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Guardian Online Series Explores Global Health Worker Issues

The Guardian reports, as part of an online feature about health care workforces worldwide done in association with the Global Health Workforce Alliance (GHWA), that “Africa is desperately short of doctors and nurses. So is much of Asia. In 57 countries, the situation is deemed by the World Health Organisation (WHO) to be at crisis point … But in contrast to some other developing world problems, this is an issue that really does affect all of us. The world needs an estimated 4.2 million more health workers.”

“In its 2006 report, the WHO estimated that 23% of doctors trained in sub-Saharan Africa are working in economically developed OECD countries. Canada and the United States, with only 10% of the global burden of diseases, have 37% of the world’s health workers,” the Guardian writes. Health worker shortages in the developing world is one reason “why the global health movement has been moving in recent years away from treating diseases such as HIV/AIDS in isolation to support for ‘health systems’ in general,” the Guardian notes. “Today’s thinking is that it makes no sense for a nurse to treat only HIV when the woman in front of her may have a child with pneumonia or a baby with life-threatening diarrhoea.”

“We don’t necessarily need fancy infrastructure,” according to GHWA Executive Director Mubashar Sheikh, who is quoted throughout the article. “There is a general consensus that health workers are the lifeline of the system,” he said. The article notes the attention this has received over the last few years. “The last three G8 communiques recognised the crisis and committed to help poor countries. The U.S. has pledged to support the training of 140,000 health workers, mostly in Africa,” according to the Guardian. Brian Rockliffe, the director of the charity VSO, is also quoted (Boseley, 1/18).

A second article in the series examines the global shortage of midwives. “[E]very year more than 7 million babies are stillborn or die shortly after birth – the majority from preventable conditions,” the Guardian writes. “More than half of these deaths occur in sub-Saharan Africa, largely due to the shortage of midwives and the lack of emergency obstetric care. Sub-Saharan Africa, which has 33% of the global burden of illness and deaths of mothers and children, has only 2.8% of the world’s health workers.”

Malawi’s 10,000 paid community health workers is noted as a sign of “[g]enuine progress” in addressing the problem. The WHO’s Lale Say said, “Many newborn deaths could be averted with a combination of outreach services and improved family and community care.” The piece also highlights the WHO’s recommendation that more than 4.2 million health workers are needed to “provide access to reproductive, maternal and newborn health services in the 51 countries with the lowest incomes and highest burden of disease,” the Guardian writes (Robson, 1/18). A related interactive graphic provides data about the 57 countries with fewer than 23 health workers per 10,000 people, according to the WHO (1/18).  

“Health worker migration is a big issue,” an article looking at health worker migration reports. “[I]n 2005, it was widely reported that there were more Malawian doctors in Manchester[, England] than Malawi. Now, it seems, there are more Ethiopian doctors in Chicago than in Ethiopia. More generally, within the continent of Africa, the World Health Organisation (WHO) has estimated that more than a third of South African doctors have left for Europe, north America or Australia since 1996. While 16% of medical practitioners in South Africa came from other, poorer, African countries.”

The piece looks at why health workers move, the patterns of migration, the effects of health worker migration and the WHO’s global code of practice on the international recruitment of health workers. Matthew Foster, head of international affairs at the Royal College of Physicians, is quoted (George, 1/18).

The Guardian feature also includes content from the GHWA, including several case studies that are under consideration for the Alliance awards, which will be given out from 25-29 January in Bangkok, Thailand: