Definition and importance of
the health workforce
According to WHO, human resources for health
(HRH) are the men and women who make health
care happen. They include nurses and midwives, pharmacists,
physicians, dentists and other health
professionals. They also include auxiliary health care
workers, community health workers,
practitioners of traditional medicine, technicians and
other
paraprofessional personnel (1).They are
important because the existence and quality of services to
promote health, prevent illness or to cure
and rehabilitate depend on the knowledge, skills and
motivation of
human resources for health.
Countries must ensure that their health systems get the
right number of service providers with the
right skills to the right place at the right time. They
must also ensure that the service providers operate
within an environment that enables them to adhere
to internationally accepted and nationally adapted
standards of care, thus assuring services of good quality.
There are a range of indicators to measure the human
resources capacity in a country’s health
services
system. The principal
indicator is the proportion of health workers to the total population. Because
occupational
classifications are country-specific
and the method for
counting these workers has not
been standardized, it
has been difficult to compare
HRH capacities across
countries. For this reason,
traditionally key
cadres such as doctors and nurses have been used
to estimate the HRH
capacities.
With the advent of
HIV/AIDS, other cadres crucial to
the delivery of care
and treatment services, such
as counselors, have
become very important. Home-based care has placed a large burden for care and
treatment, including
psychosocial and nutritional supp
ort (both crucial to
adherence and effectiveness
of care and
treatment), on the family and on community health workers (CHWs). The ratios of
family, CHWs, and traditional cadres of providers to the general population and
to the population of clients
seeking facility-based
services would give a better
indication of the HRH
capacity of the country’s
health system.
Accurate measurements of these populations are not always available (2).
The
magnitude of the health workforce crisis
Health workers are
crucially important as a res
ource for producing
good health for the population.
They constitute 1 in
20 employed workers in the global economy and perform key social roles in all
societies. The
inequities faced by developing
countries are
reflected in Figures 1 and 2
below, which
highlight the
disproportionate ratio of doctors and nurses in Europe and North America as
compared
with Africa and Asia.
There is a 250-fold variation among countries in ratio of doctors per 100 000
population and
400-fold variation in the ratio of nurses per 100 000 population (3).
Figure
1. 250-fold variation in supply of doctors among countries, ratio of doctors
per 100 000
population
0 100 200 300 400 500
600
Liberia
Burkina
Faso
Somalia
Lesotho
Sierra
Leone
Angola
Madagascar
Mauritania
Guinea-Bissau
Congo
Nepal
Bangladesh
Cambodia
Maldives
Malays
ia
Romania
Croatia
Aus
tralia
Denmark
Aus
tria
Sweden
Ic
eland
Hungary
Norway
Belarus
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