"The already inadequate health systems of sub-Saharan Africa have been badly damaged by the emigration of their health professionals, a process in which the UK has played a prominent part. In 2005, there are special opportunities for the UK to take the lead in addressing that damage, and in focusing the attention of the G8 on the wider problems of health-professional migration from poor to rich countries. We suggest some practical measures to these ends. These include action the UK could take on its own, with the African countries most affected, and with other developed countries and WHO." (requires registration)
Human Resources
UK demand for overseas health professionals severely affecting sub-Saharan Africa
The Lancet 2005; 365:1893-1900
Health workforce to be the theme of World Health Report 2006
In response to World Health Assembly resolution WHA57.19, the Director-General has declared the health workforce to be the theme of the World health report 2006. And for the first time, WHO is offering open consultation on the World health report via the World Wide Web and electronic mail. Broad participation is encouraged – from schools for the health professions to national and international financing institutions to the ultimate beneficiaries of health services, the general public. Load https://extranet.who.int/datacol/survey.asp?survey_id=153 and log on using the details Username: whr2006, Password: outline. The page that loads will enable you to make a contribution.
HIV/AIDS and the health workforce crisis: What are the next steps?
In scaling up antiretroviral treatment (ART), financing is fast becoming less of a constraint than the human resources to ensure the implementation of the programmes. In the countries hardest affected by the acquired immunodeficiency syndrome (AIDS) pandemic, AIDS increases workloads, professional frustration and burn-out. It affects health workers also directly, contributing to rising sick leave and attrition rates. This burden is shouldered by a health workforce weakened already by chronic deficiencies in training, distribution and retention.
Preparing a Health Care Workforce for the 21st Century
This publication from the WHO calls for the transformation of healthcare workforce training to better meet the needs of caring for patients with chronic conditions, predicated upon the rapid escalation in chronic health problems around the world. To provide effective care for chronic conditions, the skills of health professionals must be expanded to meet these new complexities. The report presents a new, expanded training model, based on a set of core competencies that apply to all members of the workforce. This model has been endorsed by the World Medical Association (WMA), International Council of Nurses (ICN), International Pharmaceutical Federation (FIP), European Respiratory Society (ERS), International Alliance of Patients' Organizations (IAPO) and others.
Public sector reform and demand for human resources for health
This article, from Human Resources for Health, considers the effect of fiscal reform and the introduction of decentralisation and market mechanisms on human resources in the health sector. Findings show that these reforms often result in 'corporatised' institutions, with reductions in the workforce as health services are contracted out, or increased short-term and temporary employment contracts. Increased private sector provision leads health workers to move to the private sector. This often leaves worsening working conditions, lack of employment security and dismantling of collective bargaining agreements for those who remain in the public sector.
South Africa: Overtime contracts and salaries: a personal view
Critical Health Perspectives Update
"The Friday ward round starts, like any other weekday round, at 7:30 and continues till 11:30. It involves a multidisciplinary team of specialists, therapists and nurses. The children are critically ill. We review each patient and plan management for the day. Our tools include mechanical devices and powerful drugs that support vital functions, and antibiotics. Our decisions have life-changing implications. The potential to do harm is enormous, the responsibility overwhelming. The buck stops with me.
After the round, team members implement the decisions, continuously monitoring changes in the patients’ conditions. Meanwhile new admissions arrive: children who have had major operations, critically ill children with medical conditions.
The afternoon round starts routinely at 4:30. On this Friday night it ended after 7 pm. I went home at 8:57 pm after updating my notes and discussing a child’s condition with her family, leaving two registrars to cover the night. Later, during the night I had 6 phone calls from the registrars to discuss patients." The latest issue of Critical Health Perspectives, produced by the People's Health Movement, examines the issue of the overtime contracts and salaries of health workers.
Further details: /newsletter/id/30884
TB control and the health workforce
The performance of health care systems is closely related to the numbers, distribution, knowledge, skills and motivation of its workforce, particularly of those individuals delivering the services, says an article in the journal Human Resources for Health. "Improvements in global health are greatly dependent on how well health systems can meet the demands placed on them by governments, programmes, communities and ultimately individuals. Human resources for health (HRH)... constitute a sine qua non of health systems. Therefore, developing HRH and fostering appropriate HR management are crucial steps towards achieving and sustaining improved and equitable health."
Brain Drain Creating Problems in SADC
"The loss of professionals and other skilled people from the SADC region is fast assuming the dimensions of a major crisis," says this article on the website of Idasa. "The countries of southern Africa pour vast resources into training to ensure that future skills needs are met. But is all this investment in human resource development really going to benefit the countries concerned? Or are they, in effect, simply providing students with "skill passports" so that they can relocate to other parts of the world?"
Stemming the brain drain
February's WHO Bulletin looks at the migration of skilled professionals to industrialized countries as one of the factors behind the chronic shortage of health workers in many developing countries. "….International recognition that the growing shortage of health workers poses a major threat to fighting diseases such as HIV/AIDS and tuberculosis has prompted a flurry of measures to stem the exodus of health professionals from developing countries."
The health workforce crisis in TB control
Human Resources for Health 2005, 3:2
"Human resources (HR) constraints have been reported as one of the main barriers to achieving the 2005 global tuberculosis (TB) control targets in 18 of the 22 TB high-burden countries (HBCs); consequently we try to assess the current HR available for TB control in HBCs...(The study concluded that) There were few readily available data on HR for TB control in HBCs, particularly in the larger ones. The great variations in staff numbers and the poor association between information on workforce, proportion of trained staff, and length and quality of courses suggested a lack of valid information and/or poor data reliability. There is urgent need to support HBCs to develop a comprehensive HR strategy involving short-term and long-term HR development plans and strengthening their HR planning and management capabilities."