Global HealthNewsNewsletter

Labour Shortages in Healthcare

 Dr. Punom Kumar Bhattacharyya, Master’s in Public Health, Umeå University

 

Healthcare delivery systems are highly labour intensive and health workers play a vital role in accomplishing most of the health system functions. Health service delivery systems that are high quality, people-centered, integrated, safe and accessible which are responsible for providing health services for patients, persons, families, communities and populations in general are very important for moving towards universal health coverage. A healthcare service provider is an individual who provides preventive, promotional, curative and rehabilitative healthcare services in an organized way to people, families or community. “Healthcare professional” are highly skilled workers that include Physicians, Surgeons, Dentists, Nurses, Pharmacists, Midwives, Paramedics, Therapists, Psychologists, Medical laboratory technologist, Dietitians etc who commonly work in hospitals, healthcare centers like Medical Laboratory’s, Clinics, NGO’s and other service delivery points. A Health practitioner may also be a public/community health expert who might involve in academic training, research and administration. They Usually work outside formal healthcare institution for the common health benefits of the society also considered a vital part of the healthcare team.

“Healthcare professionals” are highly skilled workers that include Physicians, Surgeons, Dentists, Nurses, Pharmacists, Midwives, Paramedics, Therapists, Psychologists, etc.

Global Crisis Forecast: The health status of a population and its requirements in the human resources for health sector are linked in complex ways that typically includes three dimensions: (i) availability, which relates to the supply of qualified health professionals; (ii)distribution, which relates to the enrollment and retention of health workers; (iii)performance, which relates to the essence of the care that health workers provide. In WHO’s most recent comprehensive global study, it estimates a global shortfall of 12.9 million healthcare workers by 2035. Moreover, WHO identified in 2006 a minimum density of 22.8 skilled health professionals/10,000 people to provide the most basic health coverage (World Health Report 2006). In the 100 countries, there is currently a total shortage of about 7.2 million health workers (with available data). The South-East Asia and the African region are the most affected zones accounting for 47% and 25% of the total deficit, respectively. In contrast, the deficit of healthcare worker is smaller in the Region of the Americas (4%) and the European region (1%). The relative shortages of doctors, nurses and midwives are currently one of the major obstacles to achieving the MDGs and other international health goals. If not addressed -will have serious implications for the health of billions of people across all regions of the world. These global shortage of healthcare providers disproportionately affect low and middle-income countries because these countries have limited resources and face a major burden of disease. While malaria, tuberculosis and other infectious diseases remain significant contributors to the disease burden found in low and middle-income, now these countries also face the total array of noncommunicable and chronic diseases like diabetes, cancer, stroke, heart diseases.

The report “A Universal Truth: No Health Without a Workforce” was released on November 2013 at the Third Global Forum on Human Resources for Health, Recife, Brazil which identifies several key causes. Most importantly an ageing health workforce with staff retiring or quitting for better paid jobs without being replaced, while inversely not enough young people are entering the health sector or being properly trained. Increasing demands from a growing world population with risks of non-communicable diseases and domestic and international migration of health workers is accelerating regional imbalances. The critical shortages and inequitable distribution of health workers within countries are also major barriers for the coverage of health interventions.

Immediate Action Needed: Any problem that exists within a health care system cannot be tackled without adequate staff because health workers are the backbone of sustainable health foundations and are fundamental to attaining Universal health coverage.

  • Holistic Approach: Integrated and coordinated political approaches with High-level technical commitment is required at country, regional and global level that pay attention to every step in the “Supply Chain” of health workers with a vision to recognize and support improved working condition (adequate facilities, supervision, fair remuneration and opportunities for advancement.)
  • Education and training: Health workforce production and the empowerment of health workers must be made a top priority. Governments, trade unions, professional associations, private sectors, international organizations and civil society have a joint responsibility in producing adequate quantities of the health professionals. The voice, rights and responsibilities of healthcare workers must play a key role in establishing and implementing concrete strategies and policies.
  • Scale-up and retention: National stakeholders and development partners from finance, education, labour and other sectors have vital roles to play in the collection of reliable data and prioritize the strengthening of national HRH databases which is a critical factor for quality workforce planning, monitoring and forecasting. To be effective, a health-care system must have the proper number and appropriate mix of healthcare workers and it must ensure that they hold the manner and motivation to skillfully perform their assigned function.
  • Leadership, financing and task sharing: Well organized procedure to measure, reward and sustain high-quality service provision in association with adequate funding will ensure the coordination of and across different sectors and constituencies in support of retention of health workers in countries where the deficits are most acute and greater balancing of the distribution of health workers geographically.
  • Any Individual or Instutution committed to seeing the fulfillment of the health-related Millennium Development Goals must also be committed to identifying the global shortage of healthcare professionals. The global shortages forecasted for 2030 may not occur if labor productivity could be accelerated with the better use of technical support, quality skills development and Institutional reformation. A crucial challenge to the international community is to determine what kind of additional investments will be needed to achieve greater efficiency with the limited number of available health professionals and a more systematic deployment and distribution of them both within and across countries.

 


References:

1) Anand S, Bärnighausen T. Health workers at the core of the health system: framework and research issues. Health Policy2012;105:185–91.

2) Vujicic M, Zurn P. The dynamics of the health labour market. Int J Health Plann Manage 2006; 21: 101-15

3) A Universal Truth: no health without a workforce, The Global Health Workforce Alliance

4) News release. 11 November 2013 | RECIFE, BRAZIL – www.who.int/mediacentre/news/releases/2013/health-workforce-shortage/en/

5) Why do health labour market forces matter? Barbara McPake, Akiko Maeda, Edson Correia Araújo, Christophe Lemiere, Atef El Maghraby & Giorgio Cometto

6)United Nations General Assembly. Transforming Our World: The 2030 Agenda for Sustainable Development [Internet]. United Nations; 2015 [cited 2015 Oct 10].

7)World Health Organization. The World Health Report 2006: Working Together for Health [Internet]. 2006 [cited 2015 Mar 12].

8)Taylor A.L., Hwenda L., Larsen B.I., Daulaire N., 2011. Stemming the brain drain–a WHO global code of practice on international recruitment of health personnel. N Engl J Med. 2011 Dec 22;365(25):2348-51

9)Chen L, Evans T, Anand S, Boufford JI, Brown H, Chowdhury M, et al. Human resources for health: overcoming the crisis. Lancet. 2004;364:1984–90.

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