresponding to these questions: (1) admission; (2) competencies; (3) channels of instruction; and (4) career pathways (Frenk, et al., 2010). Additionally, there is the question of which institutions are best prepared to produce the desired quantity and quality of health professionals.