Increased international migration of health professionals is weakening healthcare systems in low-income countries, particularly those in sub-Saharan Africa. The migration of nurses, physicians and other health professionals from countries in sub-Saharan Africa poses a major threat to the achievement of health equity in this region. As nurses form the backbone of healthcare systems in many of the affected countries, it is the accelerating migration of nurses that will be most critical over the next few years. In this paper we present a comprehensive analysis of the literature and argue that, from a human rights perspective, there are competing rights in the international migration of health professionals: the right to leave one's country to seek a better life; the right to health of populations in the source and destination countries; labour rights; the right to education; and the right to nondiscrimination and equality. Creative policy approaches are required to balance these rights and to ensure that the individual rights of health professionals do not compromise the societal right to health.
Human Resources
Geographical imbalances in the health workforce are a consistent feature of nearly all health systems, especially in developing countries. This paper investigates the willingness to work in a rural area among final year nursing and medical students in Ethiopia. Analysing data obtained from contingent valuation questions for final year students from three medical schools and eight nursing schools, we find that there is substantial heterogeneity in the willingness to serve in rural areas.
As one of the oldest and most respected professions in the world, the work of midwives is celebrated annually on 5 May. To mark the occasion, the International Day of Midwives will be celebrated at WHO Headquarters on Friday 4 May. WHO staff will gather to show their support for the essential role of midwives in saving the lives of pregnant women who might otherwise die from malnourishment or lack of skilled care during pregnancy and childbirth.
In countries with a high AIDS prevalence, the health workforce is affected by AIDS in several ways. In Zambia, which has a 16.5% prevalence rate, a 2004 study aimed to: explore the impact of HIV/AIDS on health workers, describe their coping mechanisms and recommend supportive measures. Interviews revealed that counsellors and nurses were especially at risk for emotional exhaustion. AIDS complicates the already difficult work environment. In addition to health workers, management also needs support in dealing with AIDS at the workplace.
Effective and often cheap interventions exist to achieve the MDGs by 2015. In Tanzania, one of the poorest countries of the world, we explored the human resources challenges of expanding the coverage of such priority interventions. Even in an optimistic scenario, human resource availability will limit the extent to which priority interventions can be expanded in Tanzania, and the government will not be able to avoid adjusting the globally set targets for service coverage and health outcomes to local realities and priorities.
Increased international migration of health professionals is weakening healthcare systems in low-income countries, particularly in sub-Saharan Africa. As nurses form the backbone of healthcare systems in many of the affected countries, accelerating migration of nurses is most critical. In this paper we present a comprehensive analysis of the literature and argue that, from a human rights perspective, there are competing rights in the international migration of health professionals: the right to leave one’s country to seek a better life; the right to health of populations in the source and destination countries; labour rights; the right to education; and the right to nondiscrimination and equality.
Physician migration from poor to rich countries is considered an important contributor to the growing health workforce crisis in the developing world. This is particularly true for Africa. The perceived magnitude of such migration for each source country might, however, depend on the choice of metrics used in the analysis. This study examined the influence of choice of migration metrics on the rankings of African countries that suffered the most physician migration, and investigated the correlates of physician migration.
The World Health Organization (WHO) and the Office of the US Global AIDS Coordinator (OGAC) convened representatives from HIV Programmes and Human Resources for Health Departments from Ministries of Health, Professional Associations, Academic Institutions and representatives from workers associations in Geneva for a two day technical consultation about the need for a regulatory framework in support of Task Shifting. The meeting signaled the beginning of a new expert partnership for driving forward the Task Shifting Project in the context of the wider HIV/AIDS and health workforce plan “Treat, Train, Retain”.
Recent comments from the inside of the Global Fund suggest an intention to focus more on the three diseases, and to leave the strengthening of health systems and the support to the health workforce to others. This might create "Medicines Without Doctors" situations: situations in which the medicines to fight AIDS, Tuberculosis and Malaria are available, but not the doctors or the nurses to prescribe those medicines adequately.
In rural Kenya, where qualified pharmacists are rare, many people buy medicines from general shops to treat themselves at home. Often they receive incorrect medication or doses. Would the training of shopkeepers, who help treat the majority of children with fevers, be cost-effective in improving malaria treatment in young children?