A workshop on enhancing the global workforce for vaccine manufacturing was organised by the World Health Organisation from the 30 November to 2 December 2011, in Cape Town, South Africa. This workshop was attended by representatives from academia, pharmaceutical industries, research institutions, non-governmental organisations and regulatory agencies. A recurring theme during the discussions was the notion that international support for establishing or strengthening vaccine production capacity in developing and emerging economy countries must also include appropriate efforts to train and retain a skilled local workforce. A highly skilled workforce will support long term sustainability and viability of the operations of developing country vaccine manufacturers. Due to the synergies/similarities between the vaccine production workforce and the workforce producing other biological drugs, participants at the workshop argued that the two labour forces could complement each other during times of critical need. The management model of the biological drug manufacturing workforce could also serve as a benchmark for training, recruitment and retention policies.
Human Resources
The Southern African Network of Nurses and Midwives (SANNAM) met in Johannesburg, South Africa, from 2–4 December 2010, and made a number of resolutions for 2011. SANNAM called on the World Health Organization (WHO) and the Southern African Development Community to recognise the network as a partner in monitoring the implementation of WHO’s Global Code of Practice for recruiting health workers, and resolved to maintain a database on information on health worker migration in the southern African region. To help countries in the region to reach their child and maternal health Millennium Development Goal targets, SANNAM will lobby for midwifery to be declared a specialisation after midwives have completed their basic training, as well as lobby for nursing regulatory bodies in countries that don’t have them and help to implement these bodies. SANNAM will also develop a position statement that seeks to remove bureaucratic obstacles to free movement of nurses wishing to work in different countries in the region.
The shortage of health workers with the right expertise and experience has reached crisis levels in many developing countries. The human resources (HR) crisis in the health sectors of many developing countries is now firmly on the international policy agenda. The work of the Joint Learning Initiative (JLI) and the High Level Forum on Health has described the magnitude of the HR challenge, identified the key contributory factors, and defined some of the potential solutions.
* Relating Link
The Joint Learning Initiative Report: overcoming the crisis
http://www.id21.org/health/InsightsHealth7art6.html
Health worker migration from resource-poor countries to developed countries, also known as ‘brain drain’, represents a serious global health crisis and a significant barrier to achieving global health equity. Resource-poor countries are unable to recruit and retain health workers for domestic health systems, resulting in inadequate health infrastructure and millions of dollars in healthcare investment losses. Using acceptable methods of policy analysis, the authors first assess current strategies aimed at alleviating brain drain and then propose our own global health policy based solution to address current policy limitations. Although governments and private organizations have tried to address this policy challenge, brain drain continues to destabilise public health systems and their populations globally. Most importantly, lack of adequate financing and binding governance solutions continue to fail to prevent health worker brain drain. In response to these challenges, the establishment of a Global Health Resource Fund in conjunction with an international framework for health worker migration could create global governance for stable funding mechanisms encourage equitable migration pathways, and provide data collection that is desperately needed.
For this study, researchers analysed health worker policies in developing countries to assess current strategies aimed at alleviating the ‘brain drain’ of medical professionals from these countries. Although governments and private organisations have tried to address this policy challenge, the researchers found that brain drain continues to destabilise public health systems and their populations globally. Most importantly, lack of adequate financing and binding governance solutions continue to fail to prevent health worker brain drain. In response to these challenges, the establishment of a Global Health Resource Fund in conjunction with an international framework for health worker migration could create global governance for stable funding mechanisms encourage equitable migration pathways, and provide data collection that is desperately needed.
The Zimbabwe Association of Doctors for Human Rights (ZADHR) statement on World Health Day recognized that realization of the highest attainable standard of physical and mental health remains a daily struggle for all health workers in Zimbabwe. The Zimbabwean health delivery sector is presently in a severe state with a massive exodus of qualified health workers, resulting from many factors, amongst them poor remuneration and lack of basic medical equipment necessary for health workers to satisfactorily carry out their work.
In this brief, Capacity Plus notes that people living in rural areas have less access to health workers, and fail to receive vital preventive, curative, and life-saving services. The problem is especially acute in countries with predominately rural populations. Investment in the development of doctors and nurses is wasted if countries cannot place or keep them in the areas where they are most needed, Capacity Plus argues, nor can they achieve their Millennium Development Goals. A number of recommendations are made. Departments of health should aim to understand and test the factors and incentives that influence health workers’ decisions to accept and remain in rural posts, and develop tailored retention schemes. They should prioritise rural retention schemes and strategies in national health workforce plans, involve professional medical and nursing associations in retention advocacy, strengthen and streamline human resources management (HRM) systems that can affect retention, and address gender discrimination in HRM and gender-based violence in health facilities. Furthermore, they should recruit primary health workers from their own communities and from rural backgrounds, locate health professional schools in rural regions and subsidise health worker education in return for service in rural areas.
The shortage of formal health workers has led to the utilisation of Community-Based Health Volunteers to provide health care services to people especially in rural and neglected communities. This study explored factors affecting retention and sustainability of community-based health volunteers’ activities in a rural setting in Northern Ghana, through a qualitative study with thirty-two in-depth interviews with health volunteers and health workers overseeing their activities. Study participants reported that the desire to help community members, prestige and recognition as doctors in the community were key motivations for the health volunteers. Lack of incentives and logistical supplies such as raincoats, torch lights, wellington boots and transportation in the form of bicycles to facilitate the movement of health volunteers affected their work and discouraged them. Most of the dropout volunteers said lack of support and respect from community members made them to stop working as health volunteers. They recommended that community support, incentives and logistical supplies such as raincoats, torch light, wellington boots and bicycles can help retain community-based health volunteers and also sustain their activities at community level.
The number of health workers employed is an indicator of a country’s ability to meet the health care needs of its people, specially the poorest and most vulnerable. Resource-constrained countries committed to the Millennium Development Goals are facing up to the reality that shortages and uneven distribution of health workers threaten their capacity to tackle the HIV/AIDS pandemic, as well as the resurgence of tuberculosis and malaria. Worker shortages are linked to three factors: 1) decreasing student enrollment in health training institutions, 2) delays or freezes in the hiring of qualified professionals and 3) high turnover among those already employed.
The shortage of health staff in developing countries has led to renewed interest in community-based health care workers. However, poor populations are increasingly accessing health services from a wide variety of providers operating as private or semi-private agents in unregulated markets. Community health workers with little formal training do have a future. However, they will need to adapt to an environment where they must compete with other providers and prove their competence. They need to establish legitimacy and trust, and this is more likely in larger community development programmes with regular monitoring. They also need a livelihood that can be sustained.