World Health & Population
Delivering on Equity Depends on Us
I am honoured to present this most prescient issue of World Health and Population. Focused on The Global Health Workforce: Striving for Equity Tackling Challenges on the Ground, my charge to our invited authors was: “present a close-up and candid account of obstacles that confound the effective practice of the health workers on the ground, share your experiences, and recommend workable solutions.” The resulting seven papers from more than 30 authors tell us of healthcare circumstances in more than 50 countries. They describe myriad issues germane and familiar to health workforce challenges: large shortages of health professionals, competency, scope of practice, lack of credentialing and licensure mechanisms for cadres of health workers; maldistribution of the health workforce; protection of health workers; perverse incentives engendered by health systems and their impact on professional practice, access and costs; and how the lack of health workforce measurement cripples health systems and thwarts population health.
These manuscripts include: an evaluation of multi-sector collaboration in Thailand to promote public health and healthy behaviours (Sopitarchasak et al. 2015); protecting and retaining health workers in civil war-torn Syria (Abbara et al. 2015); the initial report of an innovative continuity based model for health professionals training health professionals in 11 countries (Kerry et al. 2015); a survey of 70 low- and middle-income countries to assess stock, training and credentials of medically trained clinicians, including physician assistants and medical officers (Cobb et al. 2015); one year in, an assessment of Indonesia’s national health insurance system and the contextual HRH challenges (Sciortino and Roy 2015); team-based HIV treatment services using a nurse-led practice model to expand access to services in Namibia (Wesson et al. 2015); and a global perspective on the mandate for health workforce measurement that calls for a new approach to global governance and national accountability (DeLuca and Castro Lopes 2015).
The issues are familiar; tackling solutions with tenacity and teamwork is less practiced. As we approach the post-2015 era, it cannot be ‘business as usual.’ Rather, we need new energy and resources to address the 17 Sustainable Development Goals and the Global Strategy on Human Resources for Health 2030. And yes, familiar ubiquitous health system issues still need correcting. If history is a predictor of the future, the coming years will present unforeseen population health challenges that will test the capacity, preparedness and resilience of our health workforce and health systems.
We, the global community of stakeholders, get to choose how we move forward. I suggest that we consider three tenets: think out of the box, accelerate the pace and mobilize untapped resources. We know full well that changing demographics and growing health service demands will challenge already stretched health systems. So, as you consider how to tackle the coming challenges while maximizing resources and drawing on health sciences, I encourage you to read each of the following papers with appreciation of the innovative approaches to familiar challenges. The authors share their insights as they describe how to tackle obstacles large and small. Inspiring, they show us that we get to determine the strength of health systems, now and in the future and ensure that healthcare is firmly rooted in equity for populations, regardless of where they live or who they are.
Marilyn A. DeLuca, PhD, RN
About the Author
Marilyn A. DeLuca, PhD, RN, Principal, Global Health – Health Systems-Philanthropy, Research Assistant Professor, School of Medicine, Adjunct Associate Professor, School of Nursing, New York University.
Abbara, A., K. Blanchet, Z. Sahloul, F. Fouad, A. Coutts and W. Maziak. 2015. “The Effect of the Conflict on Syria’s Health System and Human Resources for Health.” World Health & Population 16(1): 84–92.
Cobb, N., M. Meckel, J. Nyoni, K. Mulitalo, H. Cuadrado, J. Sumitani, et al. 2015. “Findings from a Survey of an Uncategorized Cadre of Clinicians in 46 Countries--Increasing Access to Medical Care with a Focus on Regional Needs Since the 17th Century.” World Health & Population 16(1): 70–83.
DeLuca, M.A. and S. Castro Lopes. 2015. “Health Workforce Measurement: Seeking Global Governance and National Accountability.” World Health & Population 16(1): 8–23.
Kerry, V., L. Cunningham, P. Daoust and S. Sayeed. 2015. “Global Health Service Partnership: First Year Findings.” World Health & Population 16(1): 24–33.
Sciortino, R. and R. Tjong. 2015. “Health Human Resources: A Critical yet Challenging Pathway to Universal Health Coverage in Indonesia.” World Health & Population 16(1): 49–59.
Sopitarchasak, S., S. Adulyanon and T. Lorthong. 2015. “Thai Health Promotion Foundation: Innovative Enabler for Health Promotion.” World Health & Population 16(1): 60–69.
Wesson, J., P. McQuide, C. Viadro, M. Titus, N. Forster, D. Trudeau and M. Corbett. 2015. “Improving Access to Care among Underserved Populations: The Role of Health Workforce Data in Health Workforce Policy, Planning and Practice.” World Health & Population 16(1): 34–48.
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