Objective: To describe the methodological steps of developing an integrated reference guide for competences according to the profile of the healthcare professionals concerned. Design: Human resources in healthcare represent a complex issue, which needs conceptual and methodological frameworks and tools to help one understand reality and the limits of one's acts. Setting: This study uses results from four contexts (Belgium/Europe, Democratic Republic of Congo, Rwanda and Senegal) in which integrated reference guides for competences for healthcare professionals have been developed. Method: Priority was given to the writing of curricula (initial training) or of training plans (continuous training) more effective in terms of professionalization and more adequate to populations' needs. Results: Pedagogical approach is presented as some (step-by-step) methodological guidance which will help one to get acquainted with this approach. This analysis questions the whole issue of healthcare training institutions' social responsibility. Conclusion: The products obtained (ie reference guides for competences) are only the visible part of the results of the far more fundamental change process that is the real reinforcement of competences and capacities of healthcare professionals in organizations aiming at better managing their resources, among which are human resources in healthcare. (Contains 4 figures and 4 tables.)