The Overseas Development Institute described the newly adopted Sustainable Development Goals as being an architectural marvel, soaring and visionary in their ambition. And so they need to be if they are to do justice to the scale and complexity of the challenges this world faces.
One in 7 people across the world today will never see a qualified health worker. According to the World Health Organization, the worldwide crisis of health worker shortages is set to grow to 12.9 million by 2035.
Without a major effort to recruit and educate health workers, how can the commitment to achieve universal health coverage be realized?
Greater emphasis needs to be placed on supporting and training health workers, building preventative capacity — as highlighted by the devastation of the recent Ebola outbreak — and ensuring that countries have a health workforce that is fit for purpose. One way to do this is to effectively harness the medical and managerial expertise available in high-resource settings.
There is a broad range of ways in which health professionals voluntarily engage in overseas work. The scale and contribution of overseas volunteering has been explored in detail in the report by the U.K. All-Party Parliamentary Group on Global Health. The report recognizes the increasing number of links between NHS Hospitals, Royal Colleges, U.K. universities and their counterparts in low- and middle-income countries.
Over the past four years the Tropical Health and Education Trust has partnered with the U.K. Department for International Development to create and support the development of such partnerships so that they are more effective, as well as to award grants that provide for a diverse range of size, reach and theme. Since the Health Partnership Scheme was launched in 2011, more than 1,500 NHS professionals have volunteered to train over 40,000 health workers across 29 countries, helping to improve training structures and fill knowledge and skills gaps.
The results of this training can be seen in the day-to-day practice of health professionals, in the development of new cadres of health workers, and the broader policy and regulatory environment they are working in. Over 500 improved clinical guidelines, policies or curricula have been generated in the past four years.
Improving the quality of mutually beneficial health partnerships
The Principles of Partnership
1. Strategic: Health partnerships have a shared vision, have long-term aims and measurable plans for achieving them and work within a jointly agreed framework of priorities and direction.
2. Harmonized and aligned: Health partnerships’ work is consistent with local and national plans and complements the activities of other development partners.
3. Effective and sustainable: Health partnerships operate in a way that delivers high-quality projects that meet targets and achieve long-term results.
4. Respectful and reciprocal: Health partnerships listen to one another and plan, implement and learn together.
5. Organized and accountable: Health partnerships are well-structured, well-managed and efficient and have clear and transparent decision making processes.
6. Responsible: Health partnerships conduct their activities with integrity and cultivate trust in their interactions with stakeholders.
7. Flexible, resourceful and innovative: Health partnerships proactively adapt and respond to altered circumstances and embrace change.
8. Committed to joint learning: Health partnerships monitor, evaluate and reflect on their activities and results, articulate lessons learned and share knowledge with others.
Find out more about tools and practical support here.
Alongside greater activity, HPS represents an important opportunity to share information and to gather evidence on what works well and what does not in partnerships and international volunteering. As part of THET’s ongoing approach to quality improvement, we have developed Principles of Partnership to accelerate the quality and effectiveness of how U.K. health care institutions engage in low and middle-income countries. We’ve defined our principles through consultation with the wider health partnership community and we plan to further develop tools and practical resources over time to highlight the most important factors for successful partnership.
A vision of ‘co-development’
At the heart of the health partnership model is the idea of reciprocity, the idea that all who engage in training health workers overseas, benefit from the kind of professional growth that brings great benefits to our working lives back in the U.K. This is what Lord Crisp terms in his seminal book “Turning the World Upside Down” as a vision of “co-development.” These partnerships are in keeping with the framing of the SDGs as global goals rather than for goals set exclusively to benefit the global poor.
Health Education England and the Academy of Medical Royal Colleges recognize the educational and learning opportunities of allowing U.K. health workers to engage in global health. Despite this, across the U.K., contributors to Improving Health at Home and Abroad commonly reported having to keep international volunteering through partnership activity “under the radar.” As a result, the scale of health partnerships remains modest, a fact recognized by the International Development Committee report on health systems strengthening in 2014, which commended volunteering schemes for health professionals but noted that the U.K. has “one of the best health systems in the world ... DfID makes only limited use of it.”
The adoption of the new SDGs is a turning point in the history of how the we live together on this planet. If that was a moment to be soaring and visionary, now is the moment to work out how we are going to deliver on our promises. We must seize this moment to direct the energy and dynamism of health professional volunteers towards the even greater challenge of building health systems fit to deliver universal health coverage to every citizen in this world.