In the context of the Millennium Development Goals, human resources represent the most critical constraint in achieving the targets. Therefore, it is important for health planners and decision-makers to identify what are the human resources required to meet those targets. Planning the human resources for health is a complex process. It needs to consider both the technical aspects related to estimating the number, skills and distribution of health personnel for meeting population health needs, and the political implications, values and choices that health policy- and decision-makers need to make within given resources limitations.
Human Resources
An approach to estimating human resource requirements for the MDGs
Health Policy and Planning 2005 20(5):267-276
Human resources for health in Africa
BMJ 2005;331:1037-1038
African countries have a very low density health workforce, compounded by poor skill mix and inadequate investment. Yet trained healthcare staff continue to migrate from Africa to more developed countries. The World Health Organization has estimated that, to meet the ambitious targets of the millennium development goals, African health services will need to train and retain an extra one million health workers by 2010.
No consensus on solution to brain drain
International and local delegates to the Scotland-Malawi conference held in Edinburgh, Scotland recently were alarmed with the shortage of health workers in the country which they said has worsened due to brain drain. But the conference failed to reach a consensus to curb the problem. Some delegates suggested that an immediate deportation of the health workers from the United Kingdom while others proposed that the UK should pay back.
An action plan to prevent brain drain: Building Equitable Health
A report by Physicians for Human Rights
"The nations of the world are setting ambitious health and development goals, including the World Health Organization (WHO) target of providing AIDS treatment to 3 million people by 2005 and health-related UN Millennium Development Goals. Unless greater attention by donors and governments is given to developing human resources, these goals almost certainly will not be met. Many of the countries in sub-Saharan Africa, the region that will be the focus of this report, are experiencing severe shortages of skilled health care workers. There are multiple causes, the significance of which varies by country, but one of the most important factors is brain drain."
Perceptions of medical students, faculty and private GPs towards the utilization of private GPs in the teaching of undergraduate medical students in Malawi: a qualitative study
Produced under the EQUINET Student Grant Scheme
A qualitative study was conducted in Malawi to describe the perceptions of medical students, recent medical graduates, faculty members of the Malawi College of Medicine and private general practitioners (GPs) towards a proposed utilization of GPs in the teaching of undergraduate medical students. General Practitioners welcomed these proposed changes whilst the majority of students, recent graduates and faculty were opposed to this idea. General practitioners were perceived not to be able to adapt to the culture of public teaching hospitals.
The Metrics of the Physician Brain Drain
The New England Journal of Medicine, Volume 353:1810-1818 , October 27, 2005, Number 17
"There has been substantial immigration of physicians to developed countries, much of it coming from lower-income countries...International medical graduates constitute between 23 and 28 percent of physicians in the United States, the United Kingdom, Canada, and Australia, and lower-income countries supply between 40 and 75 percent of these international medical graduates. The United Kingdom, Canada, and Australia draw a substantial number of physicians from South Africa, and the United States draws very heavily from the Philippines. Nine of the 20 countries with the highest emigration factors are in sub-Saharan Africa or the Caribbean."
Understanding African migration for pro-poor policymaking
id21 Research Highlight
Migration has long been an important part of labour markets and livelihoods across Africa. It is estimated that there are between 20 and 50 million African migrants today. Migration flows have implications for meeting the Millennium Development Goals, but their effects are poorly understood. Most African governments, however, are concerned with the migration of educated professionals abroad, or the 'brain drain'. It is estimated that US$4 billion is spent on replacing African professionals with expatriates, mostly through aid programmes.
International migration and the MDGs
The United Nations Population Fund (UNFPA) hosted an Expert Group Meeting on International Migration and the Millennium Development Goals in Marrakech, Morocco on 11-12 May 2005. Invited experts were requested to speak on a number of topics relating to migration and development, including: poverty reduction, health, gender, environment, and global partnerships for development with a view towards exploring migration as both a facilitating and constraining factor in the achievement of the Millennium Development Goals (MDGs). This report is a compilation of selected papers presented at the meeting together with a synopsis of the discussion highlighting some of the more salient points raised by the experts.
Maintaining health worker performance in resource-poor settings
The Lancet 2005
"In low and middle income countries, health workers are essential for the delivery of health interventions. However, inadequate health-worker performance is a very widespread problem. We present an overview of issues and evidence about the determinants of performance and strategies for improving it. Health-worker practices are complex behaviours that have many potential influences. Reviews of intervention studies in low and middle income countries suggest that the simple dissemination of written guidelines is often ineffective, that supervision and audit with feedback is generally effective, and that multifaceted interventions might be more effective than single interventions." (Requires registration)
Wastage in the health workforce: the experience of African countries
"Sub-Saharan Africa faces a human resources crisis in the health sector. Over the past two decades its population has increased substantially, with a significant rise in the disease burden due to HIV/AIDS and recurrent communicable diseases and an increased incidence of noncommunicable diseases. This increased demand for health services is met with a rather low supply of health workers, but this notwithstanding, sub-Saharan African countries also experience significant wastage of their human resources stock."