Health manpower-planning without objectives.

Health manpower developments of the past decade have resulted in an absolute increase in the number of health personnel, the expansion of the roles of some traditional categories of personnel, and the introduction of new professional categories. Inherent in these developments has been the acceptance of the principal that the relative and absolute increase in manpower would result in an increased availability of health services. Unfortunately, in the last decade, the correlation between increased numbers and increased services is not a strong one. The failure to link manpower needs to specific service objectives and to identify appropriate rates of substitution among professional types has resulted in a wastage of funds and energies.A framework for future planning must now be developed which (1) defines service priorities, (2) delineates the functions required to deliver those services, and (3) defines appropriate manpower categories with their rates of substitution to perform those functions. Training programs must be coordinated to allow appropriate linkages among categorical types of personnel. The maldistribution of health care service must be viewed as a result of the demographic maldistribution among the health professions as well as the maldistribution of organizational and financial incentives for provision of priority services as well as utilization of priority services.