Health system weaknesses mean that death rates are rising and life expectancy is falling in the poorest countries, despite the global health advances of recent years. Health workers hold the key to tackling these challenges. But urgent action is needed to improve the supply, capacity and distribution of the global health workforce.

A report by the Joint Learning Initiative, an enterprise involving over 100 global health leaders, estimates that there are 100 million people working in health care worldwide. This includes 24 million doctors, nurses and midwives, plus many more informal, traditional, community and allied workers. However, there is still a global shortage of at least four million workers. Health workers are overburdened as a result and face additional challenges from three major sources:

• HIV increases their workloads, exposes them to infection and saps their morale.
• Labour migration is accelerating from countries that can least afford the brain drain.
• Two decades of health sector reform has lead to chronic underinvestment in human resources.

Countries can accelerate health gains by investing in and managing their health workforce. This includes recruiting, training and retaining health professionals to produce a labour force that more closely meets their populations’ needs and redistributing health workers to rural and marginal communities. Improving work environments through better resource management and incentive systems would also boost health worker morale and performance.

The researchers conclude that effective workforce strategies can boost health service delivery, even under difficult circumstances. Recommendations for policymakers include:

• promoting community engagement in recruiting and retaining health workers and monitoring their performance
• managing transnational flows of health workers to harness the potential for workforce development
• delivering international assistance appropriately in the poorest countries
• tailoring national workforce plans to local needs
• delegating core health functions to well-trained community-based auxiliary workers in crisis situations
• building a culture of evidence-based knowledge.

Source(s):
id21 insights health #7, August 2005, Responding to the health workforce crisis Full document.
'Human resources for health: overcoming the crisis', Report of Joint Learning Initiative, Global Equity Initiative, 2004

Funded by: Atlantic Philanthropies, USA; Bill and Melinda Gates Foundation; UK Department for International Development (DFID); Swedish Sida; Rockefeller Foundation; Canadian International Development Agency; Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ); Global Equity Initiative, Harvard University, USA; JSI Research & Training Institute, Inc., USA; Open Society Institute; World Health Organisation; World Bank

id21 Research Highlight: 12 July 2005

Further Information:
Piya Hanvoravongchai
Global Equity Initiative
Harvard University
1033 Massachusetts Ave
Cambridge
MA 02138
USA

Tel: +1 617 998 0167
Fax: +1 617 998 0173
Contact the contributor: phanvora@hsph.harvard.edu

Joint Learning Initiative, Global Health Trust

Other related links:
'Responding to the health workforce crisis'

'Stopping the migration of Ghana's health workers'

'Filling the gaps: introducing substitute health workers in Africa'

'The crucial contribution of overseas volunteers'

'Committing donors to building health workforces'

'Finding the answers to Chad's health workforce crisis'

Eldis/HSRC human resources for health dossier