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Human Resources for Health: Global Shortage

Human Resources for Health: Global Shortage

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.

New Documents in this Dossier

Rumänien in Not, weil seine Ärzte in die Schweiz fliehen

(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.

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Human Resources for Health: foundation for Universal Health Coverage and the post-2015 development agenda

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."
http://www.who.int/workforcealliance/knowledge/resources/report3rdgf/en/

Migration of health workers: The WHO Code of Practice and the Global Economic Crisis

WHO Publication
WHO | "Many countries and global partners have responded to the Code and made significant changes to national policies. This publication provides insights into steps taken to implement the Code globally and it features detailed experiences from 13 countries: Australia, Belgium, Canada, El Salvador, Italy, the Netherlands, Norway, the Philippines, Poland, Romania, Switzerland, the United Kingdom and the United States. It also gives other countries valuable guidance and recommendations on how they, too, can implement the Code. While the country response has had positive impact, there is still much to do to redress major inequalities in international migration of the health workforce."
http://www.who.int/hrh/migration/migration_book/en/
Background

WHO Fact Sheet: Migration of health workers

The World Health Organisation has collected some key findings on the lack of health personnel on the global level.

www.who.int

Was tun, wenn nicht stehlen?

Die Migration von gut ausgebildetem Gesundheitspersonal aus ärmeren in reiche Länder mag für die einzelne Fachkraft zu einem höheren Verdienst führen. In ihrem Herkunftsland verschärft ihre Auswanderung aber die Gesundheitskrise. Die WHO will mit einem Verhaltenskodex für etwas Ordnung sorgen – ein nicht unumstrittenes Unterfangen, nach Ansicht von Thomas Schwarz, Geschäftsleiter von Medicus Mundi International

Was tun, wenn nicht stehlen?

Unsere Armut geht auf Kosten der Ärmsten

(Basler Zeitung, 26. Februar 2010) "In westlichen Ländern werden die Menschen immer älter. Das stellt auch deren Gesundheitssysteme vor Herausforderungen. Die Weltgesundheitsorganisation will Regeln für die Rekrutierung von Fachpersonal erstellen. Doch die Schweiz tut sich schwer damit," kritisieren NGOs wie das Netzwerk Medicus Mundi Schweiz.

Unsere Gesundheit geht auf Kosten der Armen

Human Resources: Solving the Crisis

"Over the last years many of us have become aware of the dire shortage of professional health care workers to deliver essential health services in sub-Saharan Africa and elsewhere. In many instances we are confronted with insufficient numbers of staff working in hospitals and especially in primary care services in rural areas." Bulletin 104 of Medicus Mundi Switzerland.

Human Resources: Solving the crisis

Wemos Briefing Paper on Human Resources for Health

In addressing the health workforce shortage, the new Wemos Briefing Paper presents ‘windows of opportunities’ on ways to ensure people everywhere have access to a skilled and motivated health worker, supported by a robust health system.

www.wemos.nl

Migration of health workers: Country case study Philippines

International migration has become an important feature of globalized labour markets in health care. A number of industrialized countries have opened their doors to highly skilled health professionals, a great number of which come from the Philippines. This study, commissioned by the International Labour Organization (ILO), aims to provide in-depth information on the migration of Filipino health workers and the repercussions this has on individual migrants, their families, their professions and the nation as a whole.

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Children's lives at risk from vaccine funding gap

"Though nowhere near crisis point, the USA and Europe are also seriously short of health workers. The problems of poor countries are therefore exacerbated by doctors and nurses from developing nations moving to find better jobs and a better quality of life, given the pressure, tough conditions and low pay they can expect in their home countries," says Sarah Boseley on Guardian Online.

www.guardian.co.uk

America Is Stealing the World’s Doctors

Report in the New York Times Magazin
New York Times Magazin | "The Council on Physician and Nurse Supply estimates that in 10 years, the United States could have a shortage of 200,000 doctors. Already, one in four doctors working in this country is trained in a medical school overseas," writes Matt McAllester in the New York Times Magazine.
www.nytimes.com/...
Switzerland's Role

Rumänien in Not, weil seine Ärzte in die Schweiz fliehen

(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.

Download File (d | 79.4 kB| PDF)

«Jetzt haben wir entschieden, dass wir zusammen sein wollen»

Pflegepersonal aus Bulgarien und der WHO-Kodex zur Rekrutierung von Gesundheitspersonal
Der Bund | Den Kodex zur Rekrutierung von Gesundheitspersonal "entwickelte die WHO im Jahr 2010, um ärmere Länder vor unkontrolliertem Personalabzug zu schützen. So wird darin unter anderem jedes Land aufgefordert, ausreichend eigenes Personal auszubilden oder den Migrantinnen faire Arbeitsbedingungen zu garantieren, schreibt die Tageszeitung Der Bund und zitiert ausführlich das Netzwerk Medicus Mundi.
http://bit.ly/14yoNAL

Qualitative Untersuchung zum ausländischen Gesundheitspersonal in der Schweiz und über dessen Rekrutierung

"Die Studie der Gesundheitsdirektorenkonferenz bietet eine qualitative Analyse der Standpunkte der Arbeitgeber und der zugewanderten Arbeitnehmerinnen und Arbeitnehmer zur Rekrutierung und zum Berufsleben in der Schweiz. Die Untersuchung wurde in den Kantonen Basel-Stadt und Waadt durchgeführt. Befragt wurden VertreterInnen von Institutionen des Gesundheitswesens in ihrer Rolle als Arbeitgeber sowie qualifiziertes Gesundheitspersonal aus der EU und aus Drittstaaten. Die dabei gewonnenen Ergebnisse werden von ExpertInnen zu einer Sicht auf die Situation in der ganzen Schweiz erweitert." (pdf)

snipurl.com

Ausländisches Gesundheitspersonal in der Schweiz

"Dieser Bericht beschreibt das ausländische Gesundheitspersonal in der Schweiz und versucht die Migration des Gesundheitspersonals im Kontext der in der Schweiz ausgebildeten Fachkräfte zu analysieren. Immigrierte Personen stammen häufig aus den Nachbarländern und sind hochqualifiziert. Tendenziell nimmt die Einwanderung dieser Personen zu, während die Anzahl im Land ausgebildeter Personen eher abnimmt. Damit entsteht eine steigende Abhängigkeit gegenüber ausländischem Personal."

bit.ly

Globaler Rahmen gegen den Diebstahl von Gesundheitspersonal: Die Schweiz ist gefordert

"Die Weltgesundheitsversammlung in Genf hat gestern Abend dem Verhaltenskodex zur Rekrutierung von Gesundheitspersonal zugestimmt. Damit existiert ein globaler Rahmen, um die katastrophale Knappheit an Gesundheitspersonal anzugehen. Nun müssen die Empfehlungen des Kodex auch in der Schweiz umgesetzt werden," schreibt das Netzwerk Medicus Mundi Schweiz in einer Medienmitteilung

Medienmitteilung: Globaler Rahmen gegen den Diebstahl von Gesundheitspersonal: Die Schweiz ist gefordert

Schluss mit dem Diebstahl von Gesundheitspersonal

"Das Netzwerk Medicus Mundi Schweiz (MMS) begrüsst den Entscheid der WHO-Exekutive, der Weltgesundheitsversammlung im Mai einen Kodex zur internationalen Rekrutierung von Gesundheitspersonal vorzulegen. Damit wird ein Rahmen gegen das unkontrollierte Abwerben von Spital- und Heimpersonal aus armen Ländern gesetzt." In einer Medienmitteilung fordert das Netzwerk Medicus Mundi Schweiz eine aktivere Rolle der Schweiz.

Medienmitteilung: Schluss mit dem Diebstahl von Gesundheitspersonal

Nationaler Bericht zum Personalbedarf und den Massnahmen zur Personalsicherung in den Gesundheitsberufen

"In der Schweiz werden heute nur zwei Drittel des jährlichen Bedarfs an Gesundheitspersonal ausgebildet. Zu diesem Schluss kommt ein Bericht, der von der Schweizerischen Gesundheitsdirektorenkonferenz (GDK) und der Branchenorganisation der Berufsbildung im Gesundheitswesen, OdASanté, in Auftrag gegeben wurde. Der Anteil an Personal mit ausländischer Nationalität beträgt in den Spitälern denn auch rund einen Drittel. Der Personalbedarf kann längerfristig nur gesichert werden, wenn alle verantwortlichen Akteure die Ausbildungstätigkeit weiter fördern und die Massnahmen zur Personalerhaltung rasch einleiten."

snipr.com
Approaches of the Swiss Health Cooperation

Human Resources for Health

SolidarMed Position Paper
SolidarMed | Getting the right workers with the right mix of skills to areas where they are needed most is key to improving health service delivery outcomes Sub-Saharan Africa will not meet any of the health Millennium Development Goals (MDGs) by 2015 if current rates of progress continue. This is primarily due to weak health systems characterised by the limited capacity, low motivation, absenteeism and overall severe shortage of health workers at all levels. This paper highlights some of the reasons behind the HR crisis and presents the experiences, lessons learned and future strategies of SolidarMed to strengthen the health workforce in SSA.
http://bit.ly/yLQScF

Swiss Contributions to Human Resources for Health Development

In the frame of the "12. Arbeitstagung der Nationalen Gesundheitspolitik" on the topic "Staff Recruitment and Migration in the Health Sector", Swiss TPH published a study, which is focusing on Swiss Contributions to Human Resources for Health Development in Low- and Middle-Income Countries. (pdf)

snipurl.com
International Approaches

1 million community health workers in sub-Saharan Africa by 2015

Rapid deployment would be possible and highly effective
The Lancet | "During the past 10 years, community health workers (CHWs) have emerged as a focal point of international discussions of primary health-care systems. Although lay community-based health workers have been active for at least 60 years, the Millennium Development Goals (MDGs) in 2000 prompted new discussion of how these workers can help to extend primary health care from facilities to communities. CHWs have since been part of an international attempt to revise primary health-care delivery in low-income settings, and CHW programmes have been changed accordingly. Instead of being regarded as unpaid, lightly trained members of the community who focus mainly on health education and provide basic treatments, CHWs are increasingly envisioned as a trained and paid corps who give advice and treatments, and implement preventive measures. Many national governments, including those of Brazil, Pakistan, Ethiopia, and India,1 are making CHWs a cornerstone of the scaling up of community health delivery."
http://bit.ly/YNyrGU

Analysis: Plugging the health worker brain drain

What has worked so far?
IRIN | "IRIN took a look at some of the push and pull factors behind health worker migration, and what countries are doing to address them."
http://www.irinnews.org/report.aspx?reportid=92949

Addressing the Global Health Workforce Crisis

Challenges for France, Germany, Italy, Spain and the UK
El Salvador , Madagascar Action for Global Health | "Action for Global Health has launched a new report on ‘Addressing the Global Health Workforce Crisis: challenges for France, Germany, Italy, Spain and the UK’. The report, which compares the foreign and domestic policies on health workers in the five AfGH European countries, looks at the causes of health shortages in both source and destination countries and explores what needs to be done to fulfil the requirements of the WHO Code of Practice and to strengthen health systems in developing countries." (pdf)
http://bit.ly/fAuicH

Chances for Change – Dutch measures to improve the global distribution of health personnel

The Dutch Alliance for Human Resources for Health is concerned about the global maldistribution of human resources for health (HRH), which particularly affects the health of people in developing countries. This publication presents measures, composed by the Alliance, to be taken by Dutch actors to improve the distribution of health staff across countries.

www.wemos.nl
WHO Global Code of Practice

Human Resources for Health: foundation for Universal Health Coverage and the post-2015 development agenda

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."
http://www.who.int/workforcealliance/knowledge/resources/report3rdgf/en/

User’s Guide to the WHO Global Code of Practice on the International Recruitment of Health Personnel

Understanding the framework for global dialogue and cooperation
WHO | "The Code aims to establish and promote voluntary principles and practices for the ethical international recruitment of health personnel and to facilitate the strengthening of health systems. (...) This User’s Guide aims to provide a concise overview of the Code and to help readers understand its content. It explains the context in which it has been developed and teases out its main messages. It targets all stakeholders concerned with or interested in the international recruitment of health personnel. The Guide provides a simple and user-friendly introduction; readers are encouraged to refer to the Code itself for a fuller understanding of its recommendations."
http://bit.ly/etT3lQ

WHO Global Code of Practice on the International Recruitment of Health Personnel

Implementation by the Secretariat
WHO | "This document outlines a strategy for WHO to support Member States and all interested stakeholders to advance rapid and effective implementation of the Code."
http://bit.ly/hkZdtx

WHO Global Code of Practice

The WHO Global Code of Practice on the International Recruitment of Health Personnel was adopted by the 63rd World Health Assembly on 21 May 2010. The adoption of this Code, after lengthy drafting group discussions, was both swift and unanimous: all Member States applauded the passage of the text. The Code, which is voluntary in nature, serves as an ethical framework to guide Member States in the recruitment of health workers. Destination countries are encouraged to collaborate with source countries to sustain health human resources development and training as appropriate. Member States should discourage active recruitment of health personnel from developing countries facing critical shortages of health workers. Member States are encouraged to publicize and implement the code in collaboration with all stakeholders, and they should periodically report the measures taken, results achieved, difficulties encountered and lessons learnt. This is only the second Code in WHO's history, after the International Code of Marketing of Breast-milk Substitutes in 1981.

apps.who.int

WHO Code of Practice on health workers risks being 'toothless tiger' warns Action for Global Health

Action for Global Health welcomes a new Code of Practice from the World Health Organisation (WHO) which aims to stem the flow of health workers leaving poor countries for rich ones. The code will have a significant impact on the current deplorable shortage of health workers in low-income countries. The current gap is 4.3mn1 medical professionals according to the WHO.

www.actionforglobalhealth.eu

Migration of health workers: The WHO Code of Practice and the Global Economic Crisis

WHO Publication
WHO | "Many countries and global partners have responded to the Code and made significant changes to national policies. This publication provides insights into steps taken to implement the Code globally and it features detailed experiences from 13 countries: Australia, Belgium, Canada, El Salvador, Italy, the Netherlands, Norway, the Philippines, Poland, Romania, Switzerland, the United Kingdom and the United States. It also gives other countries valuable guidance and recommendations on how they, too, can implement the Code. While the country response has had positive impact, there is still much to do to redress major inequalities in international migration of the health workforce."
http://www.who.int/hrh/migration/migration_book/en/

MMI on the WHO Code of Practice

"In only the second time in its history, the United Nations’ World Health Assembly voted to adopt a voluntary code directing nations to employ more ethical practices in relation to a major international health problem. The Code of Practice on the International Recruitment of Health Personnel sets forth ten articles advising both source and destination countries on how to regulate the recruitment of health personnel in a way that mitigates damage to low-income countries struggling to meet the basic health needs of their populations in a setting of serious workforce deficits."

www.medicusmundi.org

Increasing access to health workers in remote and rural areas through improved retention

"Globally, approximately one half of the population lives in rural areas, but less than 38% of the nurses and less than 25% of the physicians work there. While getting and keeping health workers in rural and remote areas is a challenge for all countries, the situation is worse in the 57 countries that have an absolute shortage of health workers. After a year-long consultative effort, this document proposes sixteen evidence-based recommendations on how to improve the recruitment and retention of health workers in underserved areas. It also offers a guide for policy makers to choose the most appropriate interventions, and to implement, monitor and evaluate their impact over time." (pdf)

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