Global Forum on Human Resources for Health Features AMREF's Experts and Innovative Programs
AMREF experts at the 2nd Global Forum on HRH are blogging from forum in Bangkok Thailand. Read the most recent blogs below and check this page often for regular updates.
Friday, January 28, 2011
By: Caroline Mbindyo (AMREF HQ)
There about 2,400 medical schools in the world, most of which are located in the global north, whereas the greatest need for medical personnel is in the global south. The same can be said for nursing, midwifery and public health educational institutions. With the global shortage of skilled health workers – and critical shortage in Africa - it is not surprising that countries are grappling with the challenge of rapidly and cost-effectively training, re-training and retaining health workers who are “fit for purpose” in the 21st century.
One thing is clear from the day’s deliberations: innovation (from recruitment of potential heath workers, through their training, employment and retention) is critical to mitigating this health worker shortage.
AMREFs eLearning program to incerase the skills of in-service nurses in Kenya rapidly and cost effectively is seen as one of these innovative strategies.
This program is run in collaboration with the Ministry of Health (Medical Services) and the Nursing Council of Kenya and has enrolled over 7000 nurses across 108 eLearning Centers over a 5-year period. Evidence from numerous eLearning projects indicate that eLearning can make a significant contribution to easing educational costs, scope, access quality and instructor shortages – all challenges in health workforce training. However, in speaking of innovation we are not just looking at technology but innovation in curricula, in selection of students, in location of school, in retention of health workers, and so forth.
As mentioned in Day 4, the World Health Organization’s progress report on Kenya indicated that the country improved 100% in all key indicators being measured accept in the implementation of Human Resource Information Systems (HRIS). Examples of implementation of HRIS in Angola and Tanzania illustrate that a HRIS customized to local needs provides leadership and healthcare managers with data to answer key policy questions. HRIS also provides evidence for production, recruitment, deployment and further development of the health workers.
Thursday, January 27, 2011
By: Hattie Begg (AMREF UK)
For me, the highlight of the day was the first formal session: “From Kampala to Bangkok”, in which the Global Health Workforce Alliance launched their latest report outlining progress made in human resources for health since the First Global Forum in Bangkok three years ago.
The report measures progress against the six key strategies recommended in the 2008 Agenda for Global Action (leadership, evidence, education and training, investment, migration and retention). The report details some interesting findings: 43 out of the 57 human resources for health ‘crisis countries’ (86%) now have a human resources for health strategy or plan; 80% have increased rates of recruitment since 2008. But on the whole the findings were rather depressing. Less than half of all plans are actually costed or have an accompanying budget, and the majority of countries reported that their implementation was seriously ‘lagging’.
The Director of the Global Health Workforce Alliance also drew attention to the issue raised repeatedly in this conference so far: the issue of the human resources for health ‘information gap’. According to Dr. Mubashar Sheik, the Alliance was overwhelmed by the struggle to gather data from the 57 priority countries, where information systems remain ‘rudimentary’.
In particular, the session highlighted three key areas in which serious progress was needed:
1. Dramatically scaling up and supporting community health workers (CHW);
2. Improved retention of health workers in rural areas; and
3. Implementation of the WHO Code for the international recruitment of health workers.
For more details on the report, please visit:
http://www.who.int/workforcealliance/forum/2011/progressreportlaunch/en/index.html
Thursday, January 27, 2011
By: Diana Mukami (AMREF HQ)
One billion people will never see a health worker in their lifetime.
AMREF strongly believes that investment in human resources for health development, for example through a Global Fund for HRH is paramount in resolving this unacceptable situation.This is a position that was the general feeling on the fourth day of the forum, which was officially opened by Her Royal Highness Princess Maha Chakri. In her opening speech, she heralded the valiant spirit of Thailand’s Father of Public Health, Prince Mahidol who revolutionised the country’s health system through his leadership.
Reflecting on the role of leadership in ensuring access and equity in health, Lisa Meadowcroft, CEO AMREF in the USA noted the key role played by political will at the national, regional and global levels. It is crucial for national leaders to create specific health functions at the community level.
There is therefore need to focus on building the capacity of community health workers to deliver primary health care services. Nevertheless, the capacity building of CHWs must go hand in hand with all the building blocks required to strengthen the health system. One way of achieving this is through linking national plans with national, supporting this through a well-coordinated of development efforts and backed by the necessary financing. Another, as Nzomo Mwita noted, is the importance of incentivising the health workforce especially those in the rural areas be it social, financial or infrastructural incentives.
In discussing the progress since the 2008 forum, Carol Jenkins, AMREF in the USA, emphasised the importance of measuring progress to ensure accountability and transparency. For instance, WHO’s progress report on Kenya indicates 100% improvement on all key indicators, except health information systems (HIS). This monitoring does not only apply to countries in the south; the northern countries need to be taken to task to ensure that they adhere to the WHO Global CODE of Practice on the international recruitment of health personnel.
From Malawi’s HRH success story, it is clear that with concerted effort, this crisis can be resolved. At AMREF, we work together – it is the only way to achieve access and equity in health care services. A health worker for everyone, everywhere…imagine that.
Tuesday January 25, 2011
By: Hattie Begg (AMREF UK)
Today was the first formal day of the Second Global Forum on Human Resources for Health (HRH) in Bangkok, Thailand. It was a day packed full of side-events (plenary sessions begin tomorrow) all competing for the attention and participation of hundreds of international delegates from North and South, including health workers, technical experts, high-level decision-makers, and journalists.
As an AMREF team, we divvied ourselves up to ensure that we attended as many of the different side-events as possible. Today was a big day for us: AMREF’s Peter Ngatia was opening the Health Workforce Advocacy Initiative’s important side-event, and we were also hosting three of our own events throughout the course of the day.
A number of common themes recurred throughout the day’s events:
- Reviewing progress and establishing a clear way forwards: The general consensus is that since the first HRH Forum in Kampala in 2008, progress on HRH development at a global level has been ‘weak and uncoordinated’. But there have been examples of real success (e.g. the U.S. PEPFAR partnership framework in Kenya, WHO Code of Practice) there is a strong call for more aggressive and focused action. In particular, there is a strong appeal from civil society for a ‘global target’ (numbers and retention of health workers) on HRH.
- Information – more and better used: The ‘information deficit’ on HRH at both country and international levels, continues to hinder progress. There should be a strong focus on obtaining this information and ensuring there is the political commitment to do so (e.g. Ministries are often reluctant to reveal data on absenteeism, ghost workers, vacant posts etc); and on better using it where it does exist. Delegates made the point that HRH will fail to attract the funding required unless we as advocates can better make the link between HRH and improved health outcomes.
- Tension – national vs. global: We heard criticism that international advocates and decision-makers are prone to talking ‘in the abstract’ about the ‘global crisis’ and ‘global targets’; national actors were rightly demanding more practical and tangible country-level action. Participants were reminded of the importance of learning and sharing ‘in context’ at the country level, rather than discussing the crisis in the abstract. The UK’s Lord Crisp provided an excellent example of this, in his newly established Zambian-UK Health Workforce Alliance (which looks explicitly at how UK organisations in Zambia can help solve the crisis).
AMREF hosted three successful side-events and workshops:
The first was AMREF’s all-day eLearning workshop. During the course of this six-hour session, experienced staff from AMREF’s HQ delivered training on the delivery of eLearning to health workers in different locations. The workshop attracted participants from countries as diverse as Egypt, Taiwan, Tanzania, Southern Sudan and Kenya. Despite these countries having their own unique characteristics, it became increasingly clear to AMREF that the human resources for health challenges in these countries were remarkably similar, and that eLearning – as a tool to scale up numbers of trained health workers, has significant - and widespread, potential. AMREF's eLearning program is nominated work an Award of Excellence at this year's forum. Learn more about the program.
AMREF UK co-hosted an event with the UK Human Resources for Health Working Group, which it established last April 2010. The purpose of the session was to reflect on the efforts of the group over the past nine months: how and why it got together, key successes, and lessons learned and challenges. The group also wanted to learn from the audience – particularly from civil society in the South, and from key UK and European decision-makers, about how the group could be more effective in the future. The session attracted over 50 participants from both North and South, including high-level European and UK decision-makers (e.g. UK Department of Health, 3 European MPs, ex-DFID staff, and one European Commission delegate). Excitingly, we obtained new recruits to the UK Working Group, including the UK Faculty for Public Health, as well as important and strategic advice for how best to move forwards.
In a side-event hosted by AMREF Italy and attended by European government representatives and HRH experts, AMREF’s Giulia Deponte presented findings from AMREF Italy’s recent report entitled: “Personale sanitario per tutti, e tutti per il personale sanitario” (“Health workers for all, and all for health workers”!) In this session, Giulia posed the important question: can we, and should we, track the contribution made by northern countries to the health workforce crisis? The consensus from participants was a resounding ‘yes’: we should track northern contributions. However, it was agreed that establishing such accountability would be impossible without clear targets and tools by which to monitor progress. The need for such tools and targets will be incorporated into the civil society platform statement published at the end of the Forum.
All in all, the AMREF team were clearly exhilarated after a day of learning about one of our favorite subjects! As Lisa Meadowcroft, CEO of AMREF USA exclaimed: “it is so exciting to be with so many people from around the world who are so committed to ensuring that there are adequate numbers of trained and motivated health workers. We know that a well-trained, motivated health workforce means the absolute difference between life and death for families around the world”.
January 21, 2011
Three of AMREF’s innovative training programs have been nominated for Awards of Excellence at the upcoming Global Forum on Human Resources for Health in Bangkok Thailand.
The nominated programs include AMREF’s work educating clinical officers to overcome the severe shortage of doctors in Southern Sudan. Training community health workers in Tanzania to reach rural communities with basic but life-saving care and upgrading the skills of more than 20,000 nurses in Kenya through E-Learning.
The Awards of Excellence highlight exceptional training programs for health care professionals from around the world.
In total, 96 nominations were submitted from 46 countries. An independent award selection committee, of prominent experts in the field of human resources for health selected the most outstanding 36 case studies – all three of AMREF’s submissions were selected.
As well as being nominated for three awards, AMREF will be running two workshops sharing expertise on advocating for human resources for health.
The forum runs from January 25 – 29, and is the second event of its kind. The First Global Forum on Human Resources for Health was held in Kampala Uganda last year. This year’s Award winners will be announced on January 29, 2011.
Visit this page for regular updates from AMREF's staff at the forum in Thailand.
Learn more
The Global Health Workforce Alliance in partnership with the Guardian, have launched a microsite to highlight and raise awareness of the global health workforce crisis ahead and the Forum. Learn more here
AMREF’s three nominated programs;
- Shifting tasks to save lives: the example of AMREF-trained clinical officers in Southern Sudan
- Community Health Workers – an important resource towards achieving the MDGs
- Using e-learning to address health worker shortages in Kenya
Learn more about the Second Global Forum on Human Resources for Health
Africa’s Health Care Worker Crisis
One of the greatest obstacles to fighting disease like HIV/AIDS, TB and malaria in Africa is the lack of trained health workers at almost every level of the health care system. Africa truly is suffering from a health care worker crisis with 25 per cent of the global disease burden but only 3 per cent of the world’s health care workers.
The World Health Organization has determined that countries with less than 2.3 doctors, nurses and midwives for every 1,000 people are “very unlikely” to achieve the health related UN Millennium Development Goals – 60 per cent of these countries are in sub-Saharan Africa.
The crisis is particularly severe in remote regions where 80 per cent of Africa’s population lives. Rural health workers feel extremely isolated living away from their families and working in incredibly difficult conditions with few resources. Morale is low, and if a position arises in a more urban area, or overseas with better facilities and a greatly improved standard of living, the majority will seize the opportunity.
Responding to the Crisis
The only way of effectively responding to this crisis is to invest in African solutions that strengthen entire health systems.
Training more health care workers is essential but only part of the solution.
African nations need strong national health plans that ensure there are enough administrative and management staff and that performance and quality of work are closely monitored.
These plans must also guarantee the most basic needs of health care workers are met to keep them motivated including supportive supervision, proper training, strong referral systems, availability of necessary medicines and equipment, safe working environments and above all a decent wage.
AMREF addresses the crisis from the grassroots upwards strengthening systems to better serve the most vulnerable communities. AMREF also focuses on training mid-level and community health care workers who have a critical role in bringing good health closer to people’s homes.
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