Why is the crisis a global crisis?

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The urgency to address the health worker crisis is not restricted to countries with critical health worker shortages. It is a challenge for all high-, middle- and low-income countries alike.

The causes of the human resource shortages are multifaceted and complex, but not so complex that they cannot be understood and acted upon. The factors that produce health workforce shortages are not the same in all countries or in all parts of countries.

Some of the causes of local health workforce shortages are “homegrown” due to inadequate planning, financing, and policy. However, local shortages can also be caused or exacerbated by conditions in other countries. One country’s domestic and foreign policies can significantly affect health worker shortages in other countries. These policy choices are often made without regard for the potential negative impacts on the health workforce in other countries. Developed countries, for example, the United States have not demonstrated a commitment to pursue a policy of national self-sufficiency (or at least a high level of self-sufficiency) in the production of local health workers. Because of its failure to plan for the education of American health workers, the United States relies on large numbers of migrant health workers to keep its health system fully operational. Countries like Canada, the United Kingdom, Australia, and New Zealand all have higher levels of relative reliance on foreign-born doctors and nurses than the United States

An effective response to the worldwide human resource shortage requires global cooperation, in combination with international, national, and local initiatives. Each country must make a contribution to solving this difficult and entrenched problem by examining the domestic and international actions it can take to reverse it.