Representatives of Oxfam International, Physicians for Human Rights and Health GAP today called the critical shortage of health workers in developing countries "a major challenge to meeting the promise of universal access to treatment." They demanded massive new investment from government to train and retain health workers. "Campaigns to fulfill the right to health have brought anti-retroviral medicines to hundreds of thousands of people. But without the health workers and health systems to administer these medicines, that right remains unrealized for millions more," said Leonard Rubenstein, JD, Executive Director of Physicians for Human Rights.
Human Resources
The consequences of health professional mobility have become a prominent public policy concern. This paper considers trends in mobility amongst doctors and nurses and the consequences for health systems. Policy responses are shifting from a reactive agenda that focuses on stemming migration towards a more active agenda of managed migration that benefits source and destination countries. Improved working conditions and effective human resource practice are required to encourage retention of health professionals in both source and destination countries.
The global phenomena of massive migration of health professionals and the advent of e-Health solutions are evidence of the fact that significant trends in health are no longer regional. Worldwide, doctors, nurses and ancillary staff are increasingly seeking better prospects for themselves, not only in the northern economic powerhouses but also in developing countries. However, a severe lack of knowledge-sharing mechanisms and appropriate funding has meant that patients and health professionals in poor countries are still denied the opportunity to benefit from pioneering e-Health programmes now being developed in countries such as the UK and Canada.
The challenges in the health workforce are well known and clearly documented. What is not so clearly understood is how to address these issues in a comprehensive and integrated manner that will lead to solutions. This editorial presents – and invites comments on – a technical framework intended to raise awareness among donors and multisector organisations outside ministries of health and to guide planning and strategy development at the country level.
New laws introduced by the British government in mid-August 2006 are unwittingly giving the southern African region a temporary reprieve from the brain drain of medical staff. The new laws stipulate that employers in Britain will only be granted work permits for foreign nurses if they can prove that no suitable British or European Union candidate can be found.
This paper outlines the Human Resources for Health (HRH) issues during the period of reconstruction in post-conflict countries, drawing examples from Afghanistan and Cambodia. It explores issues of restoring a health workforce and outlines key HRH actions for workforce reconstruction, including: identifying available staff; developing HRH management structures, systems and capacity; clarifying HRH roles and responsibilities; establishing health worker equivalencies and upgrading skills; supporting civil service reconstruction; and widely disseminating HRH information.
Many health professionals in Malawi experience overly challenging environments. In order to survive some are involved in ethically and legally questionable activities such as receiving gifts from patients and pilfering drugs. The efforts by the Malawi government and the international community to retain health workers in Malawi are recognised. There is however need to evaluate of these human resources-retaining measures are having the desired effects.
A study conducted by the Department of Nursing at the University of the Witwatersrand has revealed the top 10 reasons for dissatisfaction in the nursing profession. The study was administered over a period of two years (2003- 2005) in a public hospital in Johannesburg. Dr Ansie Minnaar, lead researcher in the study says “generally all the nurses interviewed experienced low satisfaction. Our findings show that it is not only salaries that are a factor in the nursing profession. Other factors are career prospects, policy implementation, the behaviour of supervisors, and relationships with other nurses and patient.”
Canada is a major recipient of foreign-trained health professionals, notably physicians from South Africa and other sub-Saharan African countries. Nurse migration from these countries, while comparatively small, is rising. African countries, meanwhile, have a critical shortage of professionals and a disproportionate burden of disease. What policy options could Canada pursue that balanced the right to health of Africans losing their health workers with the right of these workers to seek migration to countries such as Canada?
The East, Central and Southern Africa College of Nursing (ECSACON) is an institution invested with the responsibility of improving the quality of health of the communities in the ECSA region through strengthening the contribution of nursing and midwifery services. ECSACON is conducting a needs assessment for its work and has disseminated a questionnaire for those in Authority at the Ministry of Health (MOH) or those in Nursing Regulatory bodies to complete. They ask that the questionniare found at the url given be completed and returned to ECSACON.