Resources: the health workforce

Resources: the health workforce

This section of the course is designed to help understand the importance of an adequate, well trained, and well performing health workforce

Two of the Sustainable Development Goals are especially relevant to our discussion on the health workforce:

SDG 3: Ensure healthy lives and promote well-being for all at all ages

3.8 Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all

3.9c Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States.

SDG 4: Ensure inclusive and equitable and quality quality education and promote lifelong learning opportunities for all

In a perceptive paper, Forecasting imbalances in the global health labor market and devising policy responses, Scheffler et al state:

"To deliver essential health services required for the universal health coverage target of the Sustainable Development Goal 3, there will be a need for almost 45 million health workers in 2013 which is projected to reach almost 53 million in 2030 (across 165 countries). This results in a needs-based shortage of almost 17 million in 2013. The demand-based results suggest a projected demand of 80 million health workers by 2030."

They conclude: "Demand-based analysis shows that high- and middle-income countries will have the economic capacity to employ tens of millions additional health workers, but they could face shortages due to supply not keeping up with demand. By contrast, low-income countries will face both low demand for and supply of health workers. This means that even if countries are able to produce additional workers to meet the need threshold, they may not be able to employ and retain these workers without considerably higher economic growth, especially in the health sector." The picture below, from their paper, demonstrates the intersection of the education and health systems

Global health workforce initiatives

The Global Health Workforce Alliaance was established in response to this statement from its original web site: "Health workers are the heart and soul of health systems. And yet, the world is faced with a chronic shortage - an estimated 4.2 million health workers are needed to bridge the gap, with 1.5 million needed in Africa alone. The critical shortage is recognized as one of the most fundamental constraints to achieving progress on health and reaching health and development goals.

The Global Health Workforce Alliance (GHWA) was created in 2006 as a common platform for action to address the crisis. The Alliance is a partnership of national governments, civil society, international agencies, finance institutions, researchers, educators and professional associations dedicated to identifying, implementing and advocating for solutions." 

The work of the GHWA has led to the recent publication of Global Strategy on Human Resources for Health: Workforce 2030. This is a comprehensive document with the goal to "improve health, social and economic development outcomes by ensuring universal availability, accessibility, acceptability, coverage and quality of the health workforce". WHO has established the Global Health Workforce Network 'as a global mechanism for stakeholder consultation, dialogue and coordination on comprehensive and coherent health workforce policies in support of the implementation of the Global Strategy on Human Resources for Health and the recommendations the Commission'.

From the important paper The global health workforce stock and distribution in 2020 and 2030: a threat to equity and ‘universal’ health coverage?:

• The latest NHWA data for the year 2020 show a total stock of 65 million health workers globally, which represents an increase of 14 million net jobs as compared with 2013, and furthermore a potential increase of 19 million net jobs by 2030.

• Consequently, the revised estimates of the global HWF shortages indicate a reduction (of the 18 million figure) to 15 million in 2020 and a projected number of 10 million by 2030 based on current trajectories into the future (mostly depicting a pre-COVID-19 situation).

• Significant regional disparities remain, and inequities have increased, as the projected 2030 shortage will cluster in the 47 countries included in the WHO support and safeguard list. Those countries alone will bear two-third of the global shortage.

Clearly addressing these challenges will require a massive effort to build workforce capacity and Peoples-uni has developed a model of online global learning: Building public health capacity through online global learning. This course on Health Systems is one of a series of Open Online Courses of designed to meet this need (see others here) . The key features of the model are:

• Online learning using Information and Communication Technology;
• Global context realising that global health  challenges are relevant to all;
• Bidirectional learning between and within students and tutors in low and high income settings;
• Focus on further educational developments and delivery channels;
• Lifelong learning relevant to the stages of career progression.
  

The Learning Ladder below comes from the paper, and demonstrates that learning requirements evolve over the stages of career development.