Transcript HIV Health Workforce Crisis: An international perspective on Human Resources Gaps and Needs for HIV Care Dr.

HIV Health Workforce Crisis: An
international perspective on Human
Resources Gaps and Needs for HIV Care
Dr. Mubashar Sheikh
Global Health Workforce Alliance
XIX International AIDS Conference, Washington DC, USA
24 July 2012
Fast facts – Health Workforce Crisis
• One billion people have no access to a skilled health worker.
• WHO estimates - four million health workers are needed to improve
child and maternal health and treat diseases like HIV/AIDS.
• WHO recommends a minimum of 23 health workers per 10 000
people to provide the most basic health coverage.
• "expanding coverage is often hindered by the severe lack of human
resources, especially in rural areas and slums" (UNAIDS, 2011)
• Sub-Saharan Africa requires two times its current HRHA population
to be added every year for the next 10 years to achieve universal
coverage" (Barninghausen 2007)
Source: WHO, WHR 2006; UNAIDS 2011; Barninghausen et al AIDS Patient Care and STDs, 2007
The human resources for health
crisis in Sub-Saharan Africa
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Source: HHA
HRH labor market dynamics
Source: WHO, 2006.
HIV and HRH: a multi-faceted interface
"…increasing human resource
capacity for the response, including
by scaling up the training and
retention of human resources for
health policy and planning, healthcare personnel…" (UNGASS 2011)
Source: WHO, 2006, UNGASS 2011.
Universal Access to HIV/AIDS Services - Can
MDG 6 be achieved with the Health Workforce we
have?
• Insufficient financial resources
• Low salaries, large workloads, and difficult working environment
• Basic HRH information is often unavailable or fragmented
• Excessive focus on in-service training instead of pre-service education
• Insufficient focus on HIV prevention workforce.
• Ethiopia: 2009 public sector healthcare workforce was 66,300.
Strategic plan 2009-2020 calls for scale up to 193,264 by 2020.
• Côte d’Ivoire: Structural adjustment measures and financing gaps have
limited recruitment of health workers. New hires in 1996 - 2005
represented only 40 percent of the needs identified by the MoH.
Source: GHWA, WHO, 2011. Will we achieve universal access to HIV services with the health workforce we have. Task Force on
Human Resources for Universal Access .
Source: “Institute of Medicine Committee on Envisioning a Strategy to Prepare for the long-term burden of HIV/AIDS UNAIDS’
perspective”, Karl L Dehne, 3 March 2010
Task sharing to improve the skills mix efficiency
Source: Fulton B et al HRH 2011; Callaghan et al HRH 2010; UK APPG, 2012; GHWA 2010; Lewin et al, Cochrane database 2010; GHWA 2012, forthcoming
HRH actions needed for an effective HIV/ AIDS
response
• Government ownership, political will, and commitment
• Preparation and implementation of costed human resources for
health strategic plans embedded in national health strategies, and
facilitating the coherent involvement of all stakeholders.
• Estimate numbers and types of health workers needed to reach
national universal access targets for HIV services
• Integration of HIV services into mainstream health services
• Strengthen HRH management systems
• Address health worker retention, motivation, and job satisfaction
• Training on universal access to ARVs and task sharing for ARV
delivery to follow-up patients
• Increase attention given to HIV prevention
Source: GHWA, WHO, 2011. Will we achieve universal access to HIV services with the health workforce we have. Task Force on
Human Resources for Universal Access .
Aligning partners' support for HRH to national
priorities
Source: Vujicic et al, HPP, 2012
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Progress is possible: % ART coverage in selected
countries
Source:UNAIDS, 2008; UNGASS progress report, 2010 .
For further information
http://www.who.int/workforcealliance/en/
[email protected]
http://www.who.int/workforcealliance/knowledge/resources/uareport_en/en/