The
Newsletter of the Pan American Health Organization - August
2006People: Our Most Precious Health Resource
Working for health is more than a job; it's a calling. But it's not always an easy one.
Health workers carry vaccines and immunization supplies during "Vaccination Week in the Americas." Getting "the right people with the right skills in the right place" is critical for public health. © Armando Waak/PAHO
Millions of health workers across the Americas toil every day curing the sick, preventing disease, and teaching people to protect their own health. Yet too many of them work under conditions beyond their control that hamper their efforts.They may lack the equipment or training they need, they may be exposed to unnecessary health risks, or they may be underpaid for their work. Many work too-long hours, and the strain can impede their effectiveness.
This year's World Health Day, April 7, was dedicated to highlighting the critical importance of health workers and urging new policies to improve their education and training, compensation, incentives, management, and working conditions.
"It takes real people to translate good public health policies into good health care," said Mirta Roses, director of the Pan American Health Organization (PAHO). "On World Health Day, we want to express our deep appreciation for health personnel but also to propose policies and concrete actions that can enhance their contributions."
This year's campaign builds on an effort launched last year in Toronto, Canada, at an international meeting of experts on human resources in health. The meeting concluded with the Toronto Call to Action, which lays out a regional agenda to support and enhance human resources in health over the next 10 years. It targets five main areas:
- Aligning human resource policies with countries' present and future health needs.
- Putting "the right people in the right places"—with an emphasis on primary health care and multidisciplinary teams—to promote greater access to quality health care for everyone.
- Managing health worker migration.
- Shaping health education to better meet the needs of health services.
- Motivating and empowering health workers through better compensation, healthier work environments, and opportunities for professional development.
"World Health Day will help reinforce our call for governments and stakeholders to make this a policy priority and to commit the political will and resources we need to make this truly the Decade of Human Resources for Health," said Roses.
Matching resources to needs
In the Americas region, more than 12 million people work in health-related fields, including direct patient care but also research, technology, education, and health policy. They include physicians, nurses, and public health professionals along with policy-makers, educators, scientists, pharmacists, and clerical staff.
Helping Health Workers, Improving Health
The Pan American Health Organization (PAHO), through its Human Resources for Health unit, is working to help its member countries improve their health services by strengthening their health workforces. PAHO helps countries develop policies and programs that promote better training, compensation and working conditions, and better distribution of human resources. PAHO also promotes information exchange through databases and networks, supports country-to-country and subregional efforts, and works to build relationships between the health, education, and labor sectors and professional associations, labor organizations, and universities.
"The quality of a country's health system depends on the capabilities of its health workforce. These need to be strengthened through better policies, education and training opportunities, and more information to help forecast workforce allocation needs," says Felix Rigoli, PAHO regional advisor on human resources development.
"But there are also simple things we can do," he adds. "For example, every health worker should be guaranteed regular health exams and vaccination against diseases like tetanus, tuberculosis, and hepatitis. Obviously, if we protect our health workers, they'll be better able to protect us."
An estimated 60–70 percent of the region's national health budgets are dedicated to supporting this health workforce. Yet throughout the Americas, there are major mismatches between the characteristics of the health workforce and countries' actual health needs.
The United States, for example, currently has a shortage of 168,000 nurses, and Canada expects a shortfall of 60,000 nurses in the next 6–7 years. In the Caribbean, 35 percent of nursing jobs are currently vacant, in part because of emigration to meet the high demand for nurses abroad.
Problems of internal distribution can be just as serious. In many countries, health professionals are concentrated in cities, leaving rural areas underserved. In Quito, Ecuador, there are 12 nurses per 10,000 inhabitants, but the country as a whole averages only 5.3 nurses per 10,000. In Uruguay, 80 percent of physicians live in the capital, serving only 45 percent of the country's population.
In 19 countries of the Americas, there are more physicians than nurses. This includes the Dominican Republic, where there are eight doctors for every nurse. In Brazil, two-thirds of all health professionals are physicians. And in Uruguay, two-thirds of doctors are specialists.
"The purpose of the Decade of Human Resources in Health is to get countries to address workforce imbalances through such things as better training and education and better workforce management," says Charles Godue, chief of PAHO's Human Resources Development unit. "The challenge is to get the right workers with the right skills in the right place doing the right things."