This presentation was given at the First Forum on Human Resources for Health in Kampala. It presents five questions on the financial concerns of scaling up the number of health workers to provide adequate health care.
Human Resources
Financing Human Resources for Health: Five Questions for the International Community
Soucat A: World Bank; Global Health Workforce Alliance
First Global Forum on Human Resources for Health
First Global Forum on Human Resources for Health, 2-7 March 2008, Kampala, Uganda
The first Global Forum on Human Resources for Health held in Kampala, Uganda from 2-7 March, 2008 called for immediate and sustained action to resolve the critical shortage of health workers around the world. Attendees at the Forum endorsed the Kampala Declaration and the Agenda for Global Action. This high profile event was attended by nearly 1500 participants, including donors, experts and ministers of health, education and finance.
Focus on Human Resources for Health in Africa
Progress towards the Millennium Development Goals (MDGs) in sub-Saharan Africa is slow. There is a growing consensus that human resources are a vital part of improving African health systems and making progress towards the MDGs. Reasons for human resource problems in African health systems are complex. Moreover, they vary greatly between and within countries. This means that solutions will be complex and are dependent on the political, economic, historic and social context of each country. Of particular concern are issues such as capacity and training of health workers, migration of skilled workers out of the region, the impact of HIV and AIDS, as well as the need for massive scale-up of ART
(anti-retroviral therapy) services.
Focus on human resources for health in scaling up ART Delivery
Eldis Health Systems Reporter - HIV/AIDS Feature
With a shortage of health care workers and increasing demand to provide ART, existing ART delivery models may not be adequate and many have argued the need to rethink standard delivery models. Researchers and practitioners have argued that we should consider context-specific delivery models that rely much less on medical doctors in situations where they are in short supply. This feature discusess this matter in detail.
For public service or money: understanding geographical imbalances in the health workforce
Serneels P, Lindelow M, Montalvo JG: Health Policy and Planning 22(3): 128-138, May 2007
Geographical imbalances in the health workforce are a consistent feature of nearly all health systems, especially in developing countries. This paper investigates the willingness to work in a rural area among final year nursing and medical students in Ethiopia. Analysing data obtained from contingent valuation questions for final year students from three medical schools and eight nursing schools, we find that there is substantial heterogeneity in the willingness to serve in rural areas.
Free State’s Community Health Workers’ Case Postponed to 29 January 2015
Sangonet pulse: October 14 2014
Over a hundred community health workers (CHW)’s and the members of the Treatment Action Campaign appeared at the Bloemfontein Magistrate’s Court today, regarding their criminal charges following their arrest at a peaceful vigil on 10 July 2014. The 129 community health care worker’s case was postponed to the 29th of January 2015. The South African Police Services (SAPS) arrested the CHW’s in the early hours of the 10th of July, during a peaceful vigil through which they were protesting the crumbling state of the public health system in Free State, their poor conditions of employment, and the 15 June’s autocratic decision of the MEC for Health in the Free State department of Health, Benny Malakoane to effectively terminate their employment without warning. The postponement is meant for the prosecution to provide the CHW’s the evidence against them and for the CHW’s to make representations to the National Director of Public Prosecutions, Mxolisi Nxasana, that the charges should be unconditionally withdrawn.
From staff-mix to skill-mix and beyond: Towards a systemic approach to health workforce management
Dubois C and Singh D: Human Resources for Health 7(87), 19 December 2009
Throughout the world, countries are experiencing shortages of health care workers. Policy-makers and system managers have developed a range of methods and initiatives to optimise the available workforce and achieve the right number and mix of personnel needed to provide high-quality care. The literature review for this study found that such initiatives often focus more on staff types than on staff members' skills and the effective use of those skills. The study describes evidence about the benefits and pitfalls of current approaches to optimisal roles of health workers in health care. It concludes that health care organisations must consider a more systemic approach – one that accounts for factors beyond narrowly defined human resources management practices and includes organisational and institutional conditions.
Future career plans of Malawian medical students: a cross-sectional survey
Mandeville KL, Bartley T and Mipando M: Human Resources for Health 10(29), 13 September 2012
As significant numbers of medical school students continue to emigrate from Malawi upon graduation, the authors of this study explored the postgraduate plans of current medical students to find out why, and to determine the extent to which their decision is influenced by their background. A self-administered questionnaire was distributed to all medical and premedical students on campus over one week and collected by an independent researcher. One hundred and forty-nine students completed the questionnaire out of a student body of 312, a response rate of 48%. When questioned on their plans for after graduation, 49% of students said they planned to stay in Malawi. However, 38.9% were planning to leave Malawi immediately upon graduation. Medical students who completed a 'premedical' foundation year at the medical school were significantly more likely to have immediate plans to stay in Malawi compared to those who completed A-levels, an advanced school-leaving qualification. The authors caution that the government’s plans to substantially upscale medical education may be undermined unless more medical students plan to work in Malawi after graduation.
G8 told to wake up over human resources for health
A message from health workers, NGOs, and governments in Africa, Asia, and Latin America and the Caribbean to Heads of Government and State of the Group of 8 on supporting human resources for health to achieve the Millennium Development Goals
"We are nurses and doctors, pharmacists and laboratory technicians, medical assistants and community health workers. We are non-governmental organizations. We are [members of] government[s]. We are people with HIV/AIDS. Some of us sit in government ministries, some of us work in rural health facilities, and some of us work wherever it is we find people in need. We share in common a deep concern for the health and well-being of the members of our communities and citizens of our countries. Yet despite our best efforts, health systems throughout our lands are in crisis, and millions of people are dying and becoming seriously ill whose lives we could save and whose health we could preserve."
Further details: /newsletter/id/30945
Gaps and Shortages in South Africa’s Health Workforce
Rawat A: Africa Portal: June 2012
In 2006, the World Health Organization (WHO) reported that 57 countries, most of them in Africa and Asia, face a severe health workforce crisis. They estimate that over 2 million health service providers and 1.8 million management support workers are needed to fill the gap (WHO, 2009). Health workers play a critical role in the effective delivery of health services, especially in high disease-burdened countries like South Africa. Constraints in the health workforce have emerged as a key obstacle to scaling-up access to prevention and treatment for the 5.7 million people currently living with HIV/AIDS in South Africa. A recent strategic plan, released in 2012 by the South African government, aims to address the gaps in human resources for health and is expected to mitigate the resource shortage within the next 15 to 25 years. This report analyses the plan and proposes that actors in other health systems, especially those in high HIV-burden, low-resource countries, may be able to learn from the forthcoming experience of implementing the strategy in South Africa.