WHO asks countries to invest more on training healthworkers
New Delhi, Apr 7: The World Health Organisation today expressed concern over the global shortage of well trained health workers and urged countries to exhibit political will to ensure strong, responsive and equitable health systems by investing more in their health workforce.
Talking to reporters on the occasion of World Health Day today, WHO Regional Director for South East Asia Region Dr Samlee Pilanbangochang said,''For strong, responsive and equitable health systems, what is needed is political will. Today, there is a global crisis in human resources, a chronic shortage of well trained health workers. There is an urgent need for countries to invest in their health workforce, which is a vital part of the health systems.'' Speaking on this year's theme 'Working together for Health', Dr Samlee stressed the need for public-private efforts to redress these shortages. He said that the way to improve the performance of the health system depends ultimately on improving the knowledge, skills, motivation and availablity of human resources.
The danger is that even recent health gains would be at risk with dwindling workforce.
Pointing out that privatisation and market economies have eroded free public health care systems, he said that investment in health was very important and unless it was increased, there would be little improvement in health workforce.
In 12 countries of WHO's South East Asia Region with a quarter of the world's population, the workforce was only 12 percent of the global health workforce. On an average, there were 29 health service providers per 10,000 population in the Region, well below the global average of 62.
The key human resource challenges for countries of the region include, a shortfall in the numbers of trained health workers and an imbalance in their distribution mainly between urban and rural areas. In some countries of the region, only about 20 per cent of posts for rural physicians are filled compared to 96 percent in urban areas.
In India and Myanmar, the availability of health workers for primary health care varies from a low of three per 10000 population while it was 25 per 10,000 in Maldives.
The WHO official expressed concern over the large scale migration of doctors and other health workers from countries like India, Sri Lanka, Bangladesh and Nepal to developed countries.
According to available studies, in Bangladesh a majority of fresh medical graduates attempt to get jobs abroad. In Sri Lanka, nearly a quarter of doctors going abroad for higher studies fail to return to the country after training abroad. However, the largest number of doctors migrate from India.
Dr Samlee said the recent outbreak of public health emergencies have demonstrated the critical importance of a robust health system. It is essential for the overall health security of any nation. Only a strong and efficient health system could secure the benefit of progress in new treatments and new technologies. Public health capacity is only as good as the people who constitute it, he said and added that people at the grassroot level should be trained so that they were aware of disease preventive measures. Increased public knowledge, accompanied by a well trained health workforce, could help to reduce the burden of diseases, he observed.
Pointing out that training of doctors and nurses involved large amount of resources and often they migrated to other countries or remained confined to urban areas, Dr Samlee said if grassroot level community health workers were given proper training they could play a crucial role in prevention and treatment of diseases.
The government should invest more in this field as it would contribute in health promotion and disease prevention.
Lauding the Indian government for launching the National Rural Health Mission and Public Health Foundation of India recently, the WHO official hoped that these measures would go a long way in reducing infant and maternal mortality in the country. He also called for tackling the socio-cultural dimension of the problem to reduce these mortality. This could be made by increasing awareness about institutional deliveries and equitable distribution of health care facilities.
''India could go a long way in reducing maternal and infant mortality and reducing disease burden by training the grassroot level health workers and ensuring equity in health services,'' he opined.
The WHO Regional Committee for South East Asia has called upon the countries of the region to develop appropriate national policies in production, utlisation and development of human resources for health. WHO has also launched the Public Helath Initiative 2004-2008 and the health ministers of the region have made a commitment in 2005 to prioritise public health in their national agenda. Many countries have initiated steps to renew health care skills and medical education.