From drought to deluge: how information overload saturated absorption capacity in a disrupted health sector

Provision of technical assistance is a common form of support to health sectors emerging from prolonged conflicts. But what actions signal that the Ministry of Health (MoH) is, or is not, actively analysing and digesting the output of this assistance? Where are the boundaries between doing with and doing for? This article presents a qualitative description of an early post-conflict policy process in southern Sudan, which represented an opportunity to test these boundaries. The methodology of provision of technical assistance to the MoH in the formulation of a human resource plan is reviewed. Initial objectives are compared with the results accomplished. Shortcomings are discussed and recommendations for technical assistance programmes in similar contexts are provided. Between October 2005 and May 2006, World Health Organization advisers supported the MoH in conducting a human resources assessment to lay the grounds for a human resources development plan. The study employed three consultants, ten data collectors and entailed questionnaires, field visits, interviews and a review of literature. The survey shed new important evidence on the human resources situation in southern Sudan, both in quantitative and qualitative terms, and formulated specific recommendations. The formulation of the human resources plan, however, took another direction, apparently unrelated to the findings of the survey. Various factors contributed to the scope and methodology of the survey being inappropriate to the reality of southern Sudan. In the presence of systemic capacity gaps, including uncertain governance and precarious management systems, the benefit of one-off comprehensive surveys is likely to be negligible. Inaction is not always rooted in the lack of information, as too often assumed; this case study exposes the limits of a rationalistic approach to policy formulation and planning in the field of human resources for health. An alternative approach that entails incremental steps to institutional capacity building is suggested.