The WHO report “A Universal Truth: No Health without a Workforce,” published in November 2019, identifies some of the leading causes of the problem. These include the aging and retirement of healthcare workers, their transition to higher-paying jobs, and their positions remaining vacant for long periods of time. At the same time, an insufficient number of young people want to devote their lives to medicine.
The increase in human resources demand in the health sector is also due to the growing global population, which increases the risk of non-communicable diseases (cancer, cardiovascular disease) (Britnell, 2019). The internal and international migration of health workers is also exacerbating imbalances between regions. During the Third Global Forum on the Health Workforce, held in Recife, Brazil, countries were encouraged to take the following actions to address health workforce shortages:
- Developing policies to develop human resources in the long term;
- Data collection, creation, and maintenance of databases on human resources for health;
- Maximizing the role of both professionals and individual health communities in ensuring access to primary health care;
- For countries with the most acute shortages, retention of health professionals, and more even geographic distribution;
- Providing mechanisms for health professionals to influence the development as well as the implementation of policies and strategies to achieve universal health coverage.
The Third Global Forum on the Health Workforce is the most significant event ever held in the field, with more than 1,300 participants from 85 countries, including 40 health ministers. According to Dr. Marie-Paul Keeney, WHO Assistant Director General for Health Systems and Innovation, the current principles of the health workforce will soon be corroded by a mismatch between the number of specialists and the demand of the population (Teraoka & Kyougoku, 2018). To prevent this, it is necessary to rethink and improve the training, distribution, and remuneration of health workers so that their work becomes more efficient. Positive results in addressing this problem already exist: for example, the number of countries where the health workforce is approaching a baseline of 23 qualified health professionals per 10,000 people has increased, but 83 countries have yet to reach that benchmark (Candura Stefano, 2017). As the report notes, the current rate of training of health care professionals needs to catch up to the present and projected demand, and in the future, it will be even more difficult for patients to get the primary health care services they need.
The organization of disease prevention will also suffer in a short period of time. Significant shortages are expected in some Asian countries but will be most severe in sub-Saharan Africa. For example, 47 countries have only 168 schools for the education and training of health workers, 11 countries in the region have no schools at all, and 24 countries have only one school each (Candura Stefano, 2017). According to Dr. Carissa Etienne, director of the WHO Regional Office for the Americas, the best strategy for achieving universal health coverage in such regions is to have multidisciplinary health teams to provide primary health care (Teraoka & Kyougoku, 2018). Seventy percent of the countries in the Americas have sufficient healthcare workers to provide primary healthcare interventions, but these nations still face significant challenges related to the distribution of professionals, their migration, and the appropriate use of the knowledge and skills gained in training. The reality is that, due to the stress of work and relatively low pay, many young health professionals need to be sufficiently motivated to remain in their professions.
Moreover, it is important to follow the recommendations given for this problem solution. WHO urges all countries to heed the message about the shortage of healthcare professionals (Teraoka & Kyougoku, 2018). One area where immediate action is needed for health workers is maternal and child health. About 90% of maternal deaths and 80% of stillbirths occur in 58 countries, mainly because they do not have enough qualified midwives (Osterman, 2017). In addition, of the 6.6 million deaths of children under the age of 5 in 2012, most were due to diseases that could have been treated or prevented, including increasing the number of healthcare workers (Candura Stefano, 2017). Today, there are 14,000 doctors and 29,000 nurses and midwives per 10,000 people. These figures vary widely depending on the region. For example, there are 38.5 doctors per 10,000 inhabitants in Australia, 33.3 in Europe, 24.2 in the USA, 67.2 in Cuba, 17.6 in Brazil, and 5.5 in South-East Asia (Osterman, 2017). The lowest availability of doctors is in Africa, with only 2.5 doctors per 10,000 people (Britnell, 2019). As people began a new year and a new decade, the scientists published a list of current global health challenges. This list, prepared with input from our experts working around the world, demonstrates a profound concern about the failure of national leadership to invest adequately in the development of essential health priorities and systems (Osterman, 2017). This threatens lives, livelihoods, and economies. Addressing all of these issues is challenging but possible. Ultimately, public health is a political choice and has to be considered in this way.
It is essential for everyone to understand that advancing health care is an investment in the future. Countries devote significant resources to protecting their populations from terrorist attacks rather than fighting any virus, which can be far more deadly, and its spread can have far more devastating economic and social consequences. Any pandemic could bring countries and their economies to their knees. For this reason, health security cannot be a matter for the health ministry alone. All of the challenges on this list require efforts beyond the health sector. We face common threats and have a shared responsibility to act. With the deadline for the 2030 Sustainable Development Goals fast approaching, the United Nations General Assembly has noted the need to address all the challenges on this list (Osterman, 2017). The United Nations General Assembly has pointed out that the next ten years must be a “decade of action” (Osterman, 2017). This means calling for funding at the national level to address gaps in health systems and infrastructure and to help the most vulnerable countries. Investing today will save lives and money tomorrow. The cost of inaction will be unacceptably high. Governments, local communities, and international agencies must work together to achieve these critical goals. There are no easy ways to improve global health (Candura Stefano, 2017). The year 2030 is approaching, and the leaders must be held accountable for the commitments they have made.
Much more is spent each year worldwide on outbreaks, natural disasters, and other public health emergencies than on preparedness and prevention. A pandemic of a new highly infectious atherogenic virus, very similar to a strain of influenza to which most people lack immunity, is inevitable. The question is not whether another pandemic will arise but when it will, and when such a pandemic breaks out, it will spread rapidly, potentially threatening the lives of millions of people. Meanwhile, vector-borne diseases such as dengue, malaria, Zika virus disease, chikungunya, and yellow fever are spreading as mosquito populations move to new regions due to climate change.
Such cuts would negatively affect any hospital in the world. With fewer doctors, dealing with a pandemic becomes more difficult and nearly impossible. If one considers the theoretical hospital and how the reduction in the number of physicians affects it, the fact that it cannot fully function with such limited resources becomes apparent. The reduction in the number of physicians also affects other aspects of life, as the labor force is reduced. This will not have a positive impact in any theoretical scenario for the development of a medical institution, but only a great loss in terms of lives and finances.
References
Britnell, M. (2019). Human : solving the global workforce crisis in healthcare. Oxford University Press.
Candura Stefano, M. (2017). Occupational risk of scabies among healthcare workers: problem focus and personal experience. Prevention & Research, 5(4), 134. Web.
Osterman, P. (2017). Who will care for us? Long-term care and the long-term workforce. New York, N.Y. Russell Sage Foundation.
Teraoka, M., & Kyougoku, M. (2018). Analysis of structural relationship among the occupational dysfunction on the psychological problem in healthcare workers: a study using structural equation modeling. PeerJ, 3. Web.