Bill & Melinda Gates Foundation

Five Key Steps to Making the Health Workforce a Post-MDG Priority

April 04, 2014

This post originally appeared on VITAL, the blog of IntraHealth International.

This is a pivotal year for the international development community. 

Fourteen years ago, world leaders gathered at the United Nations headquarters and set eight major goals to reduce extreme poverty and improve lives around the world. Those Millennium Development Goals provided a shared blueprint that unified the global community and accelerated progress like never before. The deadline for the goals is 2015—just around the corner. 

The big question now is this: What development goals will we set next? And how can we make even faster progress toward global health and well-being? 

These questions are very much in my mind as we celebrate the second annual World Health Worker Week, April 7-11. The answer, I believe, lies with the health workforce.  We missed the opportunity to make health workers part of the Millennium Development Goals in 2000. We should not miss it again.

There is a global shortage of 7.2 million doctors, nurses, and midwives, according to new estimates by the World Health Organization. By 2035, that number could reach 12.9 million. We missed the opportunity to make health workers part of the Millennium Development Goals in 2000—we should not miss it again.

We cannot achieve greater global health without stronger health systems, and for that we must strengthen the health workforce—both adding to its worldwide ranks and making the most of the health workers that already exist.

Here are five key steps we in the global health and development field can take to make sure health workers are part of the world’s post-2015 commitments:

  1. Give health workers a voice. Health workers are the central pillar in any health system, yet we rarely we hear directly from them. We should ask health workers for their opinions, and hear their proposed solutions to on-the-ground challenges. After all, they know the social and cultural dynamics of their communities better than anyone. Health workers’ needs are complex, their environments fast-changing. Mobile technology—and the crowdsourcing and peer networking it makes possible—holds great promise in this field. Let’s use the tools we have to amplify health workers’ voices, make them part of health sector planning processes, and create systematic policies to support them.

  2. Ramp up domestic investments in health care. While some low-income countries have increased their own investments in their health sectors, many have left the issue to outside donors. Of course, governments face any number of competing priorities when it comes to their budgets, but we must do a better job of advocating to them that an investment in the health workforce is one of the fastest, most effective ways to improve health. Let’s encourage national governments to increase domestic investment in human resources for health and to create policies that benefit health workers. 

  3. Advocate for frontline health workers. Many frontline health workers around the world are still expected to work on a voluntary basis. They are not recognized as a cadre of workers, they are often not paid, and many countries do not have systematic policies that deal with them. We can change this by improving health information systems to allow countries to collect data on community health workers who are seen as informal providers, and make those workers a more formal part of the health system. We must also promote greater south-to-south collaboration. The world could learn a lot from India, for example, which has developed some very advanced strategies for frontline health workers and, through them, has improved health in some of its most impoverished regions.

  4. Set our sights on universal health coverage. To achieve universal health coverage, we need clear, articulated strategies and plans at the country level, and even stronger global governance of human resources for health. Making basic health services available to all is a tall order—but it’s the right thing to do. High-quality health care has the power to help lift those who live in extreme poverty and aid them in becoming healthy, contributing members of society. 

  5. Embrace a systems-thinking approach. The focus in creating the health-related Millennium Development Goals was largely on specific diseases and health issues. As we look beyond 2015, let’s widen the scope of our ambitions. Let’s aim for sustainable development goals. To achieve that, we who work in global health must integrate our efforts with the fields of education, food security, women’s rights, and many others. We must set indicators to measure our progress in strengthening health systems the way we did for measuring progress in maternal health and reducing child mortality in 2000. At IntraHealth International, we often say we want to see health workers who are present, ready, connected, and safe—what we really mean is that we believe in a comprehensive approach to health workforce strengthening.

If we take these steps and work together toward our common goals, we could make even faster worldwide progress over the next 15 years. 

Universal access to health coverage—and to health workers—is almost within our sights. During this pivotal year, let’s come together, clarify that vision, and pave the way to even greater global health.

 
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