The shortage of health workers around the world is estimated at over 4 million, and 57 countries are experiencing a critical shortage, defined as having fewer than 2.3 doctors, nurses or midwives per 1,000 population. This translates to nearly a billion people who have no health worker to turn to when they or a loved one becomes ill or needs medical attention.
How is the sustained development of healthy and prosperous communities possible in such an environment?
At the United Nations Conference on Sustainable Development, Rio+20, leaders of governments, civil society, NGOs, donors and the private sector will convene to consider the future of development and humanitarian assistance. I urge us all to consider how our approach must change. U.S. Agency for International Development Administrator Raj Shah’s blog talks about U.S. investments and a shift in thinking from relief to resilience. I applaud this idea and challenge us to think about the roles health workers play in resilient communities.
For millions of families, a frontline health worker is their only source of critical care. She may also be their primary source of health information on issues like HIV prevention and family planning. Are these same health workers prepared to counsel families on lifestyle choices to prevent chronic disease? To support mental health? To promote green development, education, or women as entrepreneurs? In Rio and beyond, we must seriously discuss the roles that health workers are playing or could play within their communities. If not, we may fail to tap into the potential of a wide-reaching network of change agents.
The health workforce shortage has received increased attention over the past few years, starting with the World Health Organization’s 2006 World Health Report on the crisis. Many countries have invested in strengthening national health systems and creating a policy environment that supports human resources for health. I salute the increased investments and attention that have come from the donor community, but we are not there yet.
Health systems are still weak or failing in many countries, and health workers are witnessing how every little failure touches someone’s life. This may include having the skills to treat a child suffering from pneumonia, but no drugs due to a stockout. Or knowing that a woman needs urgent care during labor and delivery, but lacking the means to transport her to a hospital. Health workers can also help to fix these failures, given the right support and innovative thinking.
A healthy community, though, is more than a community with access to a health worker. It’s more than an absence of acute illness. Climate change, social inequities, poverty, armed conflict and other humanitarian crises, and pollution are just some of the factors affecting health and the ability of health workers to do their jobs. We need more intersectoral approaches and systems thinking to address development challenges. We cannot make these factors disappear, but together we can work to address them.
Individuals and communities around the globe are increasingly interconnected. Health workers are links within communities; they are influential, and they can be powerful. They know their community members intimately, and are with them during times of joy as well as times of sorrow. They are trusted by their friends and neighbors. Health workers can truly be change agents in helping their communities come together to address a myriad of challenges with local solutions and bringing the voice and needs of their communities forward. I have seen this happen in communities around the world, from India, to Kenya, to Senegal.
IntraHealth is a global champion for health workers, and we use a comprehensive framework to guide our investment in health workers. We are committed to making sure that more health workers are present, ready, connected, and safe. I urge the broader development community to consider everything this framework encompasses and how your work fits in, because I guarantee that it does.
Health workers need to be present — on the job where they are most needed, including serving rural and remote populations. They need to be ready, with the right skills, supplies, and support. They need to be connected to technology, information and each other. And finally, health workers deserve to be safe. They should be able to work free from occupational hazards, gender and other forms of discrimination, and they should be protected during armed and social conflict under the principle of medical neutrality.
A dramatic shift is necessary to solve some of the most pressing global health problems, and as hard as producing 4 million more health workers may be — it’s not the only solution, because the problem is not one of sheer numbers alone. Countries need more health workers, and they need to better prepare them to operate in a more integrated world.
By the end of Rio+20, I hope to see strategies and resources dedicated to better preparing health workers to operate in this increasingly connected world. If this does not happen, we will miss an opportunity to leverage the unique role and position of health workers not only in addressing health, but in addressing the overall development of their communities and countries.
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