"In this policy brief, we have described the major drivers of skill-mix initiatives, the types of skill-mix option pursued and the critical contextual facilitators and constraints to the implementation of these pursuits across several countries in the European region - all of which are experiencing a number of challenges to human resources for health, some similar and others country specific. Also, we have highlighted the evidence (or lack thereof) for the costs that can reasonably be expected of some of these decisions and initiatives." (excerpt from authors) This policy brief was written for the WHO European Minissterial Conference on health Systems, 25-27 June 2008, Tallinn, Estonia.