I’d like to start by thanking Health Poverty Action and Action for Global Health’s Human Resources Working Group for hosting this event and for giving me the opportunity to come and speak to you about this critically important issue. With a little over a week until the Third Global Forum is held in Brazil, it is timely to come together to discuss the importance of health workers globally and what more needs to be done to ensure that we continue to build global capacity.
Today I want to reflect on the UK’s work on human resources for health and our expectations for the upcoming Third Global Forum. Health workers – nurses, paramedics, doctors, health technicians - are a vital part of a health system and effective workforce and human resource strategies are critical to achieving the Millennium Development Goals and Universal Health Coverage, which has been discussed as a real aspiration for the post-2015 era.
In the UK we are rightly proud of our National Health Service. Whilst there is always scope to improve efficiency and effectiveness, we have a national service that is accessible to all.
We also recognise that immigration has enriched the culture and economy of the UK and efforts to recruit, train and retrain staff in this country have paid off in recent years. We recognise the need to support those countries facing major shortages of health workers, to build their capacity. Health needs are universal, and health worker skills are in universal demand.
The chronic global shortage of skilled health workers will put the achievement of the MDGs and of achieving Universal Health Coverage at risk. The shortages are most severe in the poorest communities of the poorest countries and it is the marginalised groups of people, and particularly women and children, that are most affected. Action to tackle this crisis will help improve health, reduce poverty and improve the lives of the world’s poorest and most disadvantaged people.
Health workers are one of the key building blocks of the Health System – without health workers our international efforts to improve drug and vaccine supply, our support to build the evidence base on the most cost effective interventions to improve health will come to little. The shortage of skilled and motivated health workers is a major challenge in all the countries in which DFID works, and action to address shortages needs to underpin all our investments in health.
So what is DFID doing in terms of human resources for health?
DFID has made commitments which are reliant on progress being made in human resources for health. For example, we have promised to save the lives of at least 50,000 women during pregnancy and childbirth and 250,000 newborn babies by 2015 and we have promised to support 2 million women to deliver their babies safely with the support of skilled midwives, nurses and doctors. Meeting these commitments means improvements across the health system, but above all, demands skilled health workers across all levels of the health workforce - ensuring there are sufficient and motivated health workers with the right skills, in the right place, at the right time, particularly midwives and others with midwifery skills.
DFID supports regional initiatives like “Making it Happen”, a programme in 5 countries that is training doctors, midwives and nurses to manage complications of pregnancy and childbirth. The programme will help save lives by increasing the number of births attended by skilled personnel.
In Ethiopia, the UK is helping to train and deploy over 2000 village Health Extension Workers recruited from local communities, who will provide health messages, basic antenatal care services and immunisation as well as distributing bed-nets and anti-malarials. This will increase access to health services and the Health Extension Workers will provide this package of basic health services to 5 million people.
The UK has supported the Pakistani government in building the Lady Health Workers, a team of 100,000 community workers who bring basic health services to remote rural and poor communities, covering around 80 million people. In addition, a cadre of Community Midwives has been trained through DFID’s programmes and has been deployed mainly in rural areas of Pakistan, increasing the number of births assisted by a skilled attendant – a key step towards reducing maternal deaths.
“Women 4 Health”, a programme in Northern Nigeria that supports girls and women to become health workers, will mean that more women are able to access services where social norms may prevent them from seeking care from male health-workers. But it is also creating jobs and improving economic opportunities for these girls and women, training 7000 girls and women.
The UK is also supporting human resources for health in Zambia, Malawi, Sierra Leona, India, South Africa and Nepal.
Within the UK, we are also working to improve human resources for health by harnessing UK health expertise through the Health Partnership Scheme: a scheme that supports partnerships between UK health institutions and those in low-income countries in order to strengthen capacity in 16 countries. For example, HPS provides funding for the Royal College of Paediatrics and Child Health’s work with Makerere University to reduce infant and child mortality in Kenya, Rwanda and Uganda. The HPS is also funding the VSO to develop a strong, long-term volunteering programme that enables the transfer of skills between UK and Malawi health professionals, leading to improvement in the quality of maternal health services for poor and rural women in Malawi.
But this is a global challenge and it needs a global partnership to tackle it. We have supported and funded the work of the Global Health Workforce Alliance for a number of years and continue to place great value on the Alliance as a convening power. There is still a great deal more to be done.
The Third Global Forum will be an important opportunity to ensure that the human resources for health agenda remains a high priority in global health. The Forum will be an excellent opportunity to highlight that human resources for health are critical for universal health coverage and the post-2015 development agenda, and to inspire greater engagement in solutions to the health workforce crisis. I do hope that this will be the event to “kick start a decade of action for human resources for health”.
The UK is supporting, and will continue to support, this global effort to tackle the health workforce crisis. We will continue to work with developing countries to support them in their efforts to build health service quality and access. Health workers are the key stone in achieving the goal of Universal Health Coverage. I hope the Forum can make sure that health workers remain the heart of the issue.