What do we mean by availability, accessibility, acceptability and quality (AAAQ) of the health workforce?

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The current discourse on HRH is evolving from an exclusive focus on availability of health workers – i.e. numbers – towards according equal importance to accessibility, acceptability, quality and performance.

  • Availability – the sufficient supply and appropriate stock of health workers, with the competencies and skill‐mix to match the health needs of the population;
  • Accessibility – the equitable distribution of these health workers taking into account the demographic composition, rural‐urban mix and under‐served areas or populations;
  • Acceptability – health workforce characteristics and ability (e.g. sex, language, culture, age, etc.)to treat all patients with dignity, create trust and promote demand for services;
  • Quality – health workforce competencies, skills, knowledge and behaviour, as assessed according to professional norms and as perceived by users.

Without sufficient availability – accessibility to health workers cannot be guaranteed; if they are available and accessible, without acceptability, the health services might not be used, when the quality of the health workforce is inadequate, improvements in health outcomes will not be satisfactory.

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