Human resources for health

Overcoming the crisis

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 lowers 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 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.

Piya Hanvoravongchai
Global Equity Initiative
Harvard University
1033 Massachusetts Ave.
Cambridge
MA 02138
USA
T +1 617 998 0167
F +1 617 998 0173
phanvora@hsph.harvard.edu

See also

Human resources for health: overcoming the crisis, report of Joint Learning Initiative, 2004
www.globalhealthtrust.org

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