The biggest and most important component of any health system is its human resources (HR). The effective, equitable and appropriate production, training and deployment of health workers has been associated with periods of high health gain in southern Africa. Despite this, many health systems in southern Africa now face a variety of HR problems and personnel scarcities have become a critical limiting factor in health interventions. Health worker migration is further compounding inequities and stresses. Responding to economic and social triggers, personnel flow from rural to urban areas, from public to private sectors, from lower to higher income countries within southern Africa and from African countries to industrialized countries, exacerbating inequities and providing a reverse (poor to rich) subsidy. However a new policy momentum exists in relation to human resources for health.
Human Resources
Members of the African Union struck a deal with wealthy members of the World Health Organisation to be compensated for the loss of their health care workers to richer countries, the Nairobi Daily Nation reports. The negotiations were held during the 57th World Health Assembly in Geneva May 17-22. "The African Union pushed the agenda of compensation as one voice and we will jointly negotiate the terms like the European Union does," said Gideon Konchella, Kenya's assistant minister for health.
The provision of health services to rural and remote communities has been the source of much concern and debate in recent times. One aspect of this is the universal problem of insufficient medical practitioners in rural areas and the associated issues of recruitment and retention. Rural communities can play an important role in the recruitment and retention of health professionals, particularly in terms of aiding the integration of health professionals and their families into the community.
This report describes the exodus of healthcare workers from areas of poverty and low socio-economic development, to more highly developed areas. The flows follow a hierarchy of ‘wealth’ and result in a global conveyor belt of health personnel moving from the bottom to the top, increasing inequity. The report describes personnel flows and migration from rural to urban areas, from public to private sectors, from lower to higher income countries within southern Africa and from African countries to industrialized countries. The report describes a variety of push and pull factors that impact on the movement of healthcare professionals.
Predicted shortages and recruitment targets for nurses in developed countries threaten to deplete nurse supply and undermine global health initiatives in developing countries. A twofold approach is required, involving greater diligence by developing countries in creating a largely sustainable domestic nurse workforce and their greater investment through international aid in building nursing education capacity in the less developed countries that supply them with nurses.
At least 100,000 health workers are needed to distribute anti-AIDS drugs in Africa, where 70 percent of the world's HIV/AIDS sufferers live, the head of the World Health OrganiSation said Wednesday. "It's difficult to grasp the magnitude of the problem," Dr. Lee Jong-Wook said while visiting Singapore. "The 8,000 people dying every day from AIDS is equivalent to 30 jumbo jets crashing every day." The WHO's aim to provide 3 million HIV-infected people in Africa with the latest available drugs by the end of 2005 was achievable if workers are found to deliver the drugs, Lee said.
This report examines the trends and policy issues relating to the international mobility of one key group of knowledge workers: nurses. The increase in 'knowledge worker' migration, partly as a result of developed countries attempting to solve skill shortages by recruiting from developing countries, is a key component of current international migration patterns. The report examines trends in international recruitment and migration of nurses. It uses data from professional registers and censuses to examine the scale of the movement of nurses. Core data from a selection of five 'destination countries' is used to track trends from source countries. The five destination countries are Australia, Ireland, Norway, UK and USA. Information is also assessed from four 'source' areas - the Caribbean, Ghana, South Africa and the Philippines.
Several countries are increasingly relying on immigration as a means of coping with domestic shortages of health care professionals. This trend has led to concerns that in many of the source countries - especially within Africa - the outflow of health care professionals is adversely affecting the health care system. This paper examines the role of wages in the migration decision and discusses the likely effect of wage increases in source countries in slowing migration flows.
The quality of health care is hugely dependent on the skills of health professionals. Clinical skills centres are neutral and protected settings in which a variety of skills and techniques can be taught. In developing countries, resource constraints and pressure to direct skilled staff away from teaching to working in health service facilities can limit the opportunities for developing and implementing an effective training curriculum.
The authors surveyed workforces in southern Africa to determine HIV prevalence among formally employed, largely male populations. Voluntary, anonymous, unlinked seroprevalence surveys of 34 workforces with 44 000 employees were carried out in South Africa, Botswana, and Zambia in 2000-2001. Average HIV prevalence for the entire sample was 16.6%. Country-wide prevalence was 14.5% in South Africa, 17.9% in Zambia, and 24.6% in Botswana.