Abstract
The most common form of support that any international aiding agency can provide to the health sector of a country or nation emerging from prolonged conflict is technical and financial assistance. But where are the boundaries between ‘doing with’ and ‘doing for’? How much technical work can be done by consultants, before national authorities lose ownership? What actions signal that the Ministry of Health (MoH) is, or is not, actively analysing and digesting the output? What decisions can an outsider legitimately make? Are these decisions doomed from the start in the absence of an able and committed national health authority?
This article presents a qualitative description of an early post-conflict policy process in Southern Sudan, which represented an opportunity to test these boundaries. The methodology of provision of technical assistance to MoH in the formulation of a human resource plan is reviewed. Initial objectives are compared with the results accomplished. Shortcomings are discussed and recommendations for technical assistance programmes in similar contexts are provided. WHO advisors supported the MoH in conducting a human resources assessment to lay the grounds for a human resources development plan. The study employed three consultants, 10 data collectors and entailed questionnaires, field visits, interviews and a review of literature. The survey sheds new important evidence on the human resource situation in Southern Sudan, both in qualitative and quantitative terms, and formulated specific recommendations. The formulation of the human resource plan, however, took another direction, apparently unrelated to the findings of the survey. Various factors contributed to the scope and methodology of the survey being inappropriate to the reality of Southern Sudan. The benefit of one-off comprehensive survey is likely to be inconsequential in the presence of systematic capacity gaps, involving unstable and uncertain governance and ambiguous management systems. This case study discloses the limit of a rationalistic approach to policy formulation and planning in the field of human resources for health. An alternative approach that necessitates incremental steps to institutional capacity building is suggested.