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Human resources challenges in health system reforms: A systematic review

  • Roghayeh Khalilnezhad ,
  • Hassan Abolghasem Gorji ,
  • Mahboubeh Bayat ,


Background: The health system reform in many countries has been focused on the structural changes, cost reduction, market mechanisms and service consumers, and despite the importance of human resource management, these issue have been discussed less or even neglected altogether in HSR reforms. This study seeks to sensitize decision-makers and policymakers to the role of human resource policies in advancing the goals of health system reforms through systematic review of the studies on human resource challenges in implementing health system reforms.

Materials and Methods: This study is a systematic review based on PRISMA. The selected time period for data collection is the interval of 2000-2017. Different database search methods and manual search was used to find the related articles. Results of the manually reviewed articles were analyzed using thematic analysis by two members of the research team and conflicts were referred to the third person.

Results: According to the considered inclusion and exclusion criteria in this study finally 13 Article were selected to determine the human resource challenges in implementing the health system reforms. Selected studies were analyzed in three general themes; context and dynamics of the reform process, Capacities needed to implement the reform and negative impact of Reform on HR.

Conclusion: Achievement of the health goals is completely dependent on provision of the adequate high quality effective human resources in appropriate positions and available in all geographical regions. The lack of clear human resources policies simultaneous and consistent with the goals of health reforms is one of the main reasons for the failure of these reforms to achieve the intended goals. Therefore, determining human resource problems and development of the related HR policies should be the start point for planning any kind of health system reform.



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How to Cite

Khalilnezhad, R., Gorji, H. A., & Bayat, M. (2018). Human resources challenges in health system reforms: A systematic review. Bali Medical Journal, 7(1), 255–261.




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Roghayeh Khalilnezhad
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Hassan Abolghasem Gorji
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Mahboubeh Bayat
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