Achieving the health-related MDGs. It takes a workforce!
Critical shortages, inadequate skill mix and uneven geographical distribution of the health workforce pose major barriers to achieving the health-related Millennium Development Goals (MDGs).*
Density of doctors, nurses and midwives in 49 priority countries
Only 5 of the 49 countries categorized as low-income economies by the World Bank meet the minimum threshold of 23 doctors, nurses and midwives per 10 000 population that was established by WHO as necessary to deliver essential maternal and child health services. These 49 countries have been prioritized by the UN Global Strategy for Women's and Children's Health.
Countries that fall below this threshold struggle to provide skilled care at birth to significant numbers of pregnant women, as well as emergency and specialized services for newborn and young children. This has direct consequences on the numbers of deaths of women and children.
Some pregnancy-related services can be delivered by mid-level health workers. Community-based health workers can provide a number of life-saving child health services, such as immunizations and the management of non-severe pneumonia. These healthcare providers are not counted in the above threshold. Therefore, an effective workforce should consist of a carefully-planned balance of professional, paraprofessional and community workers.
However, in almost all countries, a poor mix of the types of health workers and their range of individual skills, combined with a shortage of qualified health workers in remote and rural areas, impedes access by women and children to life-saving interventions and services.
A comprehensive approach, supported by strong national leadership, governance and information systems, is needed to ensure skilled, motivated and supported health workers in the right place at the right time. For example, national authorities may focus on rapidly increasing the outputs of education and training programmes, along with measures to improve recruitment, performance and retention of workers - especially in rural and underserved areas - and actions to address imbalances in the mix and use of skills within a primary health care framework.
* The health workforce consists of all people engaged in actions whose primary intent is to improve health. This includes health service providers, such as doctors, nurses, midwives, pharmacists and community health workers. It also includes health management and support workers, such as hospital administrators, district health managers and social workers, who dedicate all or part of their time to improving health.
- Tools and guidelines for human resources for health
- Global atlas of the health workforce
- Migration of health workers
- Key facts
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