Ciência & Saúde Coletiva
Print version ISSN 1413-8123
ARROYO, Juan. Unbalanced human resources systems in health: the Peruvian case, 1990-2005. Ciênc. saúde coletiva [online]. 2006, vol.11, n.4, pp. 1063-1072. ISSN 1413-8123. http://dx.doi.org/10.1590/S1413-81232006000400027.
This article concludes that today Peru is an example for an unbalanced policy of human resources in health for having lived a long cycle of decline that began in the 90s. This led to a situation characterized by an unbalance between offer and demand of human resources in health, the non-governability of health training and a trade-off between performance and unstable wages and labor conditions for the health personnel. Five key-points are analyzed: a) the dissociation between health work and health education; b) the increase of the productivity of health services based on a higher performance of the health personnel; c) the change of the labor regime from the system of appointments to the system of contracts and the pauperization and insecurity of the health personnel and the status of the health professional; d) the "revolution of the health staff's capacities" claiming for post-degree training, continued education and management; and e) the replacement of governance and governability by self-regulation in a context lacking a point of equilibrium allowing for corrections in the system. We suggest that the human resources policies in health adopted in Peru and many other Latin-American countries were trying to develop competences and performance without promoting the development of human resources in the health area.
Keywords : Human resources in health; Health training; Governability; Health systems; Health reforms.