No health without health workers

Facts

• Some 4.3 million extra healthcare workers are needed worldwide to make essential healthcare accessible to all
• Up to 50 per cent of doctors from Angola, Haiti, Liberia, Mozambique, Sierra Leona or Tanzania work in an OECD country

 Bridging the gap

As world leaders and international experts meet in Bangkok to discuss the global health workforce shortage, Action for Global Health launches its latest report, “Addressing the Global Health Workforce Crisis: Challenges for France, Germany, Italy, Spain and the UK”. The report provides a comparative study of the impact that health systems and policies of these five countries have on southern countries health workforce.

With up to 50 per cent of doctors from countries such as Haiti, Sierra Leone and Tanzania working in OECD countries, the network of health and development organisations is calling on the EU and its member states to take immediate steps to fulfil the WHO Global Code of Practice on the International Recruitment of Health Personnel.The Code is the first major international recognition of the global nature of the health worker shortage and how brain drain undermines progress on the health MDGs.

The Code recognises both the right of communities to adequate healthcare and the rights of individuals seeking employment. It sets out guiding principles and voluntary international standards for the ethical recruitment of health workers to increase consistency between national policies and prevent unethical practices.

Moving beyond the Code

To implement the Code fully, the network says EU member states must ensure they train sufficient numbers of health workers to meet the health needs of the population and increase efforts to retain existing health workers. They must also put in place national health workforce information systems, which allow the monitoring of migration trends and evidence based policy making, where they are currently lacking.

“It’s time for Europe to take the lead in tackling the health workforce crisis. It’s a basic fact that healthcare systems cannot function without health workers and, in the run-up to the MDG deadline, Europe must take decisive steps to stem the harmful flow of health workers from developing to developed countries. EU member states cannot rely on migration alone to fulfil their healthcare needs,” stated Frazer Goodwin, Global Health Project Manager at the European Public Health Alliance, a partner of Action for Global Health.

Human resources for Health shortfall: According to the World Health Organisation (WHO), 4.3 million extra health workers (doctors, nurses and midwives) are needed worldwide to make essential healthcare accessible to all. All countries face a shortage, but the situation is particularly dramatic in developing countries: 57 countries, 36 of them in Sub-Saharan Africa, face a severe crisis of human resources in health.

Africa shoulders more than 24 per cent of the world’s disease burden. Yet, it has only three per cent of the world’s health professionals and, even taking into account loans and grants of Official Development Assistance (ODA), less than one per cent of its resources for health. In comparison, the Americas (Latin America, the Caribbean and North America) with just 10 per cent of the world’s burden of disease, has 37 per cent of the world’s health workers and more than 50 per cent of total funds dedicated to health.

In the most deprived countries, this shortage of human resources for health throws the population into a dramatic health crisis. Various studies, such as the Joint Learning Initiative, have shown that the minimum health worker to population coverage ratio is 2.5 per 1,000. While this is still not comparable to developed countries, it would allow 80 per cent of birth deliveries to be assisted by a qualified person and vaccination coverage to reach 80 per cent of the population. Today, 2.5 billion people worldwide are without this basic minimum. In Africa, coverage is only 0.8 health workers per 1,000. In Europe, it is as high as 10 per 1,000.

A shortage of qualified health workers is one of the major obstacles to the realisation of the health Millennium Development Goals (MDGs). Health workers are at the heart of a health system and the ability to deliver the universal right to health. They play a vital role in ensuring the appropriate management of all the aspects of a health system: from medicine and facilities to budgets and healthcare programmes.