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Health Workforce and Women's and Children's Health

July 11-14, 2010

The purpose of this discussion was to determine the policy positions and advocacy messages of the Global Health Workforce Alliance in relation to human resources for health issues related to women's and children's health.

Discussion Statistics

Number of participants: NA
Number of participants' countries: NA
Number of contributions: 18
% of contributions from developing countries: 80%
Number of countries contributing: 10 countries

Contributing countries: Angola, Kenya, Malawi, Malaysia, Ethiopia, South Africa, Tanzania, Tunisia , USA, Switzerland

Purpose and Objectives


Inputs into the discussion will form the basis of the Alliance’s advocacy and messaging on health workforce issues related to women's and children's health, consistent with the overarching framework of the Kampala Declaration and Agenda for Global Action.

Determine the policy positions and advocacy messages of the Global Health Workforce Alliance in relation to human resources for health issues related to women's and children's health.   
Topics for Days 1-4

  1. Please share with everyone your ideas on what health workforce policy, governance, financing and other measures are necessary at global, country and local levels to accelerate progress on women’s and children’s health.
  2. Global issues to develop maternal and child health.
  3. Human resources for health policy and advocacy messages of relevance to maternal and child health: RMNCH.
  4. IMF policies: human rights, health workers, and women's and children's health
Cross-cutting themes.

Donor funding
  • "One specific thing that I would like to add is that the support provided by donors is sometimes part of the problem instead of the solution: while the Global Fund, PEPFAR and others spend a lot of money in per diems and short-term training for HIV and other diseases, which take staff away from the health facilities where they are supposed to work, the real priority is for these funding organizations [should be] to help in training and recruiting new health workers, who can work on more health issues, including maternal and child health".  
  • "We tend to think of funding decisions being the main way for decisions affecting countries with high rates of maternal and child mortality, but we also have to consider all ways our actions and strategies shape the efficiency of health [services] around the world for better and healthy future."  
  • "Because of IMF-mediated policies (often all-to-willingly adopted by IMF-trained Ministries of Finance), when donors give aid to developing countries for health, the governments in turn divert money from their own domestic health budgets to other purposes".
  • "Wealthy countries need to make a greater financial contribution to fighting the disease [AIDS]; pharmaceutical corporations must work to provide drugs at prices poor people can afford (currently one-tenth of one percent of Africans have the money to buy life-prolonging AIDS drugs), and international intellectual property rights rules must be loosened. Perhaps most important, countries' debts must be cancelled unconditionally. Until that happens, African societies will be unable to respond to the disease that threatens to destroy them".  

Collaboration among stakeholders
  • "I think the health workforce issue is very complex, and the first thing that I want to note is that it is not only a health sector issue. Decisions affecting the health workforce are often taken by ministries of finance, education, by the civil service, professional associations, etc. So I think a key issue is that these entities must collaborate better in countries to solve health workers crisis".  
  • "Many HRH plans are one-off affairs, written at national offices within hermetically sealed rooms. They do not include input and buy-in from relevant departments, e.g. Department of Education, Department of Public Service, and Ministry of Finance, nor from stakeholder educational institutions and professional bodies. They do not adequately address the continuum of care and optimal skills mix of the planned health workforce and therefore the potential of what has been called task-shifting. They aren't addressed to the multiple levels of government where training and hiring decisions are made, nor do they involve these regional and local officials in the planning".

Training and experience
  • "Developed countries should be encouraged to form health education training formation and technology initiative partnerships".  
  • "In particular, shortfalls in clinical faculty and the absence of training and student mentoring opportunities complicate strategies for disease elimination. As a result, medical, nursing and midwifery trainees not only lack updated professional curricula and learning materials (e.g. on rapid, point-of-care treponemal tests and syphilis treatment algorithms) but also practical experience. Addressing this information gap requires the inclusion of current, updated curricula and protocols within pre-service education as well as taking opportunities to observe and provide holistic antenatal care in which syphilis prevention and treatment are incorporated into routine antenatal service delivery".  

Distribution of health workers
  • "In Kenya we might perhaps have a good number of doctors, but they are mostly in Nairobi, Mombasa and few other big towns. The rural districts, on the other hand, suffer, as no one wants to work there. So I don't know if the UN plan can do that, but national plans should create mechanisms and incentives whereby health workers are encouraged to stay in rural areas. And given that doctors are unlikely to go there in any case, the priority should be to train and deploy mid-level providers, as we have recently discussed in the online discussion on that issue".  
  • "The issue of distribution of qualified and experienced nurses and midwifes to the peripheral clinics to support the health of women and children of the indigenous population, many of whom are not having the best medical treatment. Awareness and accessibility are the key issues identified. Nurses and midwifes are reluctant to work in these areas due to lack of incentives and support from the government".
Discussion Outcomes and Report
This inputs from this discussion have been consolidated into a background paper that accompanied the UN Secretary General Global Strategy for Women's and Children's health, launched at the UN MDG Summit in New York in September 2010.

The UN Secretary General Global Strategy and its HRH background paper are available on the PMNCH website

The HRH background paper was also used for a side event of the UN MDG summit, entitled "No health workforce, no health MDGs. Is that acceptable?", which was attended by high-level delegates, policymakers and civil society organizations.

We encourage you to use the HRH background paper and make reference to it as part of your policy and advocacy work, in support of the UN Secretary General Global Strategy and to promote the HRH agenda more widely.

Organizing groups 
HRH Exchange, Global Health Workforce Alliance

Giorgio Cometto, Global Health Workforce Alliance