country has always been a concern for Ministry of Health officials, the issue emerged as a public problem in 2000 after the establishment of the Millennium Development Goals (MDGs), notably in relation to Goal 5 on the reduction of maternal mortality. It became evident that this goal could not be attained without qualified personnel in remote areas, as one of the lead officials at the time confided:

"*Practically all the midwives were in the city; yet we need midwives outside of the city to reduce maternal mortality if we hope to achieve MDG 5. From that moment on*, *we decided to recruit midwives for the regions"* (decision maker)

The idea to regionalize the recruitment of health personnel emerged in the Ministry of Health at the Secretary General office based onthe regions. We started to recruit already-trained personnel*." (decision maker)

Formulation of the regionalization of recruitment policy
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The option of regionalized recruitment came about after several meetings in 2001. However, the process remained limited only to central Ministry of Health officials. Neither the regional and district officials, nor the organizations representing health personnel were involved in the formulation process.

The Ministry of Health conducts the regionalized recruitement by a statement which clearly states by region, the number of positions available. This statement specifies that the regionalized staff is recruited to serve only in the area chosen by the candidates. But there is no policy document that specifies the content of this policy, recruitment conditions, departure arrangements in the region, and the career plan for this staff.

The key informants interviewed unanimously acknowledged