Sharing knowhow and joining forces towards Health for All

Nurses and doctors in a globalized context

Nurses and doctors in a globalized context

"'Hanna Wafula lives in a small village in Zambia. She is 50 years old and lives with her husband and four grandchildren. Three of her six children have died: two when they were very young, and one last year at the age of 30. She notices that the doctor in the nearest health centre is rarely present. On the radio she heard that the government plans to spend more money on health care, but she has not seen any effects of increased spending yet. When she goes to the health facility, there is absolutely no guarantee there is a doctor or nurse to attend to her. The shortage of health personnel seriously impacts Hanna’s life. Should she be in need of medical care there might not be a health worker available to treat her or her family.'
 
The world is 7.2 million health workers short. Low-income countries are particularly affected by the shortage of health personnel. Too few health workers are being trained and retained due to insufficient public investments in health care and medical staff. Migration of health workers increases the inequalities and presents a challenge for all countries. Vacancies in high-income countries have a pull effect on qualified health workers from low- and middle-income countries. One of the reasons is that health personnel are leaving for greener pastures – countries where salaries are higher and facilities are better. Case in point, 57 per cent of all physicians trained in Zambia now work abroad, mainly in wealthier countries.
 
If the international recruitment is not carried out responsibly, it can have serious repercussions. When the much needed health workers are recruited from fragile health systems, those systems can be dangerously undermined. Equally, individuals who go to work in unfamiliar settings may be vulnerable to various forms of exploitation if no appropriate measures are taken. Allutis et.al. (2014) state that the health workforce crisis can be regarded as ‘one of the most pressing global health issues of our time’. If nothing changes, the global health workforce shortage will reach 12.9 million in 2035.
 
Europe is part of the problem. Various European countries recruit trained health personnel from abroad, a practice that is unsustainable, increases inequality and further weakens health systems in and outside Europe. In this context is it even more worrying that in the aging societies of European countries, the number of people who need long-term care is growing, thus fuelling the demand for health workers. Forecasts indicate that, by 2020, Europe will need one to two million additional health workers. As the labour market becomes more globalized, rising demand is driving migration and mobility amongst health personnel.

Adequate measures are needed to prevent staff shortages anywhere in the world. In May 2010, the member states of the World Health Organization (WHO) adopted a global code of practice (WHO CoP) on the ethical recruitment of health workers. The WHO CoP encourages countries to solve their own (anticipating) shortages of health personnel in a sustainable and responsible manner. By adopting the code, member states agreed that they will be self-sufficient in the domestic health workforce deployment and that they will make sure that health systems in source countries are not undermined by international migration of health personnel. In addition, the WHO CoP calls for a fair and equal treatment of foreign health workers. By applying all the principles of the WHO CoP, countries become less dependent on foreign healthcare staff, and on a global and European scale they will subsequently pull away fewer health professionals.  (...)"

Article by Linda Mans and Diana Hoeflake, Wemos
Read more on the Wemos website

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