Momentum for HRH grows ahead of the Third Global Forum
With about a month left to the Third Global Forum on Human Resources for Health, political momentum for HRH continues to grow at an extraordinary pace.
In September, world leaders gathered in New York for the 68th United Nations General Assembly (UNGA) a special summit on achieving the Millennium Development Goals (MDGs). World leaders reaffirmed their commitment to Every Woman Every Child (EWEC), a movement launched by the UN Secretary-General Ban Ki-moon in 2010 to mobilize global action on women’s and children’s health. The week also featured numerous side events that provided the opportunity for countries, NGOs and nongovernmental organizations to further discuss issues related to global health.
Alliance partner Johnson & Johnson convened a side event with the title “Promising Practice: Working Together to Strengthen the Healthcare Workforce”. During the event, Ethiopia was widely praised for reaching the development target on reducing child mortality two years earlier than expected. For many, the reason behind Ethiopia’s achievement was the country’s health extension worker (HEW) initiative, which has enabled the training and deployment of more than 36,000 community health workers.
The importance of frontline health workers for the achievement of the MDGs and universal health coverage was reiterated in the second report of the independent Expert Review Group (iERG) on Information and Accountability for Women’s and Children’s Health. The Alliance contributed to the report through its Board member, Professor Miriam K Were, who serves as member of the iERG. According to the report, “one essential element of a quality revolution is the availability of educated health professionals to deliver high-quality care”. To validate this claim, the report presents a series of country case studies.
The Alliance Secretariat, in collaboration with in-country experts1, prepared a case study on HRH development in Malawi. The study analyzes the impact of the Emergency Human Resource Programme (EHRP), which was launched in 2004 by the Government of Malawi together with development partners, including the Global Fund and DFID. The EHRP provided incentives for recruitment and retention of health workers, expansion of domestic training capacity for priority cadres and scale-up of community health workers. The scheme also offered technical assistance to build capacity in HRH management, monitoring and evaluation in the Ministry of Health. An independent evaluation of the programme concluded that, between 2004 and 2009, the initiative contributed to increasing the number of health workers, raising the HRH density and saving over 13,000 lives. Now, Malawi is fully on track to meeting MDG 4 (child mortality reduction) and advancing towards MDG 5 (maternal mortality reduction) targets.
It seems that countries and donors are starting to grasp the crucial role of health workers. In fact, as The PMNCH 2013 report describes, recent political and financial commitments have resulted in the training of up to 1.7 million additional health workers, including doctors, midwives, nurses, skilled birth attendants and community health workers. This achievement has also been accompanied by supporting efforts to strengthen the quality of the existing health workforce and establishing or improving training facilities.
However, there is still more to do. To close the health workforce gap, it was estimated that up to 3.5 million additional health workers would need to be trained and deployed in 49 countries by 2015. If one considers the 75 countries where over 95% of all maternal and child deaths take place, the number of required health professionals increases significantly. Furthermore, there is inequality in the distribution of health staff: in fact, of the 210,000 new health workers that PMNCH can locate geographically, only 18,000 are in sub-Saharan Africa, the area with the greatest health workforce shortfall. Finally, it is important to note that an increase in the health workforce does not automatically translate into improved access to health services, especially for the rural poor.
The Third Global Forum taking place on Nov 10-13 in Recife, Brazil will, therefore, be an opportunity for governments, development partners, international agencies, and all national and international actors to renew their commitments towards health workers and “kick start a decade of action for human resources for health”. The forum will also highlight the need for sustained political will at the highest level, if countries are to succeed in translating their commitments into concrete actions.