PHM-Exch> No Progress towards Universal Health without Health Workers: A Civil Society Commitment

[Claudio Schuftan]

Recife, 12 November 2013, during the 3rd Global Forum
on Human Resources for Health

No Progress towards Universal Health without Health Workers: A Civil
Society Commitment

The health workforce crisis remains a core barrier to achieving the
Millennium Development Goals (MDGs) for health with only 31% and 12%
respectively of 75 Countdown countries likely to attain MDGs 4 and 5.
Despite donor and country commitments at the 1st and 2nd Global Forums on
Human Resources for Health, the global health workers’ shortage persists.
Of the 57 countries identified as falling below the WHO target only 19 have
seen an improvement in their aggregate health worker density. Earlier
commitments to increase domestic resources or external aid, as well as
implementationof the WHO Global Code of Practice on the International
Recruitment of Health Personnel, remain largely unfulfilled.

National and international funds have been channelled to strengthen health
workforce programs, like task shifting and the scaling-up of community
health worker’s programmes. However, too little investment has been
targeted at the recurrent costs of health workforce development, for
instance on salaries, education and social protection measures for health
workers. The inequitable distribution of health workers through increased
mobility and migration within and between countries adversely affects
access to health.

Health workers and a robust health system are essential for universal
health coverage (UHC), and realizing the right to health through universal
health systems.

Therefore at the 3rd Global Forum on Human Resources for Health in Recife,
Brazil, we, the undersigned representatives of civil society organizations
hereby commit to:

We will:

   -

   Help amplify the voices of health workers, especially those at the lower
   levels of care and support their work to influence national and global
   health policies and plans.
   -

   Assist local civil society organizations to ensure their voices are
   heard in global and national health workforce policy discussions.
   -

   Assist in strengthening the capacity of patient groups to advocate for
   equitable and quality services staffed by sufficient, competent and
   equipped health workers at all levels of care.
   -

   Recognise the gender dimensions of the health workforce and champion the
   rights of women health workers.

   Catalyse a strong movement for health workers

   We will:


   -

   Advocate for governments at all levels to institute plans and allocate
   adequate resources for human resources for health (HRH) to ensure that
   every person has access to a trained, supported and equipped health worker.
   -

   Press bilateral and multilateral organizations and civil society actors
   to increase health workforce development efforts and financing, including
   of national training institutions, in alignment with government plans.
   -

   Work with training institutions, professional and regulatory bodies to
   achieve quality in health worker education, including on the social
   determinants, so that every health worker is competent to provide quality
   care and accountable to the populations they serve.

    Strengthen the advocacy of health workers and civil society for
improved infrastructure, support and working conditions

   -

   Support the development of a strong, motivated, public workforce to
   counter some of the ill- effects of an increasingly globalised, inequitable
   and unstable economy and rapidly changing health and demographic patterns.
   -

   Commit our own resources and expertise to assist in converting HRH
   policy and plans into action.

   Ensure accountable HRH systems at national and global levels

We will:

   -

   Work with governments, the Global Health Workforce Alliance, the World
   Health Organization, and other stakeholders to develop mechanisms to
   measure progress towards improved and equitable access to competent health
   workers
   -

   Monitor and report on progress of public HRH commitments made by global
   actors and governments.
   -

   Assist citizens and health workers in developing strategies to enhance
   accountability of national and global actors and challenge inequitable
   policies that impact on HRH development.
   -

   Increase transparency of our programmatic and technical contributions to
   national HRH strategies and attempt to reduce onerous reporting
   requirements placed on countries. We will commit ourselves to supporting a
   strong public sector for health workforce development and be accountable in
   our own funding and technical programs to mitigate the ‘internal brain
   drain’ from the public to the private sector.

   We will hold donors, government and multilateral actors accountable to:


   -

   Ensure that economic governance arrangements and fiscal space enables
   the development of a strong national health workforce as a long-term
   investment in the wellbeing of the people and the economy of a country. The
   return on investment to employ a health worker is many times higher than to
   bail out a bank.
   -

   Provide the leadership, resources and stewardship needed to fulfil
   commitments made to urgently and effectively address the health workforce
   crisis and ensure improved and equitable access for every person to
   competent health services.
   -

   By 2015, develop, finance, and implement HRH action plans, including
   strengthening national training institutions, with concrete targets and
   integrate them into national health plans.
   -

   Ensure that health workers and civil society organizations are active
   partners in the health workforce policies, planning and development.
   -

   Promote equitable access to health care by investing especially in
   health workers at primary and community levels and in community structures
   to facilitate citizens’ voices.
   -

   Improve investment in health workforce development, including salaries
   and social protection, and in national training institutions in order to
   rapidly increase numbers of HRH.
   -

   Assist in development of robust HRH information systems to facilitate
   improved planning and management.
   -

   Respect and implement the Global Code of Practice on the International
   Recruitment of Health Personnel including additional enforceable
   legislation and redistribution mechanisms to compensate for the
   international ‘brain drain’ that exacerbates global health inequalities.

   SIGNATURES:


   -

   Equinet
   -

   European Public Health Alliance EPHA
   -

   Health Poverty Action
   -

   Health Workers for All and All for Health Workers
   -

   Latin-America Association of Social Medicine ALAMES
   -

   Medicus Mundi International Network MMI
   -

   People’s Health Movement PHM
   -

   Public Services International PSI
   -

   The Centre for Health Sciences Training, Research and Development
   CHESTRAD
   -

   Wemos
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