PanAfrica: Health Workers Focus of World Health Day 2006

[Angel]

A chronic, global shortage of well-trained health workers is a critical issue around the world, according to a new World Health Organization (WHO) report to be released April 7, World Health Day.

Working Together for Health: The World Health Report 2006 defines the health work force as "all people engaged in actions whose primary intent is to enhance health."

The definition includes those who promote and preserve health, those who diagnose and treat disease, and health management and support workers who help make the health system function but do not directly provide health services.

Each year, the world health report provides an expert assessment of some aspect of global health, including statistics relating to all countries, to give countries, donor agencies, international organizations and others the information needed to make policy and funding decisions.

[break=The Health Care Work Force]
THE HEALTH CARE WORK FORCE

In the first decade of the 21st century, "immense advances in human well being coexist with extreme deprivation," according to the report.

WHO estimates there are 59.2 million full-time paid health workers worldwide. Health service providers make up about two-thirds of the work force, health management and support workers the remaining third.

Fifty-seven countries have critical shortages of health workers, according to WHO, equal to a global deficit of 2.4 million doctors, nurses and midwives, with the largest shortfalls in sub-Saharan Africa and Southeast Asia.

As a result, clinics have no health care workers, hospitals cannot recruit and keep key staff members, and patients go without treatment, the report said.
The spreading HIV/AIDS epidemic imposes huge work burdens, risks and threats on health workers around the world, the report says.

According to the report, the WHO region of the Americas, with 10 percent of the global burden of disease, has 37 percent of the world's health workers and spends more than 50 percent of the world's health financing.

The African region has 24 percent of the burden but only 3 percent of health workers commanding less than 1 percent of world health expenditure.

The loss of skilled professionals to other countries amid so much unmet health need puts Africa at the center of the global health work force crisis.
[break=Crisis of Rich and Poor]
CRISIS OF RICH AND POOR
The report predicts that future demand for health care providers will escalate greatly in all countries, rich and poor. In richer countries, growing populations of elderly people will cause a needs shift toward chronic and degenerative diseases programs that have high care demands.

Technological advances and income growth will demand a more specialized work force, while the need for basic care increases because of families' declining ability or willingness to care for elderly members.

If greater numbers of health workers in richer countries are not trained, the growing gaps will pull even more health workers away from poorer regions. In poorer countries, 1 billion adolescents will join an increasingly aging population, with both groups rapidly urbanizing.

Many poorer countries also are dealing with infectious diseases and the rapid emergence of chronic illness complicated by the HIV/AIDS epidemic.

According to the report, chronic diseases - including cardiovascular and metabolic diseases, cancers, injuries and neurological and psychological disorders - are major burdens that affect rich and poor countries, as are epidemics, natural disasters and conflicts.

The quality of response, the report says, depends on work-force preparedness based on local capacity and backed by timely international support.
[break=Strategies]
STRATEGIES
"The solution is not straightforward," said WHO Director-General Dr. Lee Jong-wook, "and there is no consensus on how to proceed."
But the report lays out a "working lifespan" approach to the dynamics of the work force, the time when people are part of the work force, and the point at which they leave the work force. The proposal addresses these three decision-making points:

Entry -- Preparing the work force through strategic investments in education and effective and ethical recruitment practices;

Work force -- Enhancing worker performance through better management of workers in the public and private sectors; and

Exit -- Managing migration and attrition to reduce wasteful loss of human resources.

Strategies, the report says, should address cutting waste and improving performance through compensation adjustments, work incentives, safer working conditions, and worker mobilization efforts; anticipating the future by engaging affected entities to craft national strategic plans that anticipate future trends; and acquiring critical capacities by strengthening core institutions for sound work-force development.
[break=Global Cooperation]
GLOBAL COOPERATION

National leadership, the report adds, must be complemented by global cooperation in investing in a standard of measurement and assessment for the health work force, striking cooperative agreements to create international capacity to deal with global emergencies such as bird flu and eliciting an urgent, sustained and coordinated response from the international community.

In the United States, Department of Health and Human Services Secretary Michael Leavitt said, "I commend these dedicated and hard-working men and women who save lives every day, and encourage others to enter these professions and take on the fulfilling challenges of improving the global health condition."

Working through such initiatives as the President's Emergency Plan for AIDS Relief and the International Partnership on Avian and Pandemic Influenza, the United States is helping address these concerns.

The State Department commended the World Health Organization for its initiative on health workers and endorsed its goal of strengthening the global public health work force.

National leadership, the report concludes, urgently must produce country-based actions and sustain them for at least a decade, from 2006 to 2015. Over the next few years, lead countries should pioneer national plans to scale up effective strategies, increase investments, cut waste and strengthen educational institutions.

By 2010, more than half of all countries should have sound national plans that include good policies and management practices addressing work force incentives, regulation and institutions. Sustained international financing should be in place to support recipient countries for the next 10 years as they scale up their work forces, WHO said.