The human resource (HR) problem in the health sector in sub-Saharan Africa (SSA) has reached crisis proportions in many countries. Although the gravity of the problem varies across the region, the situation in some countries is so grave that urgent action is needed. A complex set of factors has contributed to this problem, some exogenous, such as the austere fiscal measures introduced by structural adjustment, which often result in cutbacks in the number of health workers. But endogenous factors are also to blame, including misdirected human resource and training policies, weak institutions, and inappropriate structures.