Commitment, competencies and skills of people working in the health sector has significant impact on sector performance and its reform process. The current paper is a part of broader multi state studies carried out by the authors in India. The paper attempts to analyse the commitment of state health officials and its implications for human resource practices in Gujarat. The study suggests Gujarat, as compared to other states of India, have achieved significant progress in ensuring commitment of its health officials. However, the state needs to invest progressively and in a proactive manner towards improving the leadership quality, supervision skills and autonomy at workplace to improve and sustain the motivation of its health officials. Improving motivation for the health staffs also involves issues related to infrastructure, involvement, supervision and monitoring, continuous medical education and training, human resource planning, smooth reporting process, administration and audit requirements and prioritisation and synchronisation of health programmes. In order to achieve this, two sets of strategies for reforms are suggested. One relates to short term achievable reforms and other relates to long-term research based actions.