Never before have there been such levels of commitment to resolve the chronic shortage of health workers around the world. Human resources for health and the health workforce crisis are issues now anchored on the global agenda, thanks largely to a growing alliance of people and organisations around the world. Stakeholders from government, private companies, civil society and international agencies are collaborating to help solve the problems that face the health workforce. The Global Health Workforce Alliance (“the Alliance”) Secretariat plays a facilitating role to bring them together and work for change. Mubashar Sheikh, Executive Director of the Alliance, talks about what they are trying to achieve.
There's an urgent need to focus on neglected health workers and communities who are at the forefront of ensuring that everyone receives good health
Serious problems in the health workforce exist in many countries: staff shortages, low retention, and poor environments in which to work. Migration of staff to urban areas or other countries in the world is happening on a critical scale. This is a truly global crisis. Action to address these problems had been happening for a while but people tended to be working on their own, and were not coordinated in their efforts to put human resources for health on the global agenda. But gradually, people realised that the health-related Millennium Development Goals could never be realised without an effective health workforce, and efforts began to pull together. The World Health Organization’s (WHO) World Health Report in 2006 on the health workforce put a real dimension to the problems, why they exist and what needs to be done. There needed to be a forum to allow different stakeholders to solve problems together.
The Global Health Workforce Alliance (“the Alliance”) was set up in May 2006, to create a platform and an alliance for joint action at a global level. There are now more than 200 members representing national health sectors, global bodies such as WHO, and the World Bank, civil society organisations, researchers, educators etc. – which emphasises the wide variety of stakeholders working on this issue.
As the Alliance Secretariat, we have a convening role. We bring stakeholders together at different levels: national, international, regional. We look for opportunities to broker, network and support partners. These can be in the form of discussion forums, events and meetings, organised by us or our partners, to raise and discuss issues on human resources. If we convene meetings at country level, we go beyond the Ministry of Health to include the private sector, the health financing sector, professional associations and civil society, for example.
We connect to front line health workers through our partners, now a huge network, and these partners often work in peripheral and rural areas, with projects on the ground. We will soon also operate Knowledge Centres, providing direct support to health workers at district and sub-district levels in Ethiopia and Mali. There are possibilities of expanding this further to ensure that health workers who cannot easily access facilities have access to knowledge and skills.
A milestone for the response to the health workforce crisis was the First Global Forum which we convened in Kampala in 2008. Over 1,500 members from all over the world, including top political leadership in countries, major donors, and civil society organisations, came together to identify how to tackle the problems we face in human resources for health. The Kampala Declaration and Agenda for Global Action, endorsed at the Forum, contains a ‘road map’ for the next ten years. We have agreed a joint strategy and have a joint commitment and accountability mechanism.
The Alliance has come a long way but we face challenges. One is ‘how do we maintain the focus and the high level commitments at global level and turn them into action?’ The last two G8 communiqués recognised the global health work force as a major player in improving the health of populations, and that the problems in the global health workforce need to be addressed. The G8 also noted the Kampala Declaration and Agenda for Action as the reference document and guideline for moving the response forward. We must look to ‘what next’. What are we doing to ensure pledges made on the health workforce – such as those at the G8 and through the Kampala Declaration – are turned into real action? We are trying to monitor progress according to the commitments made and are in the process of working with WHO to prepare a baseline report to show where we are in terms of the commitments made, achievements and gaps. We are holding the second Global Forum in 2011 to ensure momentum, follow up and continued commitment by partners and the development community. We have put a call out to partners and members, who include health workers, to develop the agenda for that meeting.
We also need to convince countries that are in real crisis, to make solving health workforce problems a priority that needs investment and attention, not only politically but in terms of resource allocation. It is also difficult to get reliable data about the health workforce in countries. The process for collecting and analysing data is not the same, it is not consistent, and does not cover all aspects of the crisis or the challenge. We need a good evidence-based plan that takes into account that every country is different.
Other major questions we are asking are ‘how do we ensure that health infrastructures and systems are in place and adequate? How do we ensure that the health system provides the right environment?’ If the environment and the supportive mechanisms for health workers are not in place and sustainable, (such as supervision, financial and non-financial incentives, safety against violence in the workplace, especially for female workers for example) then we cannot expect to achieve our goals.
We have come a long way as an alliance but there is much to be done. We want to focus on neglected health workers and communities who are at the forefront of ensuring that everyone receives good health care. We need quick and urgent action and financial commitment, by political leadership in countries and in the international community. If we are serious about achieving the MDGs, we need trained and motivated health workers working in safe, effective and sustainable health systems.
The Global Health Workforce Alliance is a partnership dedicated to identifying and implementing solutions to the health workforce crisis. It brings together a variety of actors, including national governments, civil society, finance institutions, workers, international agencies, academic institutions and professional associations. The Alliance is hosted and administered by the World Health Organization. For more information on the Alliance and its Secretariat, please visit: www.who.int/workforcealliance
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Filed under: Prioritising our health workforce
