The Meghalaya State Health Policy – 2021, envisages a healthcare system that delivers holistic care to its people. The policy also recognizes the importance of ensuring the availability of health care providers in the state as an essential building block to achieve the ambitious objectives set in the policy. It must be acknowledged that the performance of a health system depends largely on the development and management of its human resources. While meeting its own needs, the health system should also cater to the aspirations of its health workforce.

Transparent posting and transfer policy are the key factors that influence the availability and retention of human resources for health within the health system (Henderson and Tulloch 2008, Murthy et al 2012, Singh et al 2012). The absence of a posting and transfer policy, coupled with factors external to the health system like availability of quarters, condition of the roads, limited facilities for supporting children’s education, and geographical inaccessibility greatly influence the retention of existing human resources for health.

Similar to other states, health staff from a regular cadre occupies a significant proportion (76%) of the total health workforce in Meghalaya while the rest is constituted by the staff engaged through National Health Mission on contract basis. Another category of the staff engaged by the State Health Department are under ‘3F’ which is not accounted for in the health workforce data shared by the state during program implementation plans for 2022-24.

The absence of a posting and transfer policy leads to decisions on a discretionary basis. This may lead to further dissatisfaction among the existing human resources who may perceive it as arbitrary and unfair. The above situation calls for a comprehensive review of the existing transfer and posting policy for the Human Resources for Health (HRH) in the state.