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
Purpose:
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.
Objective:
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
Questions:
- 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.
- Global issues to develop maternal and child health.
- Human resources for health policy and advocacy messages of
relevance to maternal and child health: RMNCH.
- IMF policies: human rights, health workers, and women's and
children's health
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
http://www.who.int/pmnch/activities/jointactionplan/en/index.html.
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.
http://www.who.int/workforcealliance/media/news/2010/mdg2010statement/en/index.html
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.
HRH
Exchange, Global Health Workforce Alliance
Giorgio
Cometto, Global Health Workforce Alliance
