Report by chapter -Overview -Chapter 1: Health workers: a global profile Health workers are people whose job it is to protect and improve the health of their communities. Together these health workers, in all their diversity, make up the global health workforce. This chapter gives an overview of what is known about them. It describes the size and distribution of the workforce, and some of its characteristics, including how much it costs. It shows that there is a substantial shortage of health workers to meet health needs, but that shortages are not universal, even across low income countries. The chapter then considers how much it would cost to scale up training to meet this shortfall and pay health workers subsequently. -Chapter 2: Responding to urgent health needs This chapter identifies some of the most important performance challenges facing health systems and the global health workforce today, examines the ways in which the health workforce is meeting them, and suggests how these responses can be improved. These challenges are, first, to scale up interventions to attain the health-related MDGs; second, to shift successfully to community-based and patient-centred paradigms of care for the treatment of chronic diseases; third, to tackle the problems posed by disasters and outbreaks; and fourth, to preserve health services in conflict and post-conflict states. -Chapter 3: Preparing the health workforce The previous chapter provided an overview of the enormous challenges facing the health workforce. Chapter 3 and the following two chapters deal with many of these challenges, using the framework of strategies to train, sustain and retain the workforce. This chapter is about preparation: getting it right at the beginning; giving the right training to the right people to create an effective workforce for the delivery of health care. It focuses on the entry of health workers into the workforce and on the health training institutions – schools, universities and training colleges – which provide them with the knowledge and competencies for the jobs they will be required to do. -Chapter 4: Making the most of existing health workers A country’s health workforce is made up of health workers who are at many different stages of their working lives; they work in many different organizations and under changing conditions and pressures. Whatever the circumstances, an effective workforce strategy has to focus on three core challenges: improving recruitment, helping the existing workforce to perform better, and slowing the rate at which workers leave the health workforce. This chapter explores the second of these challenges: optimizing the performance of current workers. -Chapter 5: Managing exits from the workforce Each year, substantial numbers of health workers leave the health workforce, either temporarily or permanently. These exits can provoke shortages if workers who leave are not replaced, and such shortages compromise the delivery and quality of health services (1, 2). Chapter 3 discussed the routes new workers take into the workforce; this chapter examines the other end of the spectrum – the various ways in which workers depart active service. It also suggests ways of managing exits in times of worker shortage as well as in times of surplus, in order to optimize the performance of the health workforce. Finally, it reviews and analyses the factors that influence exits and proposes strategies for managing them. -Chapter 6: Formulating national health workforce strategies The ultimate goal of health workforce strategies is a delivery system that can guarantee universal access to health care and social protection to all citizens in every country. There is no global blueprint that describes how to get there – each nation must devise its own plan. Effective workforce strategies must be matched to a country’s unique situation and based on a social consensus. -Chapter 7: Working together, within and across countries There are five broad areas of concern that impel countries to look beyond their borders and work together with others in order to address issues of human resources for health more effectively