"This paper examines policy towards health professionals' migration from economic and governance perspectives. Our aims are conceptual and agenda-setting. In essence, we argue that current policy responses to migration of health professionals from low income developing countries underestimate the pressures and mis-identify the reasons for rising migration, overestimate the impact of recruitment policies on migration flows while ignoring unintended side effects, and mis-specify the ethical dilemmas involved."
Human Resources
The ‘Skills Drain’ of health professionals from the developing world
Medact paper
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
Minister urges WHA to stem migration and poaching
African Ministers of Health currently attending the World Health Assembly (WHA), have all joined South African health minister Dr Manto Tshabalala-Msimang in expressing their concerns about the continued migration and recruitment of health personnel from developing to developed countries. The resolution also calls upon the Director General of the World Health Organisation (WHO) to ensure that the previous decision of the WHA aimed at addressing this matter is fully implemented. This includes strengthening of the Human Resources for Health division in the WHO by allocating adequate financial and resources to enable the division to effectively execute the necessary actions aimed at addressing this matter.
UK demand for overseas health professionals severely affecting sub-Saharan Africa
The Lancet 2005; 365:1893-1900
"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)
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."