South Asia’s health worker shortage to figure at G8 meet

July 6th, 2008 - 9:55 am ICT by IANS  

By Patralekha Chatterjee
Geneva, July 6 (IANS) South Asia - including India - needs an additional 2.8 million health workers. The shortage there and in Africa is now so acute that it will figure on the agenda of the G8 summit of the world’s wealthiest nations in Japan July 7-9. “There is a worldwide shortage of 4.3 million health workers. Africa’s share is at least 1.5 million; the figure for South Asia is 2.8 million,” Mubashar Sheikh, executive director of the Global Health Workforce Alliance (GHWA), told IANS in an interview.

“We need to give this issue much greater recognition, and we expect something from the G8. It is on the G8 Summit agenda and we are hoping for positive outcomes,” said Sheikh, himself a doctor from Pakistan.

The leaders of 16 major economies - the G8, as well as G5 (including India), Australia, Indonesia and South Korea - are meeting in Japan next week. The G8 summit takes place from July 7-9.

“If you look at actual numbers, the problem is much bigger in South Asian countries like India, Pakistan, Nepal and Bangladesh because these countries have larger populations,” Sheikh said.

India is among the 57 countries identified by the World Health Organisation as facing a critical shortage of trained health professionals, including doctors, nurses and midwives. The scarcity is derailing efforts to reduce child mortality, improve maternal health and combat major diseases.

“Africa gets more attention because it has limited resources, a very high burden of disease, and lower capacity to produce health workers,” he said.

“The crisis is not just of numbers but also of the quality of services. I would like to stress that we are talking not only of doctors and nurses but all categories of workers required to support a health system,” Sheikh said.

“You can have the best technologies but if you do not have the right people, there will be no results.”

The Geneva-headquartered GHWA was set up in May 2006, with a secretariat provided by the WHO, to address the problem of worldwide shortage of nurses, doctors, midwives and other health workers, and to suggest solutions.

In the run-up to the Japan summit, the GHWA has called upon leaders of industrialised countries to commit to new, long-term financing for the development of the health workforce; scale up the education and training of health workers; scale up all cadres of health workers, with the mix of health workers determined by each country’s epidemiological profile and use proven strategies to develop national health workforce plans.

Migration of health workers from developing countries to the developed world gets top billing in most discussions about health workforce shortage, but in reality, it is only a part of the problem, Sheikh stressed.

“Of equal importance is underproduction of health workers not only in India, Pakistan and Africa that we hear about but also in the developed world.

“The US, for example, is producing 30 percent fewer doctors than required. We are also trying to push these countries to produce more so that their need to take health workers from outside is less.”

Apart from migration, many doctors are moving to other professions. Many health workers are shifting from villages to cities and others from the public sector to more lucrative private sector jobs.

“The underlying reasons are complex, relating to not only salaries but also the working environment. The GHWA has set up a task force to examine the key issues. The report will go into the factors which make people leave and what can be done to check the trend,” Sheikh said.

The debate about health workforce shortage has also brought to the fore many other emerging issues such as “task-shifting”.

“Training a doctor or even a nurse is a long process. Many countries just do not have the capacity. That is why we have begun to hear so much of task shifting. Some of the tasks traditionally assigned to doctors can be passed on to nurses and those tasked to nurses can be shifted to other cadres,” said Sheikh.

He helped establish a cadre of lady health workers (LHW) to provide primary healthcare to villages in remote, tribal pockets in his country in the early 1990s.

“Though the scheme met with great resistance at the start, it is now considered a great success. Today Pakistan has 100,000 LHWs across the country. Many evaluations have been done which show that this has had a positive impact on maternal and child health indices.

“Pakistan’s health minister told me recently that the new government has promised to double the number of LHWs in its manifesto,” Sheikh said.

No government can train all the health workers it needs on its own, and the private sector has to play a greater role in medical education, the GHWA chief stressed.

(Patralekha Chatterjee can be contacted at patralekha.chatterjee@gmail.com)

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