By Moy Bracken, Key Correspondent for the Irish Forum for Global Health
The importance of training and education was on the agenda at the second day of the 4th Global Forum on Human Resources for Health (HRH) in Dublin. Dr. Ryan Tandjung, (Head of the Healthcare Professions Division, Federal Office of Public Health, Switzerland) noted that “investing in good education is the mainstay for system change”. Fixing the HRH crisis is not just about the number of health workers, but also the quality of care provided.
Delegates from around the world pointed to similar issues in both high and low-income countries. Dr. George Sigounas, (Administrator for the U.S. Department of Health and Human Services’ Health Resources and Services Administration USA) identified three factors adding to the HRH problem:
- Health professional shortages,
- Maldistribution of skilled health workers, and
- Education and training.
Similar experiences were recounted by panelists from Cambodia, Thailand, and Mozambique. This highlights how the HRH crisis is a global issue, but similar problems can be experienced in different contexts.
Increasing the number of skilled health workers seems like an obvious response to overcoming shortages. However, Dr Martinho Dgedge, (General Inspector of Health, Ministry of Health, Mozambique) recounted a disconnect between training and employment. Expanding training programmes in Mozambique increased numbers of people trained, but there were no employment opportunities for them afterwards. Increasing the number of health workers is a pointless when a limited health budget prevents them from being employed afterwards.
In America, the government has provided educational grants to keep doctors in rural areas. As part of the deal the doctors must practice for two years in a rural area, and in return their student loans are paid off. Following the program, 97% of doctors remained in their post after the two-year period ended.
Professor Paul Worley (National Rural Health Commissioner, Australia) provided an interesting insight into rural health practice in Australia. There are many challenges in providing quality health care in remote Australian territories. Health outcomes for the populations in these areas are similar to sub-Saharan Africa. Lifestyle factors and problems with access to healthcare result in low life expectancy. Medical schools in Australia are generally located in cities where healthcare is already good. This means the issues affecting the rural communities are often neglected. The Centre for Remote Health was set up to provide training in these areas, helping provide work experience in remote environments whilst improving the health of the rural population.
HRH faces similar challenges regardless of context. We can all learn from the successes and failures experienced in different countries – and appropriate education and training is key to solving the problem.
November 16th, 2017
Moy Bracken recently graduated from the Masters in Global Health Programme at Trinity College Dublin. Moy’s interests cover the areas of epidemiology, access to medicines, and achieving health equity. She is currently working as a locum pharmacist in Dublin.