“Enough talking the talk! Now we must walk the talk”.
African leaders and health experts met for the First Consultation by the Africa Platform on Human Resources for Health (HRH).
The Consultation, held in Nairobi, Kenya from 11 to 13th October 2010, was intended to provide space to secure long-term commitment and funding for health workers in Africa, and to share country-level experiences and lessons learned.
Hattie Begg, Research and Advocacy Officer at AMREF UK, attended the meeting. ‘It is clear what sets this meeting apart from the rest’, she said. ‘It is a forum for African voices, in which African leaders and health experts can discuss, among themselves, African health issues, African solutions, and decide on an Africa-led framework for action’.
In the opening speeches, the overwhelming human resources for health challenges facing the African continent were discussed: 57 countries in the world are facing health worker shortages - 39 of these are in Africa. One out of four doctors, and one out of 20 nurses trained in Africa are now working in developed countries. And the challenges extend beyond the shortages: there are additional and large-scale problems of inequitable health worker deployment, and issues surrounding poor performance, motivation and retention.
The message of the opening presenters, including the Executive Director of the Global Health Workforce Alliance – Dr. Mubashar Sheikh and AMREF’s Dr. Peter Ngatia is clear: African leaders must step up to the mark, to effectively address the HRH crisis in Africa – i.e. as Dr. Ngatia said, to 'stop talking the talk… and to begin walking the talk’.
However, some things are beginning to change. There is some continental leadership. A number of African countries, including Ethiopia, Kenya, Liberia and Tanzania, made new commitments to HRH at the MDG Summit. The issue is squarely on the agenda of the African Union; and it has received increasing attention from the Regional Economic Community.
What needs to happen now
Breakout group discussions at the meeting concluded that:
• There is a need for greater country ownership and leadership on human resources for health, including the need to develop comprehensive and costed HRH plans, and to invest in African-led advocacy on the issue.
• There is need for greater task-shifting to lower-level positions, a more diverse skills mix and greater balance between professionals, mid-level health workers and community health workers (CHW). The range of mid-level health workers must be expanded, and CHW must no longer be seen as volunteer health workers, but should be trained for longer.
• Increased recruitment and retention. There must be increased efficiency in recruitment and deployment of health workers, and greater flexibility in conditions of service. Retention strategies must be developed and rolled out, and the WHO’s new Global Code of Practice must be implemented on a global scale.
• Health workers must be placed at the centre of health systems strengthening efforts. It must be recognised that whilst health workers are critical to strengthened health systems, stronger health systems are also critical to the success of the health workforce. A dysfunctional health system undermines performance, morale and retention of staff.
• Greater knowledge: more information on the health workforce at national and regional levels is needed, and this information must be used and acted upon. Human resources for health information systems must be developed, and integrated within broader health management information systems.
For more information, visit the African Platform for Human Resources for Health's website