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Worldwide there is a shortage of health personnel. Especially developing countries are affected, where the health systems are already weak. The shortage is threatening the health of the poorest. (Photo: Direct Relief/flickr, CC BY-NC-ND 2.0)
Statement by Administrator Samantha Power
USAID "In the small town of Dodota, Ethiopia – population 96,000 – health workers go to extraordinary lengths to track malaria. With only two health centers for a town where every single person has an elevated risk of contracting or dying from malaria, health workers are essential foot soldiers in the battle to keep the disease at bay, going door to door, asking residents if anyone inside has suspicious symptoms. And when COVID-19 descended on Dodota, these health workers doubled down, equipped only with hand sanitizer and masks – testing patients with fever not just for malaria, but for COVID; spreading awareness of social distancing and handwashing; and, when necessary, directing COVID patients into isolation."
Maximizing health system benefits and safeguarding health workforce rights and welfare through fair and ethical international recruitment
"International migration and mobility of health workers has increased in volume and complexity in recent decades. If not adequately managed, migration of health workers from low-and middle-income countries can exacerbate shortages and weaken health systems in these countries, widening inequities. This in turn can threaten international health security, with grave repercussions for economies and societies globally. Among the different pathways for movement of health workers, government-to-government agreements hold important potential to ensure that health workers and the health systems of participating countries benefit from health worker migration and mobility. This guidance is a tool for improving the capacity of state actors involved in the development, negotiation, implementation, monitoring and evaluation of agreements related to international health worker migration and mobility (...)."
This book aims to collate information produced by WHO on social determinants of health, to help the educators of health workers to integrate the social determinants of health into education and training
"Achieving greater equity in health will demand that the health sector assumes a greater leadership role in addressing social inequalities. This requires equipping health and care workers to better understand how the social determinants of health impact patients and communities. Education of the health workforce is thus a key step to advancing action. Integration of the social determinants of health into education and training will prepare the workforce to adjust clinical practice, define appropriate public health programmes and leverage cross-sector policies and mechanisms."
Propos recueillis par Nadja Papageorgiu
"La santé pour tous, partout dans le monde: telle est la vision de Medicus Mundi Suisse. Cette année marquera le 50e anniversaire de l’organisation. Son directeur, Martin Leschhorn Strebel , se confie sur ce qu’elle a accompli à ce jour, la façon dont elle influe sur le discours du Conseil fédéral et ce que les pays du Nord peuvent apprendre des pays du Sud."
The Lancet "Unsalaried community health workers in dual-cadre programmes often face labour exploitation, potentially leading to inadequate health-care provision. Labour laws must be upheld and the creation of professional community health worker cadres with fair contracts prioritised, international funding allocated to programmes that rely on unsalaried workers should be transparently reported, the workloads of community health workers should be modelled a priori and actual time use routinely assessed, community health workers should have input in policies that affect them, and volunteers should not be responsible for the delivery of essential health services."
"Belgium, which takes over the presidency of the Council of the European Union in January 2024, plans to make the healthcare workforce crisis a central item on its agenda, the first time the issue will be prioritized at the highest level of EU policymaking in over a decade. “We are actively considering the health workforce and all the challenges around health workforces to be one of the main priorities of the Belgian presidency,” Lieven De Raedt, a strategic advisor on the international unit of the Belgian Federal Ministry of Health, told the European Health Forum in Gastein, Austria, on Thursday."
Frontline health workers have issued a joint document calling on governments and international agencies to recognize and uphold their essential rights
"Approximately 20,000 community health workers in the Indian state of Haryana have been on strike for the past three weeks. Known as Accredited Social Health Activists (ASHAs), they are part of a workforce of over one million women across India who are at the frontlines of public health care in rural and urban areas. Despite performing nearly 60 critical tasks— related to preventive, reproductive, maternal and child, and broadly, community care— ASHAs are not recognized by the government as public sector workers. Instead, they are classified as “volunteers” — a precarious category that does not afford these women basic labor rights and protections including a minimum wage, sick leave, or pensions."
By Remco van de Pas, Linda Mans & Myria Koutsoumpa
"The World Health Organization’s Global Strategy on Human Resources for Health: Workforce 2030 identified a pro- jected shortfall of 18 million health workers by 2030, primarily in low- and middle-income countries. The need for investment was re-enforced by the 2016 report and recommendations of the United Nations High-Level Commis- sion on Health Employment and Economic Growth. This exploratory policy tracing study has as objective to map and analyse investments by bilateral, multilateral and other development actors in human resources for health actions, programmes and health jobs more broadly since 2016. This analysis will contribute to the accountability of global human resources for health actions and its commitment by the international community. It provides insights in gaps, priorities and future policies’ needs."
"Health workforce challenges hinder progress towards universal health coverage, improved health outcomes and health security. The global health workforce shortage is declining, but progress is slower in the African and Eastern Mediterranean regions and Small Island Developing States. International migration of health workers, when not adequately managed, can exacerbate pre-existing inequalities, further depleting the availability of health workers in countries already affected by shortages."
The short reports provide an insight into the training of medical licentiates and nurses, and the provision of housing for health workers in Zambia. The films are in English with German subtitles.
"Discover how SolidarMed, in partnership with the Hilti Foundation and the Lichtenstein Development Service, is transforming nurse education in Zambia. With a critical shortage of health professionals hindering the country's development and impacting the well-being of its population, SolidarMed has pioneered a decentralized approach to nurse training. Unlike the traditional centralized model, the Decentralized Nurse Training Model focuses on underserved rural nursing colleges and leverages existing rural hospitals and clinics to create a networked ecosystem of practical training sites. This innovative approach allows students to gain early hands-on experience, develop crucial clinical skills, and assist short-staffed hospitals and clinics in patient management. The benefits are far-reaching."
As the United Nations multi-stakeholder meeting on universal health coverage (UHC) convenes on Tuesday afternoon in New York, we urge that women health workers are properly recognized and rewarded
"The global health workforce crisis is no longer a looming possibility. It is a reality. Pre-pandemic the World Health Organization (WHO) projected a global shortage of 10 million health workers by 2030 and since then the situation has significantly deteriorated. Staff shortages are reported ever more frequently, health workers strike more often and high-income countries increase their incentives for nurses to move from low-income countries. So why is it that recent international documents on global health, including the G7 foreign ministers’ communique on 18 April, fail to acknowledge the crucial role of health workers in the achievement of universal health coverage (UHC)? Why don’t health ministers and heads of state address the real reasons for the emptying rosters, the rock-bottom morale and the sky-high burnout?"
Mit einem Interview mit Martin Leschhorn Strebel, Geschäftsführer Medicus Mundi Schweiz
"Schweizer Spitäler suchen zunehmend ennet der Grenze nach Personal. Aber auch dort herrscht vielfach Mangel an Ärzten und Pflegekräften. (...) Das Kantonsspital Aarau führt Castings in Rom durch, die Privatklinikgruppe Hirslanden machte an einer Messe in Berlin Werbung für den Standort Schweiz. Auch die Unispitäler Zürich und Bern suchen ennet der Grenze nach Fachkräften. (...) Rechtlich ist das kein Problem – es gilt die Personenfreizügigkeit. Ethisch allerdings sieht es anders aus. Die Schweiz hat den WHO-Kodex zur Rekrutierung von Gesundheitspersonal unterschrieben, nach dem jedes Land Fachkräfte ausbilden und im Job halten soll. Davon sei die Schweiz weit entfernt, sagt Martin Leschhorn (53), Geschäftsführer von Medicus Mundi."
Rich countries still falling short on global code of practice for international recruitment of health professionals
"Eight more countries in the global south have dangerously low numbers of healthcare workers in the wake of the COVID pandemic, a new WHO report has found. The World Health Organization’s 2023 report on “Health workforce support and safeguards” found that some 55 countries now rank below the global median in terms of their density of doctors, nurses and midwives per capita. (...) The WHO report series tracks countries where the number of professionally trained healthcare workers falls below the global median of 49 per 10,000 population. It also examines countries’ rankings in terms of a Universal Health Service coverage index. The negative health, economic and social impacts of COVID-19, coupled with the increased demand for healthcare workers in high-income countries experienced during the pandemic, likely helped trigger more outward migration of healthcare workers from countries that are already suffering from low health workforce densities, the report found."
Ärztemangel: Drei von vier neu zugelassenen Ärztinnen und Ärzten stammen aus dem Ausland. Unter den Top 4 Herkunftsländern ist neu auch Rumänien. Die Forderungen, endlich selber mehr Personal auszubilden, werden lauter.
"(...) Dass die Schweiz auf rumänische Ärzte zurückgreift, stösst auf Kritik. Martin Leschhorn von Medicus Mundi Schweiz, einem Netz von Entwicklungshilfeorganisationen im Gesundheitsbereich, sagt: «Seit deutsche Mediziner weniger leicht zu bekommen sind, bedient sich die Schweiz nun bei den Schwächsten.» Es sei nicht fair, wenn die ärmeren Länder der EU die Ausbildungskosten übernähmen und die Schweiz dann die fertigen Ärztinnen und Ärzte anstelle. Tatsächlich würde es hier – insbesondere nach der Corona Krise – nicht an interessierten Studierenden mangeln. Über 7000 meldeten sich vergangenes Jahr für ein Medizinstudium an, Platz gab es allerdings nur für 2172."
This report is dedicated by the Women in Global Health movement to the millions of women in the health sector who work every day to keep us healthy and safe
"Women in Global Health’s latest policy report - "Her Story: Ending Sexual Violence and Harassment of Women Health Workers" - is the culmination of our #HealthToo research project and online platform. It reveals the prevalence of sexual exploitation, abuse and harassment (SEAH) experienced by significant numbers of women health workers. In the absence of comprehensive data on SEAH in health, our report uses the testimony of women as data to bring the reality and nature of sexual violence and harassment to life, as well as the conditions that enable it. Women submitted stories to #HealthToo from 40 countries, in ten languages and we have collected accounts through literature and partners from many other countries."
Experts say that the exploitation of women's labour has negative effects on health systems. Udani Samarasekera reports
The Lancet "More than 6 million women worldwide are subsidising health systems with their unpaid or grossly underpaid labour, according to a new report by Women in Global Health (WGH), released on July 7. Most of these women work in low-income and middle-income countries, mainly in community health roles. But the Subsidizing Global Health report also found examples of women working without pay in some professions, including nursing. Although men also work unpaid in health systems, usually at the community level, their numbers are smaller compared with women."
Ein Gastkommentar in der NZZ von Martin Leschhorn Strebel
"Mit der Annahme der Pflegeinitiative erfüllt die Schweiz eine wichtige Forderung des WHO-Kodexes: Jedes Land soll seinen Bedürfnissen entsprechend im eigenen Land genügend Gesundheitspersonal rekrutieren. Es kommt selten vor, dass eine Volksinitiative eine so deutliche Mehrheit wie die Pflegeinitiative findet. Verschiedene Faktoren haben zu dieser Annahme geführt: Die Furcht davor, dass unsere Gesundheitsversorgung in Zukunft aufgrund des Personalmangels nicht mehr sichergestellt werden kann, die Corona-bedingte Erkenntnis, dass die Pflege ein Schlüsselbereich unseres Gesundheitssystems ist, und die grundsätzliche Sympathie gegenüber den Pflegenden."
Die Situation im Gesundheitswesen ist prekär. Mit einem Statement von Martin Leschhorn Strebel vom Netzwerk Medicus Mundi Schweiz
"In keiner Branche gibt es so viele offene Stellen wie im Gesundheitswesen. Neueste Zahlen zeigen: 5761 Jobs in der Pflege sind derzeit unbesetzt. Ein Höchststand. Im selben Zeitraum 2019 waren es noch 4716, Anfang desselben Jahres nur 3626. Ausgewertet hat die Daten die Firma x28. Deren Jobsuchmaschine findet praktisch alle offenen Stellen, die auf den Websitesder Arbeitgeber ausgeschrieben sind. Wie konnte es so weit kommen? (...) «Doch statt selber genügend Pflegende auszubilden, bedienen sich die westlichen Staaten bei den Schwächsten», sagt Martin Leschhorn von Medicus Mundi Schweiz, einem Netzwerk von Schweizer Organisationen in der Entwicklungszusammenarbeit.
Sonntagszeitung - Pflege: Front
Sonntagszeitung - Pflege, S. 2
Sonntagszeitung - Pflege, S. 3
"Nurses and midwives play a critical role in the provision of care and the optimization of health services resources worldwide, which is particularly relevant during the current COVID-19 pandemic. However, they can only provide quality services if their work environment provides adequate conditions to support them. Today the employment and working conditions of many nurses worldwide are precarious, and the current pandemic has prompted more visibility to the vulnerability to health-damaging factors of nurses’ globally. This desk review explores how employment relations, and employment and working conditions may be negatively affecting the health of nurses in countries such as Brazil, Croatia, India, Ireland, Italy, México, Nepal, Spain, and the United Kingdom."
Communiqué de presse du 8 juin 2021
Medicus Mundi Switzerland Les membres du Réseau Medicus Mundi Suisse se sont prononcésaujourd’huien faveur de l’initiative populaire «pour dessoins infirmiersforts». Renforcer la formation et la qualité des emplois dans les soins infirmiers ici en Suisse, c’est aussi contribuer à remédier à la pénurie mondiale de personnel de santé. (...) La Suisse, dans son ensemble,formetrop peu d’infirmières et d’infirmiers, et leur offre un environnement de travail inadéquat en termes de qualité.
On this World Health Day, 7 April 2021, the Health Workers for All Coalition (HW4All) releases its political declaration and invites civil society partners to endorse this statement
Worldwide, the crisis in global health is rooted in the unequal distribution of and unequal access to skilled health and care workers. As recent pandemics have clearly and brutally shown, health workers themselves are one of the most neglected elements of dismantled and underfinanced public health systems, in virtually every country. Even in weakened health systems, health workers are the linchpin of health care and are key to the provision of available, acceptable, accessible and quality health care.
Medienmitteilung: Weltgesundheitstag im Zeichen der globalen Gesundheitskrise
Sonntagszeitung Instead of the Germans, now Romanian doctors have been filling the gap of medical staff in the Swiss health care system. The managing director of the network Medicus Mundi Switzerland, Martin Leschhorn criticizes this practice in the Sonntagszeitung and demands from the BAG to train more own physicians, instead of recruting them in poorer countries, where they are urgently needed. Manfred Zahorka from the Swiss TPH supports this criticism: "It is not fair when the poorer countries of the EU pay the training costs and then we hire the ready-made doctors." (Photo: Techniker Krankenkasse / flickr, CC BY-NC-ND 2.0 )
Wertvolle Gelegenheit des Austausches mit ugandischen KollegInnen
Researchers for Global Health (R4GH) Vom 20.-21. November 2017 werden in Kampala, Uganda, die Dialogue Days 2017 (DD17) durchgeführt. Das Symposium, welches inzwischen zum dritten Mal stattfindet, wird unter der Ägide des ugandisch-schweizerischen Vereins «Researchers for Global Health» (R4GH; www.r4gh.org) organisiert. R4GH ist seit diesem Jahr Mitglied von Medicus Mundi Schweiz und baut auf dem Kooperationsprojekt zwischen dem Infectious Diseases Institute (IDI) der Makerere Universität in Kampala und der Klinik für Infektiologie des Universitätsspitals Zürich auf. Seit fünf Jahren wurden in dieser Partnerschaft diverse Projekte in Forschung, Lehre und Klink realisiert.
Report of the High-Level Commission on Health Employment and Economic Growth
World Health Organisation (WHO) How can at least 40 million new jobs in the health and social sector be created? How can the estimated decline in the health workforce of 18 million, especially in developing countries, be prevented by 2030? The Commission calls on the international community to act: a global investment in the health workforce not only promotes the economic and social recovery in many countries, but also represents an important step towards the implementation of the SDGs. (Photo: DFID - UK Department for International Development / flickr)
Human Resources for Health Supplement
BioMed Central "The fourteen papers included in this special supplement add to the evidence on the relevance and effectiveness of the Code, and propose actions in support of the EAG recommendations. A central point captured across the papers is the striking lack of systematically collected data on health personnel migration in neither countries of origin nor destination."
Swisso Kalmo Eine Hebamme oder ein/e Krankenpfleger/in ist in Somalia heute für ca. 10'000 Einwohner zuständig, was weit unter dem WHO Standard, den Vorgaben der Weltgesundheitsorganisation liegt. Auffrischungskurse, Personalerhaltung und eine angemessene Entlohnung gibt es kaum. Dr. Hersi von Swiss Kalmo ist sehr enttäuscht, dass Somalia noch nie auf dem richtigen Weg war, um die Millenniums-Entwicklungsziele auf dem Gebiet der Gesundheitsversorgung zu erreichen. Um etwas Abhilfe zu schaffen, hilft Dr. Hersi dem Gesundheits- und dem Erziehungsministerium indem er berufliche Studiengänge aufgebaut hat, die ermöglichen, angehende Fachkäfte am Arbeitspatz auszubilden.
Documentation of the civil society side event to the World Health Assembly
MMI The WHO Global Code of Practice (Code) on the International Recruitment of Health Personnel was adopted by the 63rd World Health Assembly on 21 May 2010. The 2010 WHA resolution requested the first review of the relevance and effectiveness of the Code be made during the World Health Assembly in May 2015. An expert advisory group (EAG) was convened to carry out the review and will submit its report to the WHA for consideration. The side event organized by MMI in cooperation with several civil society partners provided a good an opportunity to get insights and assessments from members of the EAG before the formal WHA debate. With over 120 participants and some inspiring statements, the side event was a strong and encouraging call for making the Code what we want it to be: a real instrument for change.
WHO Code should be enforced
WHO Bulletin In an editorial for the WHO Bulletin Michel Sidibé (UNAIDS) and James Campell (Global Workforce Alliance) write: "Education, training and incentives should be focused on creating an efficient workforce that is centred on people rather than disease." Furthermore they point out, that to address the trans-border dynamics, fragmentation, gaps and inefficiencies that hinder national solutions, the Global code of practice on the international recruitment of health personnel should be rigorously enforced.
GHWA An informative animation on the shortage of health workers, produced by the Global Health Workforce Alliance in partnership with bliinktv, UK. One billion people never see a healt worker in their lifetime.
Beitrag von 10vor10
"Deutsche Politiker bedauern die Aktivierung der Ventilklausel. Doch es gibt auch Deutsche, die sich darüber freuen, dass die Schweizer Grenze bald nicht mehr so durchlässig ist. Diese Stimmen kommen vor allem aus dem Gesundheitswesen. Denn immer mehr Ärzte und Pflegende wandern gleich nach der Ausbildung in die Schweiz aus." Über den in diesem Zusammenhang stehenden Dominoeffekt informiert im Beitrag das Netzwerk Medicus Mundi Schweiz.
Report of the Third Global Forum on Human Resources for Health, (Nov 2013) Recife Brazil
WHO "The Third Global Forum on Human Resources for Health provided an opportunity for an inclusive dialogue with many stakeholders involved in efforts to develop human resources both in countries and globally. The Forum shed light on what universal health coverage really means in relation to human resources for health. Universal health coverage is not a distant dream; it is feasible journey, it is wanted and many countries are progressing towards this goal. The report summarizes the thematic debates and discussions and various other acitivies of the Forum."
SonntagsBlick, 28. Juli 2014 «Die Schweiz ist mitverantwortlich für den Ärztemangel in Rumänien», sagt Martin Leschhorn von Medicus Mundi Schweiz, einem Netz von Entwicklungshilfeorganisationen. «Es ist wie ein Dominospiel – die Schweiz stösst den ersten Stein um.» Weil hierzulande zu wenige Ärzte ausgebildet werden, füllen Ausländer die Lücken. Ende 2013 waren von 33 242 Humanmedizinern 5583 (17 Prozent) Deutsche. Das ist mit Abstand die grösste Ausländergruppe, berichtete der SonntagsBlick am 20. Juli 2014.
MMS On an initiative of the Network Medicus Mundi Switzerland a broad coalition of NGOs, trade unions and professional associations ask the implementation of the Global Code of Practice on the International Recruitment of Health Personnel.
Call for papers MMS Bulletin #162
Medicus Mundi Switzerland In this MMS Bulletin, we would like to discuss the potential of community health workers with a focus on middle and low-income countries (LMICs). Are CHWs pioneers in the strengthening of health systems and achieving health for all? Can this workforce compensate for the shortage of health workers? Which challenges and deficits exist in the health policies of many countries and which measures should be introduced (best practice examples) so that the potential of CHWs can be fully developed? For more information and some key questions from our perspective, please see the document enclosed.
WHO "The migration of health workers affects all countries in one way or another. In some cases, health workers leave their home countries looking for better working conditions and career opportunities abroad. In others, they leave rural areas for urban ones. The result: increasingly inequitable access to health care, within and between countries. This is why WHO and its partners are developing solutions so countries can address the twin challenges of managing migration and improving the retention of health workers. One key element is to establish a supportive working and living environment and opportunities for professional growth so that health workers are less likely to migrate. Another is to implement the 2010 Code of Practice on the International Recruitment of Health Personnel."
Health Worker Shortage around the World
Impact magazine "In this issue of Impact magazine, PSI, in partnership with IntraHealth International, examines the vital contributions of health workers to global health and development. In articles and interviews with key stakeholders, this issue makes the case that building a robust and effective global health workforce should urgently become a top priority for the international community."