{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T22:53:08Z","timestamp":1767826388842,"version":"3.49.0"},"reference-count":58,"publisher":"Springer Science and Business Media LLC","issue":"1","funder":[{"DOI":"10.13039\/501100005635","name":"Funda\u00e7\u00e3o Calouste Gulbenkian","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005635","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Hum Resour Health"],"published-print":{"date-parts":[[2017,12]]},"DOI":"10.1186\/s12960-017-0189-0","type":"journal-article","created":{"date-parts":[[2017,2,7]],"date-time":"2017-02-07T15:11:11Z","timestamp":1486480271000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Can we halt health workforce deterioration in failed states? Insights from Guinea-Bissau on the nature, persistence and evolution of its HRH crisis"],"prefix":"10.1186","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2716-369X","authenticated-orcid":false,"given":"Giuliano","family":"Russo","sequence":"first","affiliation":[]},{"given":"Enrico","family":"Pavignani","sequence":"additional","affiliation":[]},{"given":"Catia S\u00e1","family":"Guerreiro","sequence":"additional","affiliation":[]},{"given":"Clotilde","family":"Neves","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2017,2,7]]},"reference":[{"key":"189_CR1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1478-4491-1-1","volume":"1","author":"G Dussault","year":"2003","unstructured":"Dussault G, Dubois C-A. Human resources for health policies: a critical component in health policies. Hum Resour Health. 2003;1:1.","journal-title":"Hum Resour Health"},{"issue":"9449","key":"189_CR2","doi-asserted-by":"crossref","first-page":"1984","DOI":"10.1016\/S0140-6736(04)17482-5","volume":"364","author":"L Chen","year":"2004","unstructured":"Chen L, Evans T, Anand S, Boufford JI, Brown H, Chowdhury M, et al. Human resources for health: overcoming the crisis. Lancet. 2004;364(9449):1984\u201390.","journal-title":"Lancet"},{"key":"189_CR3","unstructured":"Pavignani E. Beyond the aid horizon: charting poorly understood health territories. University of Queensland and DANIDA; 2014. (Findings from a multi-country research programme on health service delivery in severely-disrupted countries)."},{"key":"189_CR4","volume-title":"Analysing disrupted health sectors. A modular manual","author":"E Pavignani","year":"2009","unstructured":"Pavignani E, Colombo S. Analysing disrupted health sectors. A modular manual. Geneva: WHO - Department of recovery and Transition Programmes; 2009 (Health Action in Crisis)."},{"issue":"12","key":"189_CR5","doi-asserted-by":"crossref","first-page":"e1001146","DOI":"10.1371\/journal.pmed.1001146","volume":"8","author":"N Fujita","year":"2011","unstructured":"Fujita N, Zwi AB, Nagai M, Akashi H. A comprehensive framework for human resources for health system development in fragile and post-conflict states. PLoS Med. 2011;8(12):e1001146.","journal-title":"PLoS Med"},{"key":"189_CR6","unstructured":"WHO. Guide to health workforce development in post-conflict environments [Internet]. WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland; 2005 [cited 2016 Apr 21]. Available from: http:\/\/www.who.int\/hac\/techguidance\/tools\/guide%20to%20health%20workforce%20development.pdf"},{"key":"189_CR7","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/1752-1505-8-18","volume":"8","author":"E Roome","year":"2014","unstructured":"Roome E, Raven J, Martineau T. Human resource management in post-conflict health systems: review of research and knowledge gaps. Confl Health. 2014;8:18.","journal-title":"Confl Health"},{"key":"189_CR8","doi-asserted-by":"crossref","unstructured":"Witter S, Wurie H, Bertone MP. The free health care initiative: how has it affected health workers in Sierra Leone? Health Policy Plan. 2015;31(1):1\u20139.","DOI":"10.1093\/heapol\/czv006"},{"key":"189_CR9","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/1752-1505-8-11","volume":"8","author":"MP Bertone","year":"2014","unstructured":"Bertone MP, Samai M, Edem-Hotah J, Witter S. A window of opportunity for reform in post-conflict settings? The case of Human Resources for Health policies in Sierra Leone, 2002\u20132012. Confl Health. 2014;8:11.","journal-title":"Confl Health"},{"key":"189_CR10","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.socscimed.2015.07.028","volume":"141","author":"MP Bertone","year":"2015","unstructured":"Bertone MP, Witter S. An exploration of the political economy dynamics shaping health worker incentives in three districts in Sierra Leone. Soc Sci Med. 2015;141:56\u201363.","journal-title":"Soc Sci Med"},{"key":"189_CR11","doi-asserted-by":"crossref","unstructured":"Witter S, Falisse J-B, Bertone MP, Alonso-Garbayo A, Martins JS, Salehi AS, et al. State-building and human resources for health in fragile and conflict-affected states: exploring the linkages. Hum Resour Health [Internet]. 2015 May 15 [cited 2016 Jan 21];13. Available from: http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4488955\/","DOI":"10.1186\/s12960-015-0023-5"},{"key":"189_CR12","doi-asserted-by":"crossref","unstructured":"Bertone MP, Lagarde M. Sources, determinants and utilization of health workers\u2019 revenues: evidence from Sierra Leone. Health Policy Plan. 2016;31(8):1010\u20131019.","DOI":"10.1093\/heapol\/czw031"},{"key":"189_CR13","doi-asserted-by":"crossref","unstructured":"Bertone MP, Lurton G, Mutombo PB. Investigating the remuneration of health workers in the DR Congo: implications for the health workforce and the health system in a fragile setting. Health Policy Plan. 2016;31(9):1143\u20131151.","DOI":"10.1093\/heapol\/czv131"},{"key":"189_CR14","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/1752-1505-8-20","volume":"8","author":"PS Hill","year":"2014","unstructured":"Hill PS, Pavignani E, Michael M, Murru M, Beesley ME. The \u201cempty void\u201d is a crowded space: health service provision at the margins of fragile and conflict affected states. Confl Health. 2014;8:20.","journal-title":"Confl Health"},{"key":"189_CR15","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/1478-4505-10-5","volume":"10","author":"MO Kok","year":"2012","unstructured":"Kok MO, Rodrigues A, Silva AP, de Haan S. The emergence and current performance of a health research system: lessons from Guinea Bissau. Health Res Policy Syst BioMed Cent. 2012;10:5.","journal-title":"Health Res Policy Syst BioMed Cent"},{"issue":"3","key":"189_CR16","first-page":"443","volume":"44","author":"D Fistein","year":"2011","unstructured":"Fistein D. Guinea-Bissau: how a successful social revolution can become an obstacle to subsequent state-building. Int J Afr Hist Stud. 2011;44(3):443\u201355.","journal-title":"Int J Afr Hist Stud"},{"key":"189_CR17","unstructured":"Anderson L. Antiquated before they can ossify: states that fail before they form. J Int Aff [Internet]. 2004 [cited 2016 May 17];58(1). Available from: http:\/\/www.columbia.edu\/itc\/journalism\/stille\/Politics%20Fall%202007\/Readings%20--%20Weeks%201-5\/LEH57JE3248.pdf"},{"issue":"3","key":"189_CR18","first-page":"145","volume":"20","author":"M Barros de","year":"2013","unstructured":"de Barros M, Gomes PG, Correia D. Les cons\u00e9quences du narcotrafic sur un \u00c9tat fragile : le cas de la Guin\u00e9e-Bissau. Altern Sud. 2013;20(3):145.","journal-title":"Altern Sud"},{"issue":"2","key":"189_CR19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/15423166.2014.950118","volume":"9","author":"AE Abdenur","year":"2014","unstructured":"Abdenur AE, Neto DMDS. Rising powers and the security-development nexus: Brazil\u2019s engagement with Guinea-Bissau. J Peacebuilding Dev. 2014;9(2):1\u201316.","journal-title":"J Peacebuilding Dev"},{"key":"189_CR20","unstructured":"The World Bank. Guinea Bissau country overview [Internet]. 2015 [cited 2016 Feb 17]. Available from: http:\/\/www.worldbank.org\/en\/country\/guineabissau\/overview"},{"key":"189_CR21","unstructured":"UNDP. Human development report. New York: United Nations Development Program; 2013. Report No.: ISBN 978-92-1-126340-4."},{"key":"189_CR22","doi-asserted-by":"crossref","unstructured":"IMF. Guinea-Bissau IMF country report [Internet]. Washington, DC: International Monetary Fund; 2015 [cited 2016 Apr 27]. (Selected Issues). Available from: https:\/\/www.imf.org\/external\/pubs\/ft\/scr\/2015\/cr15195.pdf","DOI":"10.5089\/9781513564456.002"},{"key":"189_CR23","unstructured":"MINEF. Lei do Or\u00e7amento Geral do Estado 2015 [Internet]. Minist\u00e9rio de Economia e Finan\u00e7as; 2015 [cited 2016 Apr 27]. Available from: http:\/\/www.mef-gb.com\/doc\/OGE\/OGE2015.pdf"},{"key":"189_CR24","unstructured":"MINIST\u00c9RIO DA ECONOMIA E FINAN\u00c7AS, DIREC\u00c7\u00c3O GERAL DO PLANO INSTITUTO NACIONAL DE ESTAT\u00cdSTICA (INE). Inqu\u00e9rito aos Indicadores M\u00faltiplos (MICS) 2014, Principais Resultados. Bissau; 2015"},{"key":"189_CR25","unstructured":"Minist\u00e9rio da Sa\u00fade P\u00fablica da Rep\u00fablica da Guin\u00e9-Bissau. Plano Nacional de Desenvolvimento Sanit\u00e1rio I. 1997"},{"key":"189_CR26","unstructured":"MINIST\u00c9RIO DA SA\u00daDE P\u00daBLICA DA GUIN\u00c9-BISSAU. Plano Nacional de Desenvolvimento Sanit\u00e1rio II 2008-2017. 2007"},{"key":"189_CR27","unstructured":"MINIST\u00c9RIO DA ECONOMIA, DO PLANO E DA INTEGRA\u00c7\u00c3O REGIONAL DA REP\u00daBLICA DA GUIN\u00c9-BISSAU. Deuxi\u00e8me Document de Strat\u00e9gie Nationale pour la R\u00e9duction de la Pauvret\u00e9-DENARP II 2011-2015. Bissau; 2011"},{"key":"189_CR28","unstructured":"Ferrinho P. Subs\u00eddios para a revis\u00e3o do Plano Nacional de Desenvolvimento Sanit\u00e1rio 2008-2017 at\u00e9 2020. Lisbon; 2015"},{"issue":"889","key":"189_CR29","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1017\/S1816383113000726","volume":"95","author":"E Pavignani","year":"2013","unstructured":"Pavignani E, Michael M, Murru M, Beesley ME, Hill PS. Making sense of apparent chaos: health-care provision in six country case studies. Int Rev Red Cross. 2013;95(889):41\u201360.","journal-title":"Int Rev Red Cross"},{"issue":"Suppl 1","key":"189_CR30","doi-asserted-by":"crossref","first-page":"i45","DOI":"10.1093\/heapol\/czr025","volume":"26","author":"G Bloom","year":"2011","unstructured":"Bloom G, Standing H, Lucas H, Bhuiya A, Oladepo O, Peters DH. Making health markets work better for poor people: the case of informal providers. Health Policy Plan. 2011;26 Suppl 1:i45\u201352.","journal-title":"Health Policy Plan"},{"issue":"6","key":"189_CR31","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1093\/heapol\/czt071","volume":"29","author":"G Russo","year":"2014","unstructured":"Russo G, McPake B, Fronteira I, Ferrinho P. Negotiating markets for health: an exploration of physicians\u2019 engagement in dual practice in three African capital cities. Health Policy Plan. 2014;29(6):774\u201383.","journal-title":"Health Policy Plan"},{"issue":"6","key":"189_CR32","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1093\/heapol\/czq083","volume":"26","author":"M Beesley","year":"2011","unstructured":"Beesley M, Cometto G, Pavignani E. From drought to deluge: how information overload saturated absorption capacity in a disrupted health sector. Health Policy Plan. 2011;26(6):445\u201352.","journal-title":"Health Policy Plan"},{"issue":"4","key":"189_CR33","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1111\/j.1467-7717.2011.01236.x","volume":"35","author":"E Pavignani","year":"2011","unstructured":"Pavignani E. Human resources for health through conflict and recovery: lessons from African countries. Disasters. 2011;35(4):661\u201379.","journal-title":"Disasters"},{"issue":"6","key":"189_CR34","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","volume":"19","author":"A Tong","year":"2007","unstructured":"Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care J Int Soc Qual Health Care ISQua. 2007;19(6):349\u201357.","journal-title":"Int J Qual Health Care J Int Soc Qual Health Care ISQua"},{"key":"189_CR35","unstructured":"Harrell MC, Bradley MA. Data Collection Methods [Internet]. 2009 [cited 2016 Mar 29]. Available from: http:\/\/www.rand.org\/pubs\/technical_reports\/TR718.html"},{"key":"189_CR36","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s12960-016-0099-6","volume":"14","author":"HR Wurie","year":"2016","unstructured":"Wurie HR, Samai M, Witter S. Retention of health workers in rural Sierra Leone: findings from life histories. Hum Resour Health. 2016;14:3.","journal-title":"Hum Resour Health"},{"issue":"2","key":"189_CR37","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1111\/j.1365-2648.2006.03897.x","volume":"55","author":"J McKeown","year":"2006","unstructured":"McKeown J, Clarke A, Repper J. Life story work in health and social care: systematic literature review. J Adv Nurs. 2006;55(2):237\u201347.","journal-title":"J Adv Nurs"},{"issue":"9692","key":"189_CR38","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1016\/S0140-6736(09)60951-X","volume":"374","author":"H Coovadia","year":"2009","unstructured":"Coovadia H, Jewkes R, Barron P, Sanders D, McIntyre D. The health and health system of South Africa: historical roots of current public health challenges. Lancet. 2009;374(9692):817\u201334.","journal-title":"Lancet"},{"issue":"3","key":"189_CR39","doi-asserted-by":"crossref","first-page":"387","DOI":"10.2190\/EPLN-KN6T-G1JQ-TF8X","volume":"17","author":"J Chabot","year":"1987","unstructured":"Chabot J, Waddington C. Primary health care is not cheap: a case study from Guinea Bissau. Int J Health Serv. 1987;17(3):387\u2013409.","journal-title":"Int J Health Serv"},{"key":"189_CR40","unstructured":"The World Bank. Cost recovery in public health services in sub-Saharan Africa [Internet]. The World Bank; 1995 [cited 2016 Feb 17]. 114 p. (World Bank Institute Resources). Available from: http:\/\/elibrary.worldbank.org\/doi\/abs\/10.1596\/0-8213-3240-6"},{"key":"189_CR41","unstructured":"MINSAP. Plano Nacional de Desenvolvimento Sanit\u00e1rio 1997-2001. Tomo 1 [Internet]. Minist\u00e9rio da Sa\u00fade P\u00fablica, Governo da Guin\u00e9 Bissau; 1996 [cited 2016 Feb 22]. Available from: http:\/\/www.guine-bissau.fi\/saude\/5.2.html#_ftn30"},{"key":"189_CR42","unstructured":"MINSA. Plano Nacional de Desenvolvimento Sanit\u00e1rio 2012-2025. Minist\u00e9rio da Sa\u00fade de Angola; 2014"},{"key":"189_CR43","unstructured":"DNRH. Base de dados dos trabalhadores da fun\u00e7\u00e3o p\u00fablica da sa\u00fade. Minist\u00e9rio da Sa\u00fade P\u00fablica, Governo da Guin\u00e9 Bissau; 2016."},{"key":"189_CR44","volume-title":"Health beyond politics","author":"W Ammar","year":"2009","unstructured":"Ammar W. Health beyond politics. Beirut: Eastern Mediterranean Regional Office and Ministry of Public Health Lebanon; 2009."},{"issue":"Suppl 1","key":"189_CR45","doi-asserted-by":"crossref","first-page":"i30","DOI":"10.1093\/heapol\/czr026","volume":"26","author":"B Meessen","year":"2011","unstructured":"Meessen B, Bigdeli M, Chheng K, Decoster K, Ir P, Men C, et al. Composition of pluralistic health systems: how much can we learn from household surveys? An exploration in Cambodia. Health Policy Plan. 2011;26 Suppl 1:i30\u201344.","journal-title":"Health Policy Plan"},{"issue":"3","key":"189_CR46","doi-asserted-by":"crossref","first-page":"527","DOI":"10.2190\/6X2V-GE4T-9BQF-WYXB","volume":"34","author":"K Sen","year":"2004","unstructured":"Sen K, Mehio-Sibai A. Transnational capital and confessional politics: the paradox of the health care system in Lebanon. Int J Health Serv Plan Adm Eval. 2004;34(3):527\u201351.","journal-title":"Int J Health Serv Plan Adm Eval"},{"key":"189_CR47","unstructured":"Buckley J, Neill E, Aden AM. Assessment of the private health sector in Somaliland, Puntland and South Central. 2015 [cited 2016 Jul 4]; Available from: http:\/\/r4d.dfid.gov.uk\/Output\/202331\/Default.aspx"},{"key":"189_CR48","unstructured":"Indjai B, Catarino L, Mour\u00e3o D. Mezinhos de Orango - Plantas medicinais e pessoas da ilha da Rainha Pampa. Bissau: Instituto da Biodiversidade e das \u00c1reas Protegidas; 2010"},{"key":"189_CR49","unstructured":"MINSAP. Plano Nacional de Desenvolvimento Sanit\u00e1rio 2008-2017 - PNDS II. Minist\u00e9rio da Sa\u00fade P\u00fablica, Governo da Guin\u00e9 Bissau; 2008."},{"issue":"1","key":"189_CR50","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1093\/heapol\/czt091","volume":"30","author":"M Schaaf","year":"2015","unstructured":"Schaaf M, Freedman LP. Unmasking the open secret of posting and transfer practices in the health sector. Health Policy Plan. 2015;30(1):121\u201330.","journal-title":"Health Policy Plan"},{"key":"189_CR51","unstructured":"ENS. N\u00famero de formados da ENS na Direc\u00e7\u00e3o de Dr. Maram Man\u00e9. Minist\u00e9rio da Sa\u00fade P\u00fablica, Governo da Guin\u00e9 Bissau; 2016."},{"issue":"S1","key":"189_CR52","doi-asserted-by":"crossref","first-page":"S29","DOI":"10.1002\/(SICI)1099-1751(199706)12:1+<S29::AID-HPM465>3.3.CO;2-L","volume":"12","author":"R Knippenberg","year":"1997","unstructured":"Knippenberg R, Alihonou E, Soucat A, Oyegbite K, Calivis M, Hopwood I, et al. Implementation of the Bamako Initiative: strategies in Benin and Guinea. Int J Health Plann Manage. 1997;12(S1):S29\u201347.","journal-title":"Int J Health Plann Manage"},{"issue":"11","key":"189_CR53","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1016\/0277-9536(93)90381-D","volume":"36","author":"B McPake","year":"1993","unstructured":"McPake B, Hanson K, Mills A. Community financing of health care in Africa: an evaluation of the Bamako initiative. Soc Sci Med. 1993;36(11):1383\u201395.","journal-title":"Soc Sci Med"},{"key":"189_CR54","doi-asserted-by":"crossref","unstructured":"Karadaghi G, Willott C. Doctors as the governing body of the Kurdish health system: exploring upward and downward accountability among physicians and its influence on the adoption of coping behaviours. Hum Resour Health [Internet]. 2015 Jun 4 [cited 2017 Jan 5];13. Available from: http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4464857\/","DOI":"10.1186\/s12960-015-0039-x"},{"key":"189_CR55","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/1478-4491-8-14","volume":"8","author":"AK Tyrrell","year":"2010","unstructured":"Tyrrell AK, Russo G, Dussault G, Ferrinho P. Costing the scaling-up of human resources for health: lessons from Mozambique and Guinea Bissau. Hum Resour Health. 2010;8:14.","journal-title":"Hum Resour Health"},{"key":"189_CR56","unstructured":"Beesley M. The bottom of the sack: health service provision in the Central African Republic. DANIDA; 2013"},{"key":"189_CR57","doi-asserted-by":"crossref","unstructured":"Pavignani E. Making sense of apparent chaos: health-care provision in six country case studies - ICRC [Internet]. International Review of the Red Cross. 00:00:00.0 [cited 2016 Apr 22]. Available from: https:\/\/www.icrc.org\/eng\/resources\/documents\/article\/review-2013\/irrc-889-pavignani-michael-murru-beesley-hill.htm","DOI":"10.1017\/S1816383113000726"},{"issue":"1","key":"189_CR58","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1002\/hpm.4740060105","volume":"6","author":"M Segall","year":"1991","unstructured":"Segall M. Health sector planning led by management of recurrent expenditure: an agenda for action-research. Int J Health Plann Manage. 1991;6(1):37\u201375.","journal-title":"Int J Health Plann Manage"}],"container-title":["Human Resources for Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12960-017-0189-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T03:53:23Z","timestamp":1692676403000},"score":1,"resource":{"primary":{"URL":"http:\/\/human-resources-health.biomedcentral.com\/articles\/10.1186\/s12960-017-0189-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,2,7]]},"references-count":58,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017,12]]}},"alternative-id":["189"],"URL":"https:\/\/doi.org\/10.1186\/s12960-017-0189-0","relation":{},"ISSN":["1478-4491"],"issn-type":[{"value":"1478-4491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,2,7]]},"article-number":"12"}}