Governance Challenges for the Supply of Health Workers in Post-2015 Context

Jim Rice

Former LMG Project Director

Photo: Pedro Suarez/MSH

While substantial progress in the Millennium Development Goals (MDGs) will have been achieved in many countries by 2015, reductions in preventable child and maternal deaths lags, and the persistent drag of disease burdens from Communicable and Non-Communicable Diseases (NCDs) is worrying.

As is too often the case, the disease burden falls disproportionately on the low resourced countries of Africa, Asia and Latin America. This burden is extremely difficult to address because of the crisis in health worker supply, distribution, and skills. The World Health Organization (WHO) acknowledges that there the global health workforce shortage will reach 12.9 million in coming decades.

To address this shortage, bold new leadership and governance  initiatives are being called for as health sector leaders from across the globe gather in Geneva for the 2014 World Health Assembly. To prepare clear, creative and cost-effective strategies to address this HRH crisis requires new policies and practices to strengthen the governance of human resources for health(HRH) investments and programming. The Global Health Workforce Alliance (GHWA) is accelerating its drive by engaging over 100 health sector leaders in a series of key thematic working groups that will meet at the WHA in May 2014 and in Cape Town South Africa to define investments need to bridge gaps in HRH performance.

A recent report, "A universal truth: No health without a workforce,"[1] identifies several key causes for the health worker shortage. They include an ageing health workforce with staff retiring or leaving for better paid jobs without being replaced, while inversely, not enough young people are entering the profession or being adequately trained. Increasing demands are also being put on the sector from a growing world population with risks of non-communicable diseases (e.g. cancer, heart disease, stroke etc.) increasing. Internal and international migration of health workers is also exacerbating regional imbalances. Smart governance at the country level of the HRH initiatives will help attack these challenges.

“The foundations for a strong and effective health workforce for the future are being corroded in front of our very eyes by failing to match today’s supply of professionals with the demands of tomorrow’s populations,” says Dr. Marie-Paule Kieny, WHO Assistant Director-General for Health Systems and Innovation. “To prevent this happening, we must rethink and improve how we teach, train, deploy and pay health workers so that their impact can widen.”[2]

Addressing the health workforce crisis calls for extraordinary governance and leadership at all levels.

Such leadership is required to steward all stakeholders and achieve visibility and coherence across all sectors of government, civil society professional associations, academia, parliaments and academia, to name but a few.

Societies must explore how best to engage new governing bodies at the community, district and provincial levels to ensure that conditions are created that enable an identification of critical gaps; the design and implementation of appropriate solutions; and monitor the performance in open and coordinated national, regional and global dialogue.

We need such Country Based Stewardship and Leadership to implement sustainable solutions to the health workforce crisis and achieving our common goal of enabling “all people, everywhere to access to a skilled, motivated and facilitated health worker within a robust health system”

Photo: Pedro Suarez/MSH