World Health & Population
Time for a Copernican Revolution in Health Labour Markets
The last decade has highlighted dramatic gaps in the quantity, skill-mix and geographic distribution of the health workforce which, in turn, has restrained progress against the health-related Millennium Development Goals (Campbell et al 2013; WHO 2006). The global community has now embarked on a journey towards even more ambitious health targets outlined in the Sustainable Development Goals – scheduled for adoption by the United Nations General Assembly in September 2015 – including reaching universal health coverage (UHC). The experiences described in this special issue of the Journal of World Health and Population – The Global Health Workforce: Striving for Equity Tackling Challenges on the Ground – highlight the depth, breadth and complexity of the health workforce issues that countries will need to solve before they can reach UHC.
This issue highlights three main challenges faced by the global community: first, we do not train enough health workers to respond to the growing demand fueled by population and economic growth and transformation (particularly demand linked to aging and equity); second, we do not nurture the kind of health workers who will be able to respond meaningfully to this expanding demand, i.e. serving the poor and responding to changing needs; and third, we operate in a rapidly changing technological environments where medical practice and learning techniques are in a state of permanent transformation. The papers in this special issue provide a snapshot of the efforts at addressing these vexing issues in very different contexts, including low-income and fragile states. All countries operate in a globalized market where demand is increasing, and health workers can be mobile in response to the powerful attraction of higher wages and better working conditions in more mature markets.
To address such a global and formidable challenge, nothing less than a Copernican revolution is needed in the way the global community addresses health labour issues – a revolution that can be summarized in three strategic shifts:
- We need to move away from a manpower approach focusing on norms and standards to a more granulated understanding of the specifics of particular contexts, rural and peri-urban, cultural and economic.
- Countries will need to be more innovative and flexible in their mode of practice, allowing the development of new job profiles and new modes of medical practice, mixing public and private incentives, and maximizing the benefits of technological transformation in an increasingly pluralistic environment.
- Innovations in training are also indispensable in focusing on selecting and nurturing a health workforce that is willing to serve the poor and disadvantaged.
And for these shifts to be successful, we will need to develop a powerful measurement framework, building on a comprehensive and in-depth understanding of the drivers of labour markets dynamics and health workers’ performance.
The challenge is immense, but only if we tackle it will we reach UHC.
About the Author(s)Agnes Soucat, MD, MPH, PhD, The World Bank Group
Campbell, J., G. Dussault, J. Buchan, F. Pozo-Martin, M. Guerra Arias, C. Leone et al. 2013. A Universal Truth: No Health Without a Workforce. Forum report, third Global Forum on Human Resources for Health, Recife, Brazil. Geneva: Global Health Workforce Alliance and World Health Organization. Available from: http://www.who.int/workforcealliance/knowledge/resources/hrhreport2013/en/.
World Health Organization (WHO). 2006. Working Together for Health: The World Health Report 2006. Geneva: World Health Organization. Available from: http://www.who.int/whr/2006.
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