2015+: Where Are the Healthcare Workers?

From time to time, we will step out of our sector to see what others are saying about post 2015 goals. This is a blog from Tim Crocker-Buqué of Generation Development, first published in August 2011.  

2015+.JPGOne of the many striking omissions from the current set of MDGs is no real consideration for the severe lack of healthcare workers (doctors, nurses, technicians, support workers, skilled birth attendants, pharmacists, therapists etc etc) in low and middle income countries. Even with aspirational targets that the current MDGs set, many of them (4, 5 & 6 especially, but arguably 1 and 3 as well) cannot be reached with the current shortage of healthcare workers. Below are four maps, from the amazing Worldmapper, that show the countries of the world resized in proportion to what they are measuring. The two comparisons I have made are deaths from diarrhoeal disease Vs. physicians working and maternal mortality Vs. number of midwives.

Deaths from diarrhoeal disease (2002)

Number of physicians working (data from 2004)

Maternal Mortality (data from 2000)

Midwives working (Data from 2006)

These maps are amazing because they produce an undeniable truth when confronted with images as stark as this. The fact that the problem of recruiting, training and retaining healthcare workers has been lost in the overall international development picture. There is little hope to make a real tangible difference to health outcomes in international development without a significant focus on health workers. In my own opinion this should be a core component of any MDG replacements post 2015.

Fortunately there are some organizations working on this problem (but not nearly enough). Combining the need for health workers with an MDG target, skilled birth attendants to combat maternal mortality for example, can allow organisations to secure funding. The UN Population Fund considers skilled birth attendants “the single most critical intervention for securing safe motherhood”.

However simply training healthcare workers is not enough. The provision and support of healthcare workers needs to be sustainable, with lasting funding. The Tropical Health Education Trust (THET) here in the UK does some amazing  work in promoting links between institutions to encourage the exchagne of knowledge and experience in order to train more healthcare workers. More organisations simply arrange to send doctors or nurses overseas for short periods of time, to help with a particular issue. Although this has some value, it is automatically limited as it is not sustainable.

Many high income countries are also guilty of ‘stealing’ workers from low income countries. This ‘brain drain’ is a problem, but it should not be solved by restricting workers freedom of movement, but by supporting, nurturing and paying healthcare workers well enough to be able to stay where they are most needed.

From an interesting World Bank Publication.

Merlin, the health NGO, has an excellent campaign supporting health workers called “Hand Up for Health Workers” to try and recruit and train more healthcare workers for where they are needed. So please go and sign their petition!

The brain drain must end, and doctors, nurses and other health professionals working in the places where they are most needed must be supported, paid, safe and well trained. This should be enshrined in international policy, and should be essential in any MDG replacement framework.

What’s your experience?


  • SHARE YOUR THOUGHTS IN THE COMMENTS BELOW! Women Deliver will continue to post thoughts and opinions on this topic from key leaders in the field throughout the coming months. Please stay tuned to all our "Beyond 2015" blogs.

Entry Comments

    • Aug 31
    • .(JavaScript must be enabled to view this email address)

    The healthcare worker needs equipment and adequate supplies beside training, they need also guidance how to do their job/services better. . .

    • Sep 01
    • .(JavaScript must be enabled to view this email address)

    Pretty nice. Thanks for sharing!

    • Sep 02
    • .(JavaScript must be enabled to view this email address)

    Implementation of task shifting; developing a standardized and systematized programme for training; treat, train, and retain!

    • Sep 02
    • .(JavaScript must be enabled to view this email address)

    I work as a health worker in rural area in Ghana. I think it is disincentive there in comparison with the urban areas. You work alone virtually for nothing.

  1. I encountered this problem working on board a cruise ship. I would have been fired for refusing vaccination for the flu, but luckily for them my contract was almost up. It was a disturbing and upsetting experience.

  2. I feel so much happier now I udnrestand all this. Thanks!

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