Health worker performance is a complex and contested concept. The World Health Report defines health worker performance as a composite function of health worker availability, competence, productivity and responsiveness (World Health Organization (WHO), 2006). A well-performing health workforce is thus one that “works in ways that are responsive, fair and efficient to achieve the best health outcomes possible, given the available resources and circumstances” (WHO, 2006, p. 67). This inclusive definition factors in both technical and relational aspects of health worker performance and forms a touchstone for this chapter’s examination of different approaches to performance measurement and evaluation. Nonetheless, this chapter clearly distinguishes health worker performance from the related concept of quality, viewing quality of care as the product of concurrent and synergistic actions to ensure effective, efficient, equitable, patient-centred and timely care (Institute of Medicine, 2001). Health worker performance is thus a critical and necessary – but not sufficient or always dominant – component of overall quality of care
