A new study to be published in the Lancet has, for the first time, quantified the dangerous scarcity of healthcare workers in countries with climbing rates of HIV, tuberculosis and malaria. The report, 'Human Resources for Health: Overcoming the Crisis', says health workers from developing countries are lured by better salaries and safer working conditions in urban areas or richer countries, creating the so-called "brain-drain".
Human Resources
Health worker scarcity in AIDS-ridden countries highlighted
Public sector reform and demand for human resources for health
This article from the journal Human Resources for Health considers some of the effects of health sector reform on human resources for health (HRH) in developing countries and countries in transition by examining the effect of fiscal reform and the introduction of decentralisation and market mechanisms to the health sector. The introduction of market mechanisms often involves the formation of an internal market within the health sector and market testing of different functions with the private sector. This has immediate implications for the employment of health workers in the public sector, because the public sector may reduce its workforce if services are purchased from other sectors or may introduce more short-term and temporary employment contracts.
Bridging the human resources gap
London School of Hygiene and Tropical Medicine, London, UK
Human resources are the crucial core of a health system, but they have been a neglected component of health-system development. The demands on health systems have escalated in low income countries, in the form of the Millennium Development Goals and new targets for more access to HIV/AIDS treatment. Human resources are in very short supply in health systems in low and middle income countries compared with high income countries or with the skill requirements of a minimum package of health interventions. Equally serious concerns exist about the quality and productivity of the health workforce in low income countries.
South Africa: A health system under pressure
As South Africa rolls out its national treatment programme, the country continues to lose skilled healthcare professionals to wealthier nations abroad, leaving severe shortages in an already over-stretched public health system. On a Tuesday morning earlier this month at Johannesburg General Hospital's medical wards, an exhausted-looking Dr Candace Latilla was about to go off duty. But, as the only doctor on call that night, she would be back in a couple of hours. Latilla has been working at the hospital as an intern doctor for the past nine months. With a staff component of 470 doctors and 1,300 nurses, Johannesburg General handles more than 1.5 million patient visits a year.
Doctors and nurses with HIV and AIDS in sub-Saharan Africa
Much has been written about the impact of the HIV and AIDS pandemic on the healthcare delivery systems and resources in central and southern Africa. The unremitting pressure on hospitals and other healthcare facilities, and the disproportionate use of healthcare resources by the ever increasing numbers of patients, are threatening to undermine the capacity of countries such as South Africa to provide a comprehensive health safety net for the rest of the population, says an article in the British Medical Journal.
Health professionals and migration
Migrant health workers are faced with a set of options that are a combination of economic, social and psychological factors and family choices. They trade decisions related to their career opportunities - and to financial security for their families - against the psychological and social costs of leaving their country, family and friends. The comments of health workers themselves reflect the "push and pull" nature of the choices underpinning these "journeys of hope". Demotivating working conditions, coupled with low salaries, are set against the likelihood of prosperity for themselves and their families (by remittances), work in well-equipped hospitals, and the opportunity for professional development. An article in the WHO Bulletin points out that young, well-educated individuals are most likely to migrate, especially in pursuit of higher education.
Imbalance in the health workforce
Imbalance in the health workforce is a major concern in both developed and developing countries. It is a complex issue that encompasses a wide range of possible situations. This paper aims to contribute not only to a better understanding of the issues related to imbalance through a critical review of its definition and nature, but also to the development of an analytical framework. The framework emphasizes the number and types of factors affecting health workforce imbalances, and facilitates the development of policy tools and their assessment.
Nursing crisis cripples Malawi
Malawi is facing a health crisis as trained nurses leave to seek better wages abroad. More than half come to Britain to work for the NHS and private hospitals. Last year over 12,000 nurses from outside the European Union registered to work in the UK. In contrast Malawi, one of the world's poorest countries, trains around 60 nurses each year.
Poor countries need to tackle the health brain drain
With the United Kingdom needing 10 000 more doctors, and with more than 7000 nurses from the Philippines alone currently registered in the United Kingdom, compared with just 52 in 1999, a new report says that the countries providing the workers, as well as those that hire them, need to look for solutions. The report says that many African doctors also migrate within the continent, mostly to southern African states where salaries are often higher: for instance, $1242 a month in South Africa, compared with $50 in Sierra Leone.
strategic approaches to health care migration management
Medical practitioners and nurses represent a small proportion of the highly skilled workers who migrate, but the loss for developing countries of human resources in the health sector may mean that the capacity of the health system to deliver health care equitably is significantly compromised. It is unlikely that migration will stop given the advances in global communications and the development of global labour markets in some fields, which now include nursing. The aim of this paper is to examine some key issues related to the international migration of health workers and to discuss strategic approaches to managing migration.