Over the last ten years, performance management for health sector systems has received increased attention. In many countries privatisation, decentralisation, user involvement and cost containment have changed the structure and the functioning of health delivery dramatically. The role and performance of the workforce in the health sector has often been considered only after reform has taken place, despite the high labour intensity of the sector. Performance management for organisations and individuals can work if we take into account the fragile balance between improving performance and providing decent working conditions. The international community has devised a range of measures to make human resources management and social dialogue a full part of health sector policy and practice.

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