The clearest overall message from across the literature is that designing human resources for health (HRH) initiatives should begin by understanding the needs of a health system or population rather than choosing a specific strategy.
In other words, there are no strategies that are universally effective, only strategies that are more or less appropriate to their context.
One group of experienced researchers note the “difficulty in predicting how effective a strategy will be in a given context” (Rowe et al, 2018b). Another states that “in 2006, the World Health Report observed that a ‘solution is not straightforward, and there is no consensus on how to proceed.’ This observation remains true in 2020” (Kerry et al., 2020, p.1).
The appetite for evidence-based solutions to the health workforce crisis in low-and-middle-income-countries (LMICs) has driven a large research effort to compare different strategies across multiple contexts. The most comprehensive to date, the Health Care Provider Performance Review (HCPPR), offers some findings, but the authors themselves are tentative in their recommendations given the methodological complexity of the research task.