Creative Approaches to the Global Health Workforce Crisis

Maurice I. MiddlebergFive years ago the World Health Organization told us that 57 countries had a critical shortage of health workers—fewer than 2.3 service providers for every thousand people. Today, all 57 countries are still below this threshold. What’s holding us back from faster progress?

First, the good news: many of these countries have national health workforce plans in place. Forty-four of the 57 crisis countries have a plan, according to the Global Health Workforce Alliance’s recent progress report.

Now, the bad news: not all of these countries are implementing their plans. Among the 57 crisis countries, only 24 have evidence-based and costed plans and are in the process of implementing them. Countries may be daunted by perceived barriers to implementation.

That’s why it makes me hopeful to see how many countries are trying creative approaches and moving from planning to action. Read more »

What’s Really Holding Us Back? Resolving the Health Workforce Crisis

Maurice MiddlebergLately I’ve been thinking about the big picture in the global health workforce crisis. What’s keeping us from getting where we need to be?

On the one hand, we’ve come a long way in just a few years. Since the release of the 2006 World Health Report and the First Global Forum on Human Resources for Health in 2008, we’ve made notable progress:

  • Awareness of the health workforce crisis is now pervasive; this is reflected in high-level declarations of both developing and developed nations.
  • We’ve amassed a large body of knowledge and practical experience.
  • There is emerging consensus on the actions needed on a range of issues, from retention to community health workers to task-shifting.
  • Many countries have developed health workforce strategies.
  • A few countries (Ethiopia’s a great example) have made remarkable progress in expanding access to qualified health workers.

On the other hand, let’s face it: progress has been slow.

Access to health workers with the right skills is still denied to millions of people. We’re not yet where we need to be. What are the root causes of this unsatisfactory progress?

At the core is a failure of implementation. Read more »

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