“I like providing support and care to patients,” says Rosa Lara de Forela, the subdirector of nursing at the Pedro de Bethancourt National Hospital in beautiful Antigua, Guatemala.

Until I came here, I thought of “health system strengthening” strictly in clinical, technical terms. But it's more than that.

According to the 2010 Kenya Service Provision Assessment survey, only 46% of Kenyan health facilities have running water year-round.

Many health workers have a dream of offering high-quality services, but no way of doing their work well because they lack basic supplies or training.

In the NY Times, Tulenko discusses the dire economic and social consequences of insourcing and how it threatens the quality of care.

I saw people out of work in the US and health workers being imported from countries that could ill afford to lose them.

“If we want to stop these women and babies dying, we need to invest in skilled care,” declared Flavia Bustreo, assistant director-general of family and community health at the World Health Organization. Bustreo’s declaration came on the heels of the release of the WHO’s State of the World’s Midwifery 2011: Delivering Health, Saving Lives.

Entering a one-room health clinic in Cambodia’s Pursat Province, I saw a heavily pregnant woman suffering on the dirt floor. A midwife was the lone health worker staffing this rural post.

This month’s Health Affairs issue “Lessons from Around the World” highlights some of the most pressing issues in health systems strengthening and human resources for health.

Recently, I presented this Top 10 at the National Physicians Alliance (NPA) Annual Meeting in California.