Human Resources

WHO alliance aims to tackle the world's lack of health workers
Rehwagen C: British Medical Journal 332:1294, 3 June 2006

A new global partnership that aims to improve the world's shortage of doctors, nurses, midwives, and other health workers was launched at last week's World Health Assembly in Geneva. The announcement came six weeks after the World Health Organization made the issue a priority in its annual report, in which it called for a global action plan to tackle the shortage of an estimated 4.2 million health workers.

Further details: /newsletter/id/31583
Who are CHWs? An ethnographic study of the multiple identities of community health workers in three rural Districts in Tanzania
Rafiq M; Wheatley H; Mushi H; Baynes C: BMC Health Services Research 19(712) 1-15, 2019

unity health workers (CHWs) possess multiple, overlapping roles and identities, which makes them effective primary health care providers when properly supported with adequate resources. This also limits their ability to implement interventions that only target certain members of their community and prevents them from performing certain duties when it comes to sensitive topics such as family planning. To understand the multiple identities of CHWs qualitative and ethnographic methods involved participant observation, open-ended and semi-structured interviews and focus group discussions with CHWs, their supervisors, and their clients between October 2013 and June 2014 in Rufiji, Ulanga and Kilombero Districts in Tanzania. The findings suggest that it is difficult to distinguish between personal and professional identities among CHWs in rural areas. Important aspects of CHW services such as personalization, access, and equity of health services were influenced by CHWs’ position as local agents. However, the study also found that their personal identity sometimes inhibited CHWs in speaking about issues related to family planning and sexual health. Being local, CHWs were viewed according to the social norms of the area that consider the gender and age of each worker, which tended to constrain their work in family planning and other areas. Furthermore, the communities welcomed and valued CHWs when they had curative medicines; however, when medical stocks were delayed, the community viewed the CHWs with suspicion and disinterest. Community members who received curative services from CHWs also tended to become more receptive to their preventative health care work. Although CHWs’ multiple roles constrained certain aspects of their work in line with prevalent social norms, overall, the multiple roles they fulfilled had a positive effect by keeping CHWs embedded in their community and earned them trust from community members, which enhanced their ability to provide personalized, equitable and relevant services. However, CHWs needed a support system that included functional supply chains, supervision, and community support to help them retain their role as health care providers and enabled them to provide curative, preventative, and referral services.

WHO D-G: Shortage of health workers in developing countries undermines essential services, including treatments for HIV/AIDS, TB, malaria
Kaiser Network, 5 April 2007

Thousands of health care professionals have left their homes in developing nations in search of higher paying jobs in wealthier countries, Reuters reports. According to WHO's World Health Report 2006, there is a shortage of more than four million health care workers in 57 developing countries. The report said one-quarter of physicians and one in 20 nurses trained in Africa currently work in 30 industrialized countries included in the Organization for Economic Cooperation and Development. Sub-Saharan Africa has 24% of the global disease burden but only 3% of the health care workforce worldwide and accounts for less than 1% of global health care spending, the report said. The Americas have 10% of the global disease burden, 37% of the health care workforce and account for more than half of global health care spending, the report found.

WHO global code of practice on the international recruitment of health personnel
World Health Organization: 21 May 2010

This resolution of the 63rd World Health Assembly outlines a set of standards for the international recruitment of health personnel. The code of practice aims to establish and promote voluntary principles and practices for the ethical international recruitment of health personnel. It provides member states with ethical principles for international health worker recruitment that strengthen the health systems of developing countries. It discourages states from actively recruiting health personnel from developing countries that face critical shortages of health workers, and encourages them to facilitate the 'circular migration of health personnel' to maximise skills and knowledge sharing. It enshrines equal rights of both migrant and non-migrant health workers. The code sets the provisions for member states to monitor and report on the implementation of the code, for reporting back to the Assembly in 2012.

WHO to create international human resources database on health care

One in three countries in Africa and South East Asia has only one medical school for every 10 million people or more, a rate poorer than anywhere in Europe or the Americas, says a new report by researchers from the World Health Organisation. Nine out of 10 countries in the same two regions have fewer than 50 doctors per 100000 inhabitants, and about half of the countries have a similar density of nurses and midwives. The report outlines a series of major new WHO initiatives, which aim to provide better information to allow more meaningful international comparisons. "Despite the undoubted importance of human resources to the functions of health systems, there is little consistency between countries in how human resource strategies are monitored and evaluated," say the authors, from WHO's department of health service provision. "In many countries there is no regular recording of the numbers and activities of all health personnel, and some emphasize only the public sector or can have variable accuracy for rural areas."

Who wants to work in a rural health post? The role of intrinsic motivation, rural background and faith-based institutions in Ethiopia and Rwanda
Serneels P, Montalvo JG, Pettersson G, Lievens T, Buterae JD and Kidanuf A: Bulletin of the World Health Organization 88: 342–349, May 2010

The objective of this paper was to understand the factors influencing health workers’ choice to work in rural areas as a basis for designing policies to redress geographic imbalances in health worker distribution. Data from a cohort survey of 412 nursing and medical students in Rwanda was used to examine the determinants of future health workers’ willingness to work in rural areas as measured by rural reservation wages. The data was combined with data from an identical survey in Ethiopia to enable a two-country analysis. The research found that health workers with higher intrinsic motivation – measured as the importance attached to helping the poor – as well as those who had grown up in a rural area and Adventists who had participated in a local bonding scheme were all significantly more willing to work in a rural area. The main result for intrinsic motivation in Rwanda was strikingly similar to the result obtained for Ethiopia and Rwanda combined. In conclusion, intrinsic motivation and rural origin play an important role in health workers’ decisions to work in a rural area, in addition to economic incentives, while faith-based institutions can also influence the decision.

WHO's 2006 World health report a disappointment
Lancet: Samarasekera, U

While the World Health Organization's focus on human resources for health in its 2006 World Health Report (WHR) is welcome, the lack of detailed data in the report is disappointing, states an editorial in this week's issue of The Lancet. The author explains how ".....[it] shows just how much of a gap exists between current knowledge and what is necessary to inform policymaking."

WHO/WFME strategic partnership to improve medical education
World Health Organisation

WHO and the World Federation for Medical Education (WFME) propose a strategic partnership to pursue a long-term work plan - open to participation by all medical schools and other educational providers - intended to have a decisive impact on medical education in particular and ultimately on health professions education in general. The WHO/WFME work plan will benefit from the accumulated experience and assets of each partner.

Wising Up to the Business Implications of HIV/Aids

South African companies are missing out on lucrative returns by failing to see that money spent on HIV/Aids is an investment, rather than a cost, according to a new study into major Southern African companies.

Wits launches Centre for Rural Health
Magamdela P: Health-e News: 28 August 2009

Health care in South Africa’s rural areas is set to get a major boost, following the launch of the Centre for Rural Health by Wits University, in Johannesburg, recently. The centre’s inaugural Director, Prof Ian Couper, said the centre’s main focus is to ‘recruit human resources for rural health. We can do everything in terms of providing facilities, we can make sure the drug supplies are there, but unless we have the health workers, all of that will mean nothing. The centre is trying to focus on multiple strategies: selecting students in rural areas and supporting them to study health sciences, developing post graduate programmes, researching issues around how we can improve resources for rural health and advocacy to bring these issues to the attention of policy makers, politicians and other stake-holders.’ Deputy Health Minister, Dr Molefi Sefularo, expressed gratitude to the university for highlighting issues relating to rural health. ‘We would like you to become a leading academic centre in the field of human resources for rural health’, he said.

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