Wednesday, February 16, 2011

A Yemeni postcard from the Second Global Forum on Human Resources for Health

How is it possible to provide basic health care to people in health crisis countries when there is a significant shortage of health workforce in those countries? How is it fair to have imbalance in the health workforce between rich and poor countries? How is it possible to invest in domestic health workforce to fill shortages from both sides?

According to the World Health organization’s latest statistics, a billion people in 57 countries –Yemen is one of them- from the developing countries face a daily hardship to access basic healthcare due to health workforce shortages and uneven distribution of health workers within countries. Hundreds of thousands of men, women and children, mostly in rural areas of the world’s poorest counties, live and die without ever seeing a trained health worker.
Yemen, being a developing country with about two third of its population live in rural areas, health workforce shortage is one of the key challenges Yemen faces. The main issue is that many developed countries import a large number of health workers from developing countries to fill their own health workforce gaps. There is no specific statistics about the Yemeni health workforce working abroad but it’s believed that a great number of Yemeni health workers work in medical centers and institutions within the neighboring countries and in some cases in the United States of America.

During the Second Global Forum on Human Resources for Health, in Bangkok, Thailand (25-29 of Jan.), discussions, sessions and meetings took place under the frame work of reviewing and renewing commitments made in the First Global Forum on Human Resources for Health in Kampala, Uganda, in 2008. The main aim of the first forum was to address health workforce challenges. Since then, a great attention has been given to the important role played by health professionals in meeting the United Nation's millennium development goals by 2015. Especially, the number 4th, 5th, and 6th goals (Goal no. 4: reduce child mortality rate, goal no. 5: improve maternal health and goal no. 6: combat HIV/AIDS, malaria and other diseases).

The essential problem for those developing countries that suffer from this issue is the lack of sufficient long term financing on capacity plan and implement programs to sustain improvements. Since the issue is complex, many factors overlap in addressing the issue. Domestic and external dedicated financing and coordination action by national and international actors in health, education, development, civil society and the public and private sectors must work hand in hand tackling key health workforce’s issues.

The Second Forum was a chance where more than 1,000 national and international leaders and experts, including Ministers of Health, public health experts, health workers experts, influential figures and civil society organizations from round the world met to take key actions to accelerate progress to implement the Kampala Declaration and Agenda for Global Action, the roadmap adopted in 2008 to drive improvements in the health workforce. One of the main outcomes of the second forum was that participants unanimously stressed on the need to secure more funding to countries that need it the most.

Moreover, the biggest challenge facing health sector in the crisis/ developing countries is the disparity between the great number of patients needing basic health care and the small number of national health workers. Regarding the Arab region, Dr. Mubashar Sheikh, executive director of Global Health Workforce Alliance said, “In the Arab gulf region, wealthy countries are producing very few health workers. Consequently, they are recruiting health workers from developing countries like Yemen, Sudan, Pakistan, Indonesia, Philippines and other developing countries as well. So, the issue is that those developing countries are under severe problem. The problem is really complex and affects both sides; the developed and the developing countries. The imbalance in health workforce should be address immediately.”

Several gulf countries have always been in demand for skilled foreign health workers. The enormous number of recruited of health workers from the poor countries to rich countries compromises the quality of health workers in those poor countries. One of the best solutions to address this problem is that the rich countries invest in the domestic market. “They should encourage the private and the public sectors to invest in the health sectors to avoid the gap in their countries of health workforce so they don’t need to recruit from poor countries. That solution won’t happen overnight but it will take some time. Gradually, over period of time; between five to six years, people will have more and more health workers which are from their own population,” Dr. Sheikh added.

Dr. Jamal Nasher, undersecretary for Yemen’s Ministry of Public Health and Population, Planning and Development sector examined the challenges and talked about what the Ministry is conducting to address the issue. “One of Yemen’s key challenges in the health workforce is developing a national quality heath workforce. Even though the health sector in Yemen had a great progress over the last years, lack of health workers remains a key challenge. Yemen is among 57 countries that have crisis issues of health workforce. Yemen is also urged to meet the MDG goals by 2015. The 4th, 5th, and 6th goals are Yemen’s priorities. Those goals will be hard to meet unless Yemen has a sufficient number of health workers that will provide a quality health care.”

“One of the obstacles is the lack of funding that Yemen suffers from. If it wasn’t for that, we would have had more medical institutions. In addition, lack of strategic planning and management in the whole sectors that are in link with the health sector is also an obstacle. The Ministry of Health is now conducting several strategies under the frame work of a great plan of 2011 to 2025 and it will address all the obstacles to make sure that there is a better strategy where we will meet the MDG goals and boost our health workforce,” Dr. Nasher added.