KNCV Tuberculosis Foundation supports Ministries of Health, TB programs and NGOs to develop and implement policies and plans for a strong health workforce that is competent and qualified to provide quality TB prevention & care services and find and treat all missing persons with TB. The health workforce is an essential building block of a strong health system and fundamental in implementing the End TB strategy successfully.

Health care workers need to perform their job in a safe working environment with access to necessary equipment and tools. Developing and sustaining a competent workforce is the core of Human Resources for Health (HRH) policies and practices and will ensure better health outcomes.

Implementation areas

To develop and maintain a strong workforce, interventions will be needed in four implementation areas.

  • Workforce policy and planning

    will be part of the National Strategic Plan, Global Fund concept notes and project proposals. Workforce (re) planning is a component of plans to introduce new drugs, technologies (GeneXpert) and decentralize DR-TB care.

  • Staff performance

    requires continuous staff capacity building activities through in-service training, mentoring, coaching and supervision including top and middle management. The capacity of TB centers of excellence, (TB) training centers and trainers needs to be developed.

  • Human Resources Management Systems

    (e.g. job descriptions, appraisal systems) are in place to contribute to staff satisfaction, staff retention and better staff performance.

  • Conducive and healthy working environment

    is a must for staff performance and motivation. It includes safety, workload management, incentives and career development. Performance based financing could be explored.

Workforce challenges

Some of the workforce dilemmas and challenges in TB control are:

  • High staff turnover
  • High staff workload
  • Insufficient competencies of staff providing TB care
  • Unavailable medical products and equipment
  • Poor working infrastructure

Guiding principles

Workforce development strategies are included in the National Strategic Plans and aligned with the Ministry of Health workforce policy.

Health care workers are core in providing health care services. They need to be actively involved in decision making on how to provide (TB) care. Their needs for professional performance should be addressed. Health care workers will put the patient in the center of care and treat them as partners in TB treatment. Patient-centered care is an aspect of quality care.

Lifelong learning
Health care workers and health programs will continuously learn from practice through active monitoring and dialogue. This requires an open attitude, at all levels to learn and improve.


To build a competent and sustainable health workforce, a planned approach is needed following the three stages of the project cycle:

  1. Assess and Prioritize: to understand the health workforce challenges in TB control: policy, staff capacity, HRM system and working environment. Define the priorities, set targets and develop the TB Workforce agenda for the coming years.
  2. Implement: develop the operational plan, including the M&E plan, implement and monitor the health workforce development interventions.
  3. Build Evidence: evaluate and optimize the interventions.