Education and Training

A Midwife Crisis

“If we want to stop these women and babies dying, we need to invest in skilled care,” declared Flavia Bustreo, assistant director-general of family and community health at the World Health Organization. Bustreo’s declaration came on the heels of the release of the WHO’s State of the World’s Midwifery 2011: Delivering Health, Saving Lives. In an effort to facilitate the strengthening of midwifery education and service delivery, the report features data collected from 58 developed and developing countries and makes recommendations on how to improve access to midwives.  
Midwifery challenges
The term “midwife” literally means “being with the woman.” Midwifery care is essential in improving maternal health, reducing the likelihood of a woman’s death during childbirth, and reducing newborn deaths. The State of the World’s Midwifery report notes that 358,000 women and 3.6 million newborns die each year from complications in the neonatal, delivery, and postnatal periods. The report clearly cites that these deaths are largely preventable. Read more »

Addressing the Global Burden of NCDs: Health Workers Needed

Mesrak BelatchewIn the past few decades, the incidence and prevalence of noncommunicable diseases (NCDs) has continued to grow. The more we learn about the magnitude of NCDs, especially in developing countries, the more it’s clear that we need to focus on health workers as the center of our efforts to manage NCDs effectively.

The first Global Ministerial Conference on Healthy Lifestyles and Noncommunicable Disease Control, held in April 2011 in Moscow, drew much-needed attention to the global burden of NCDs. The conference report showed that cardiovascular diseases, diabetes, cancer, and chronic respiratory diseases are the leading causes of morbidity, disability, and mortality in the world. NCDs cause over 60% of global deaths, 80% of which occur in developing countries. In addition NCDs are projected to contribute to 75% of global deaths by 2030, significantly impacting all levels of health services, health care costs, and the health workforce, as well as national productivity. The June 2011 Global Health Council annual conference provided further exposure for global and country-based research findings, program interventions, lessons learned, and the way forward in addressing NCDs. Read more »

International Nurses Day 2011: Increasing Access and Equity

Shaun NoronhaMay 12 is celebrated the world over as International Nurses Day, with this year’s theme calling particular attention to issues of access and equity in health care.

Nurses make up the bulk of the health workforce, especially in sub-Saharan Africa, which has 5.5 nurses and midwives for every physician. While nurses’ contributions to the health system are well-established in the literature, to date, scant attention has been directed toward many of the critical issues nurses face in their careers.

The status of nursing education in developing countries is poorly understood. Read more »

Retaining Community Health Workers in Ethiopia

Mesrak BelatchewIn a recent New York Times opinion, Tina Rosenberg asked “What makes community health care work?” Her commentary highlights the important elements for sustaining community health work in developing countries—careful financing, using teaching as part of the sustainability structure, supervision and training, working with the government, and scaling up according to the program and country context—and refers to the rich experiences of BRAC in Bangladesh.

Ethiopia’s health extension worker (HEW) initiative, established in 2004, is another example of a successful program in sub-Saharan Africa. Developed and implemented by the Federal Ministry of Health in collaboration with the Ministry of Education, the HEW program has evolved both in scope and scale to accommodate new health initiatives. Read more »

Health Workers for a New Century

Hopital El Hadj Ibrahma Niaso Kaolack“Health is about people—those with needs and those who are entrusted to respond to those needs,” said Dr. Julio Frenk, Harvard School of Public Health dean and cochair of Education of Health Professionals for the 21st century: A Global Independent Commission.

Dr. Frenk presented the Commission’s new report, "Health professionals for a new century: Transforming education to strengthen health systems in an interdependent world," at the World Bank recently, noting that this report represents a change in basic thinking about health education. Read more »

Health Workforce Action after Bangkok

Maurice MiddlebergRecently a thousand people gathered in Bangkok for the Second Global Forum on Human Resources for Health. Since then many of us have been reflecting on where to focus our energies. Here’s what’s been on my mind.

Communicating about the crisis and its solutions
The forum opened with a wonderful video on health workers—the best piece in any medium I have ever seen in terms of communicating the essence of the health workforce crisis.

Effective communication about the issues—and how to resolve them—is vital to garnering the support we need to make real progress. To the extent possible, we should commit sufficient resources to this effort. Read more »

Making Money Work: Global Advisory Board to Strengthen Health Professional Schools

Amanda PuckettRecently, CapacityPlus announced the launch of the Global Advisory Board on Strengthening Medical, Nursing, and Public Health Schools in Developing Countries. The board—as part of our work to strengthen preservice education and training—will help to address management issues in health professional schools.

“The global health community needs to urgently support the strengthening of not only the curricula development of medical schools, schools of public health, and nursing schools, but even more so their management capacity and the ability of their deans and other senior leaders to play a prominent role in the health sector and HRH [human resources for health] reforms of their countries,” says Chairperson Dr. Ok Pannenborg. Read more »

Removing the Blindfold: Mapping Health Worker Schools to Improve Education

Shaun NoronhaThe transformative scale-up of health worker education can be like the game of pin-the-tail-on-the-donkey. We know so little about health worker education that it often feels like we’re playing blindfolded.

Recognizing that we can’t really transform health worker education until we know where health schools are located, the World Health Organization organized a panel at the Second Global Forum on Human Resources for Health in Bangkok to discuss global mapping of health worker educational institutions.

I was invited to speak about the mapping of nursing schools. Read more »

HRH in Africa Day: Translating African National Strategies into Successful Programs

Hopital El Hadj Ibrahma Niaso Kaolack staffAfter many years of stagnation, the time has come for human resources for health (HRH) to be seen as a critical issue for Africa's development agenda.

Supporting African HRH efforts
At the HRH in Africa Day—a side session at the Second Global Forum on Human Resources for Health in Bangkok—representatives from the African public sector, technical experts from universities, donor and technical assistance agencies, and nongovernmental organizations debated how to support countries to translate their national HRH strategies into successful programs. Read more »

Not Training: Educating Health Workers in the 21st Century

Shaun Noronha“We don’t train health workers. We train dogs. We educate health workers,” said David Gordon, visiting professor at the World Federation for Medical Education, to participants at the World Health Organization (WHO)/ PEPFAR consultation meeting on the transformative scale-up of medical, nursing, and midwifery education.

Held in Geneva in December, this high-level consultation brought together global, country, and institutional leaders from both the health worker education and health sectors in order to develop an opinion base and engage stakeholders for cooperative success.

Transformative scale-up
While the guidelines on transformative scale-up are still being written, this new concept recognizes two paradigms. Read more »

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