African Health Leaders by Omaswa Francis; Crisp Nigel;

Author:Omaswa, Francis; Crisp, Nigel;
Language: eng
Format: epub
Publisher: Oxford University Press
Published: 2014-09-06T08:19:00+00:00

Health workers: the scarcest resource

There are many shortages in Africa. Perhaps the greatest shortage as far as health is concerned is the shortage of skilled, supported, and motivated health workers. In reality their time is the scarcest resource and needs to be used to the very best effect.

The scale of the shortfall and the impact on peoples’ lives are now well known, thanks in large part to the analysis provided in the World Health Report for 2006.1 In this part of the book we look particularly at what can be done about this in both the short and the long term, and we illustrate this with two examples of inspiring leaders who have tackled these issues in different ways. Both of them have, like other leaders in the book, drawn on the resources available to them in the community (Chapters 12 and 13). Part 4 concludes with an account from Professor Gottlieb Monekosso (Chapter 14) of how professional education and services have developed alongside each other in sub-Saharan Africa and a final chapter on indigenous knowledge systems from Professor Catherine Hoppers (Chapter 15).

Both the editors have a special interest in this area. Francis Omaswa was Executive Director of the Global Health Workforce Alliance (GHWA) from its inception in 2005 to 2008; Nigel Crisp co-chaired a task force on scaling-up education and training with Commissioner Bience Gawanas of the African Union; and both editors have been involved in the development of the WHO Code of Practice on the international recruitment of health personnel and subsequently in the Health Workforce Migration Global Policy Council, which monitors its implementation. Francis Omaswa is also the current chair of the African Platform on Human Resources for Health.2

The report of the Joint Learning Initiative ‘Human Resources for Health: overcoming the crisis’ in 2004 drew global attention to the health workforce crisis, which Africans had long complained about.3 It was followed in 2006 by the World Health report ‘Working Together for Health’, which provided the first global survey of the size and nature of the workforce problem. It identified a threshold in workforce density below which it was very unlikely that a country could carry out essential health interventions or meet the Millennium Development Goals. It found that there were 57 countries with critical shortfalls against this measure: 37 of them in sub-Saharan Africa. It estimated that globally there was a shortage of 2.4 million doctors, nurses, and midwives, which, together with shortages in other cadres, amounted to a shortfall of 4 million or more health workers in total.4 Estimates for Africa suggested that there were about 1.3 million health workers in Africa and that a further 1.5 million were needed.5

The WHO analysis described, as far as was possible at the time, the nature of the workforce and the breakdown between professions, revealing wide geographical variations. Perhaps its most instructive insight was to compare countries on the basis of their share of the world’s burden of disease and their share of the global workforce and global expenditure on health.

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