Résumé : The adequacy of programs to their context of application and the reinforcement of professionals' competences are the central questions proposed in this research through the setting up of competency-based approach and active pedagogies. The finality is to evidence the mechanisms, factors and necessary visions for the improvement of the training (initial and on-going) of health professionals and the promotion of a «teaching-learning» approach favourable to the integration of quality criteria for care in public health and principles of action in health promotion. On the other hand, the complexity of the problematic of human health resources is well known. This is why the development of a conceptual frame is proposed in order to understand the field reality and the limit of ones actions. The analysis of the different levels of adequacy, between training, norms and field reality as seen by the health professionals, is being questioned. Health education and training is seen as giving access to innovation, lever for change in the management of human resources for health. The importance of the process and of all the actors concerned by this change is being analysed showing more specifically the necessity for an appropriation right from the beginning of the construction of a frame of references (competence referential) and of its instalment by the trainers and management teams at all institutional levels.