Abordando la crisis de los Recursos Humanos para la Salud: ¿Hasta dónde hemos llegado? ¿Qué podemos esperar lograr al 2015?

Abstract

The World Health Report 2006 identified 57 countries world-wide whose health worker to population density fell below a critical threshold of 2.3 per 1,000 population. This meant that below this critical threshold, a country could not provide the basic health services to its population, defined here as 80% immunization coverage and 80% skilled birth attendance at delivery. Of the 57 countries, 36 are located in Africa.This article reviews the progress countries have made in addressing their health workforce crisis. It cites 3 of the most recent global studies and the indicators used to measure progress. It also features the experiences of 8 countries, namely Malawi, Peru, Ethiopia, Brazil, Thailand, Philippines, Zambia, Mali. Their situations provide a diverse picture of country efforts, challenges, and successes. The article asks the question of whether the target of 25% reduction in the number of crisis countries can be achieved by 2015. This was a goal set by the World Health Assembly in 2008. While the authors wish to remain optimistic about the striving towards this target, their optimism must be matched by an adequate level of investment in countries on HRH development. The next four years will show how much will really be achieved.

Job satisfaction and retention of health-care providers in Afghanistan and Malawi

“…Causes of extreme shortages may vary greatly from country to country. They include protracted civil war and unrest, outmigration of trained workers to countries with higher wages and quality of life and a legacy of insufficient government investment in the health-care sector [2,3]. However, there is widespread recognition that, regardless of the cause, extreme shortages of qualified health-care workers present significant barriers to health-care service delivery and that increasing the distribution and retention of health-care workers is critical to improving health system performance [4,5].…”

“…A growing number of studies are exploring the factors driving the motivation and retention of health-care workers in developing countries [2,3,18]. In some contexts, job security, recognition and better living conditions have been highlighted as key motivators for placement and retention in remote areas.…”

Human resources needs for universal access to antiretroviral therapy in South Africa: a time and motion study

“…Data on the current health workforce specifically devoted to HIV care in South Africa are not available, but WHO estimates show that in 2004 there were around 35,000 doctors and 180,000 nurses in total in the country [34]; consequently, the HW:population ratio in South Africa exceeded the threshold of 2.3 doctors and nurses per 1,000 population that has been proposed by WHO as a critical minimum [35,36]. Although our study determined the additional numbers of health workers required for future ART scale-up under different scenarios, it did not enable us to evaluate this number directly in relation to the supply of health workers in order to establish whether there is a shortage in health workers in South Africa, either nationwide or in regions.…”

The human resource information system: a rapid appraisal of Pakistan’s capacity to employ the tool

“…Pakistan is considered among those 57 countries which face an acute shortage of HRH. Published data suggests that one of the contributing factors to the dearth of workforce is the absence of a functional HRIS, and the subsequent incapacity for a sound HR decision making [6]. There is a lack of a clear vision, policy, and strategy for HRH, and since the Government of Pakistan has devolved the Federal Ministry of Health after a constitutional amendment in 2011, the importance and need of a HRIS strategic plan with a clear breakdown of short term, medium term, and long term targets has become more noticeable.…”