In order to circumvent the risk that decisions on the expansion about training capacity are taken without adequate consideration of the long-term cost consequences, it is suggested that countries prepare a series of plans with both long-term or prospective timeframes, and short-term or operational timeframes.
The training plan should be consistent with the human resources for health plan, which in turn should be consistent with the health sector plan. This plan should set out health improvement objectives and the strategies by which they would be achieved, including the respective roles of public and private sector actors, and should be compatible with the predicted available resources, both capital and recurrent.
The HRH plan should derive from the health sector plan and provide realistic estimates of the effective demand for different categories of health workers, taking into account employment in both public and private sectors. It should then formulate strategies for matching available supply to anticipated demand, also taking account of attrition from all causes, including emigration and employment outside the health sector. The human resources for health (HRH) plan may well call for expansion in training outputs, which is the starting point for the formulation of a plan for the development of training capacity. This plan would review existing capacity, including the human resources dimension, and make proposals for the quantitative and qualitative improvements necessary to meet the training outputs specified in the HRH plan, within the available resource envelope.