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

This blog post is part of a series leading up to the 67th World Health Assembly (WHA) in Geneva, Switzerland from May 19 – 24, 2014. In conjunction with the WHA, the Leadership, Management & Governance (LMG) Project will host a side session with global health leaders titled, “Governance for Health: Priorities for Post-2015 and Beyond.” This series will offer insight on how good governance in the health system can result in stronger health impact as we move beyond the Millennium Development Goals.

Patients at a medical center in Rwanda Photo: Todd Shapera

While substantial progress in the Millennium Development Goals will have been achieved in many countries by 2015, reductions in preventable maternal and infant deaths lags, and the persistent struggle of disease burdens from communicable and non-communicable diseases is worrying.

As is too often the case, the disease burden falls disproportionately on the low-resource countries of Africa, Asia, and Latin America. With the global health workforce shortage set to meet 12.9 million by 2035, lowering the disease burden is an uphill battle hampered by the crisis in human resources for health (HRH) including health worker supply, distribution, and skills.

A recent report, “A Universal Truth: No Health Without a Workforce”, identifies several key causes for the health worker shortage. A key cause is an ageing health workforce with staff retiring or leaving for better paid jobs without being replaced. At the same time, not enough young people are entering the profession or being adequately trained. Increasing demands are also being felt in the health sector from a growing world population, with risks of non-communicable diseases such as cancer and heart disease. Internal and international migration of health workers is also exacerbating regional imbalances.

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“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.”

Addressing the health workforce crisis calls for extraordinary governance and leadership at all levels. Such leadership is required to steward all stakeholders and achieve coherence across all sectors of government, civil-society professional associations, academia, and parliaments.

Societies must explore how best to engage governing bodies at the community, district, and provincial levels. This will ensure that conditions are created to identify critical gaps; design and implement of appropriate solutions; and monitor the performance through an open and coordinated national, regional and global dialogue.

Bold new leadership and governance initiatives are being organized as health sector leaders from across the globe gather in Geneva for the 67th World Health Assembly. Coming up with clear, creative, and cost-effective strategies to address the crisis in Human Resources for Health (HRH) will require new policies and practices that strengthen the governance of investments and programming. The Global Health Workforce Alliance (GHWA) is leading efforts in HRH by engaging over 100 health sector leaders in a series of key thematic working groups that will meet at the WHA in May. Another group of health leaders will meet later on in South Africa for the Third Health System Research Symposium to define investment needs to bridge gaps in HRH performance.

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GHWA’s commitment for country based stewardship and leadership to implement sustainable solutions is making large steps to ensuring that all people everywhere will have access to a skilled, motivated and supported health worker, within a robust health system.

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