From State to market: the Nicaraguan labour market for health personnel

Few countries in Latin America have experienced in such a short period the shift From a socialist government and centrally planned economy to a libera l market economy as Nicaragua. The impact of such a change in the health fi eld has been supported by the quest for reform of the health system and the involvement of external financial agencies aimed at leading the process. H owever, this change has not been reflected in the planning of human resourc es for health. Trends in education reflect the policies of past decades. Th e Ministry of Health is the main employer of health personnel in the countr y, but in recent years its capacity to recruit new personnel has diminished . Currently, various categories of health personnel are looking for new opp ortunities in a changing labour environment where new actors are appearing and claiming an influential role. It may take more than political willingne ss from the government to redefine the new priorities in the field of human resources for health and subsequently turn it into positive action.