Qualified and motivated human resources (HR) are essential for adequate health service provision, but HR shortages have now reached critical levels in many resource-poor settings, especially in rural areas. Strategies improving performance are essential to address shortages of the existing workforce. In this report, performance is considered to be a combination of staff being available (retained and present) and staff being competent, productive and responsive (WHO, 2006). Approaches that are evidence-based will inform policy-makers as to which interventions are successful, under which circumstances, and for what groups of staff (Buchan, 2002), but little has been published on what works and what does not. This report was commissioned by WHO as a follow-up to the World health report 2006: Working together for health, to describe experiences and to provide lessons learnt with respect to interventions to retain staff and improve their productivity, competence and responsiveness. It is primarily written for health policy-makers, planners and managers in resource-poor settings