It is estimated that in 2000 almost 175 million people, or 2.9% of the world's population, were living outside their country of birth, compared to 100 million, or 1.8% of the total population, in 1995. As the global labour market strengthens, it is increasingly highly skilled professionals who are migrating. Medical practitioners and nurses represent a small proportion of highly skilled workers who migrate, but the loss of health human resources for developing countries can mean that the capacity of the health system to deliver health care equitably is compromised.
Human Resources
A growing "workforce crisis" is a serious obstacle to achieving targets for global tuberculosis control set for 2005 by the World Health Organisation (WHO). Faster and more effective recruitment and training of TB health workers is needed to ensure vacancies in developing countries are filled quickly, says a draft report written by TB experts. Of the 22 high burden countries (HBCs) which account for 80% of the world's TB cases, 17 reported that their efforts to reach the 2005 targets are being hampered by staffing problems.
We in the third world are rarely willing to admit to our "third worldliness." We aspire to first world standards, and the things we want more than anything else are hotels of international standard, a well reputed university, and, in particular, good medical and nursing schools. We are greatly gratified by the recognition of our graduates as being of international standard - "Our doctors and nurses are as good as any others" - but there are difficulties with this. As soon as a country produces graduates of an acceptable international standard then it is "fishing in the same pond" as first world countries for their services. It is inevitable that doctors and nurses will be attracted to countries where salaries or working conditions are seen as better, says this article in the British Medical Journal.
Botswana has the highest rate of HIV prevalence in the world and AIDS has now reached crisis proportions in the country. Among the initiatives implemented as a response to promote sexual behaviour change, is the Peer Education HIV/AIDS Prevention Program (PEHAPP) at the workplace. This paper assesses the impact and outcome of the PEHAPP. It concludes that the PEHAPP is having a measurable positive impact in the key areas of improving knowledge, attitudes, and practices related to risky sexual behaviour which, in turn, should reduce the incidence of transmission of HIV/AIDS and other STDs over the long-term.
Zimbabwe's brain drain has hit the medical profession particularly hard. More than 80% of doctors, nurses and therapists who graduated from the University of Zimbabwe medical school since independence in 1980 have gone to work abroad, primarily in Britain, Australia, New Zealand, Canada and the United States, according to recent surveys.
This paper from Norwegian Church Aid states that established workers' rights are often not followed when facing an HIV positive employee and therefore need to be given a renewed focus. This report concludes that workers are seldom aware of their rights, and are therefore easy victims for unjust treatment from their employers. Workers' rights seldom regulate work in the informal sector. It is probably in this sector that we find the poorest of the poor, often at high risk of contracting HIV. And when infected, they have few or no possibilities of access to proper health care, and only very rarely access to any kind of social welfare.
This paper reviews the challenges facing the public health workforce in developing countries and the main policy issues that need to be addressed in order to strengthen the public health workforce. The public health workforce is diverse and includes all those whose prime responsibility is the provision of core public health activities, irrespective of their organisational base. Although the public health workforce is central to the performance of health systems, very little is known about the composition, training or performance of the workforce. The key policy question is: Should governments invest more in building and supporting the public health workforce and infrastructure to ensure the more effective functioning of health systems? Other questions concern: the nature of the public health workforce including its size, composition, skills, training needs, current functions and performance; the appropriate roles of the workforce; and how the workforce can be strengthened to support new approaches to priority health problems.
Zimbabwe is experiencing a debilitating flight of professional and skilled people escaping the country's economic crisis, a study funded by the UN Development Programme (UNDP) has found. A large number of Zimbabweans had taken up South African citizenship and there were probably more Zimbabweans in South Africa than in the United Kingdom, the country with the highest official tally of expatriate Zimbabweans.
South Africa is suffering from a ‘brain drain’, or loss of its professionals – but how serious is the problem and what effect is it having on the homeland? This study attempts to assess the number of emigrants and the skills being lost, and asks whether the loss is permanent. Skills loss due to emigration has recently become a high-profile public policy issue in South Africa. A major, unresolved question is the actual scale of the problem and its impact. There has been growing suspicion that South Africa’s official emigration data, SSA, significantly underestimate the number of South Africans leaving the country to settle abroad. This report by the University of Cape Town attempts to assess the true extent of emigration by examining data from the recipient countries.
Human resources are an essential element of a health system's inputs, and yet there is a huge disparity among countries in how human resource policies and strategies are developed and implemented. The analysis of the impacts of services on population health and well-being attracts more interest than analysis of the situation of the workforce in this area. This article presents an international comparison of the health workforce in terms of skill mix, socio demographics and other labour force characteristics, in order to establish an evidence base for monitoring and evaluation of human resources for health.