PHA-Exch> WHO: 10 Facts on Health Workforce Crisis

[Claudio Schuftan]

From: Vern Weitzel <vern.weitzel at gmail.com>
crossposted from: "[health-vn discussion group]" health-vn at cairo.anu.edu.au


http://www.who.int/features/factfiles/health_workforce/en/index.html

The World Health Organization has issued a list of 10 facts on the global
health workforce, to coincide with the First Global Forum on Human
Resources for Health, held earlier this month in Kampala.

Here are the 10 Facts:

Fact 1 - Health workers work
Health workers are people whose main activities enhance health. They
include health care providers and people who manage and support delivery
systems. Worldwide, there are 59.8 million health workers. Without them,
prevention and treatment of disease and advances in health care would not
reach those in need.

Fact 2 - Shortage of health workers
In 2006, WHO stated that a country with less than 2.3 doctors, nurses and
midwives per 100 000 people is undergoing a critical health worker
shortage. This is the case in 57 countries (36 of which are in sub-Saharan
Africa).

Fact 3 - One million health workers missing in Africa
The global health worker shortfall is over 4.2 million, with 1 million
health workers needed for Africa alone.

Fact 4 - Sub-Saharan Africa has 25% of the global disease burden
Sub-Saharan Africa faces the greatest challenges. It has 11% of the
world's population and carries 25% of the global disease burden. Yet the
region has only 3% of the global health workforce and accounts for less
than 1% of health expenditures worldwide.

Fact 5 - Americas have 10% of the global disease burden
In comparison, North America and South America, which together have 14% of
the world's population but only 10% of the global disease burden, employ
37% of the global health workforce and are responsible for over 50% of the
global health expenditure.

Fact 6 - Pandemics
Many factors have led to the health workforce crisis, including growing
economic disparities between countries and upsurges in new and old
pandemics. Such pandemics pose special challenges to workers; for example,
HIV/AIDS is a 'triple threat' to health workers, causing far bigger
workloads, psychological stress, and the daily risk of HIV infection.

Fact 7 - Innovative trainings
Training a nurse takes at least three years; training a doctor can take
more than six. If action to expand the health workforce is taken now,
effects will only begin to be felt years later. Innovative methods
(distance learning, task shifting or community health worker programmes)
can shorten this delay effect, but there is no "quick fix" to this
problem.

Fact 8 - Migration
Health worker migration is increasing due to disparities in working
conditions, wages and career opportunities. One in four doctors and one in
20 nurses trained in Africa later migrate to work in more developed
countries. In Africa and some Asian countries, a public sector physician's
monthly wage can be less than US$ 100; in higher resource countries,
monthly salaries can exceed US$ 14 000.

Fact 9 - Funding
WHO estimates that a rapid health workforce scale-up by 2015 would cost
US$ 447 million on average per country per year. WHO advocates for 25% of
the US$ 12 billion (2004 figure) devoted to international health aid to be
spent on the health workforce.

Fact 10 - Global Health Workforce Alliance
The health workforce issue crosses many sectors - no single entity can
successfully address it on its own. The Global Health Workforce Alliance
has brought together a coalition of health leaders, civil society and
workers to explore solutions to this crisis at the first Global Forum on
Human Resources for Health in Kampala, Uganda in March 2008.

***

In my view, these 10 facts concisely describe the shortfall and
maldistribution of health workers. But they fail to address the needs of
the *existing* health workforce. I would therefore like to propose the
addition of an 11th fact - arguably the most important of all, and indeed
fundamental to the numerical crisis described above:

Fact 11 - The needs of existing health workers have for too long been
ignored. Health workers have a range of basic needs that must be met in
order to be enabled to deliver safe, effective care. These needs include
Skills, Equipment, Information, Structural support, Medicines, Incentives
and Communication facilities. These needs are being largely ignored, and
efforts to meet them have a weak evidence base and are uncoordinated. A
SEISMIC shift is required by governments and the international community
to better understand and meet the needs of health workers, especially
those in the 57 crisis countries.

 Neil Pakenham-Walsh is coordinator of the Global
Healthcare Information Network,
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