Rethinking Human Resources for Health Planning in Labour Markets Disrupted by Conflict-Affected and Fragile Settings; Comment on “Human Resources for Health in Conflict Affected Settings: A Scoping Review of Primary Peer Reviewed Publications 2016–2022”

Articles in Press

Document Type : Commentary

Author

Centre for Global Health and Intersectional Equity Research, University of Essex, Colchester, UK

Abstract

In a world still grappling with exploring the underlying dynamics of challenges confronting human resources for health (HRH), how must the HRH research and planning ensue in conflict-affected settings (CAS)? Onvlee and colleagues undertake a scoping review to respond to this important question, using the World Health Organization’s (WHO’s) Health Labour Market (HLM) framework, to leverage upon available evidence. This commentary appraises the conceptual and methodological contributions of the review, while questioning the suitability of HLM to analyse HRH challenges in disrupted health systems. It argues that CAS-specific HRH planning exacts frameworks and approaches more attuned to political economy, contextual fragility, and structural inequalities, which shape healthcare workers’ vulnerabilities and responses in CAS. The commentary identifies five gap questions for future scholarship, calling for intersectionality-driven, politically informed and context-specific research approaches for HRH evidence, transcending supply and demand framing of HRH, to inform HRH policies in conflict-affected and fragile settings.

Keywords

References

  1. George A, Scott K, Govender V, eds. A health policy and systems research reader on human resources for health. World Health Organization; 2017.
  2. Onvlee O, Kok M, Buchan J, Dieleman M, Hamza M, Herbst CH. Human resources for health in conflict affected settings: a scoping review of primary peer reviewed publications 2016–2022. Int J Health Policy Manag. 2023;12:7306. doi:34172/ijhpm.2023.7306
  3. Sousa A, Scheffler RM, Nyoni J, Boerma T. A comprehensive health labour market framework for universal health coverage. Bull World Health Organ. 2013;91(11):892-894. doi:2471/BLT.13.118927
  4. Bou-Karroum L, El-Harakeh A, Kassamany I, Ismail H, El Arnaout N, Charide R, et al. Health care workers in conflict and post-conflict settings: systematic mapping of the evidence. PLoS One. 2020;15(5):e0233757. doi:1371/journal.pone.0233757
  5. Kapilashrami A, Aziz R. Pandemic preparedness with 20/20 vision: applying an intersectional equity lens to health workforce planning. Int J Health Plann Manage. 2023;38(5):1117-1126. doi:1002/hpm.3677
  6. Bogale B, Scambler S, Mohd Khairuddin AN, Gallagher JE. Health system strengthening in fragile and conflict-affected states: a review of systematic reviews. PLoS One. 2024;19(6):e0305234. doi:1371/journal.pone.0305234
  7. Fujita N, Zwi AB, Nagai M, Akashi H. A comprehensive framework for human resources for health system development in fragile and post-conflict states. PLoS Med. 2011;8(12):e1001146. doi:1371/journal.pmed.1001146
  8. Roome E, Raven J, Martineau T. Human resource management in post-conflict health systems: review of research and knowledge gaps. Confl Health. 2014;8:18. doi:1186/1752-1505-8-18
  9. Witter S, Hamza MM, Alazemi N, Alluhidan M, Alghaith T, Herbst CH. Human resources for health interventions in high- and middle-income countries: findings of an evidence review. Hum Resour Health. 2020;18(1):43. doi:1186/s12960-020-00484-w
  10. Bertone MP, Samai M, Edem-Hotah J, Witter S. A window of opportunity for reform in post-conflict settings? The case of human resources for health policies in Sierra Leone, 2002–2012. Confl Health. 2014;8:11. doi:1186/1752-1505-8-11
  11. Fieno JV, Dambisya YM, George G, Benson K. A political economy analysis of human resources for health (HRH) in Africa. Hum Resour Health. 2016;14(1):44. doi:1186/s12960-016-0137-4
  12. World Health Organization. Health labour market analysis guidebook. Geneva: World Health Organization; 2021.
  13. Aziz R, Kapilashrami A, Majdzadeh R. Mind the ‘inequality’ gap: intersectionality-informed scoping review of inequalities and adverse experiences of health and care workers globally. BMJ Glob Health. 2025;10(8):e016795. doi:1136/bmjgh-2024-016795
  14. Van de Pas R, Kolie D, Delamou A, Van Damme W. Health workforce development and retention in Guinea: a policy analysis post-Ebola. Hum Resour Health. 2019;17(1):63. doi:1186/s12960-019-0400-6
International Journal of Health Policy and Management

Articles in Press, Corrected Proof
Available Online from 08 February 2026

Files

History

  • Received Date: 11 October 2025
  • Revised Date: 07 January 2026
  • Accepted Date: 28 January 2026
  • First Published Date: 08 February 2026
  • Published Date: 08 February 2026

Share

How to cite

Statistics