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Health Workers Save Lives

National Press Foundation


Washington, DC June 9, 2011
Laura Hoemeke, MPH Director of Strategic Communications, IntraHealth International

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people lack access to basic health care


(Source: Global Health Workforce Alliance, Imagine, 2011.)

Lives in the balance Lives in the balance

In 2006 the WHO identified 57 countries with a health workforce crisis.

Critical shortage of health service providers

Five years later all 57 countries remain in crisis.

Sub-Saharan Africa has 25% of


the global burden of disease

but only 4% of the worlds health workers.

(Source: WHO, World Health Report, 2006.)

The crisis in East Africa


2.5 2 1.5 1
n i t a l u o 0 , 1 r e p v w d i m e u n / s r t c o D

0.5 0

(Source: WHO, Global Atlas of the Health Workforce, 2011.)

Flo, the beleaguered health worker


Too Too few few

Inequitably distributed

Poorly supported

Inadequately educated

Health workers save lives.

More health workers, better health outcomes

1% increase in health professionals associated with an almost 5% increase in maternal survival and an over 2% increase in both infant and child survival

(Source: WHO, World Health Report, 2006.)

each additional health worker in population of 1000 = 10 to 15 5 decline in burden of infectious disease

Rural populations have less access to health workers


6
Kampala Gikongoro Addis Amhara Kigali Turkana Nairobi

5
Doctors per 1,000 population

4 3 2 1 0

Ethiopia

Rwanda

Kenya

Uganda

(Source: World Bank, Reducing Geographical Imbalances of Health Workers in Sub-Saharan Africa, 2010.)

Kamuli

which affects health outcomes


Percentage of births attended by a health professional 90 80 70 60 50 40 30 20 10 0 Ethiopia K ya en
Rural

% s h t r i b f o

Rwanda
Urban

Ug anda

(Source: Demographic and Health Surveys: Ethiopia 2005; Kenya 2008-09; Rwanda 2007-08; Uganda 2008.)

which affects health outcomes


Modern method contraceptive prevalence
5 0 4 5 4 0 3 5 3 0 2 5 2 0 1 5 1 0 5 0 Eh p t io ia Kn a ey
Rr l ua

A R W M f o %

R ad wn a
Ub n ra

Ua d gn a

(Source: Demographic and Health Surveys: Ethiopia 2005; Kenya 2008-09; Rwanda 2007-08; Uganda 2008.)

Projected impact of increasing health worker density on maternal mortality

Health worker density


(Sources: 83 country sample: Anand and Barnighuasen, Human Resources and Health Outcomes: Cross-Country Econometric Study, Lancet 2004; 364:1603-1609. Health worker density for Ethiopia: WHO, Global Atlas of the Health Workforce. Maternal mortality for Ethiopia: Maternal Mortality for 181 Countries, 1980-2008: A Systematic Analysis of Progress Towards Millennium Development Goal 5, Lancet 2010; 375. )

Practical solutions

Solutions to the health worker crisis


Mobilize leaders

Expand educati on

Strength en managem ent

Mobilizing leaders
Uganda
Human Resources for Health Technical Working Group
Engaging ministries, donors, partners, health workers

Malawi
Emergency HR Program
53% increase in public sector health workforce, 2004 to 2009; use of key services increased; more than 13,000 lives saved

Solutions to the health worker crisis


Mobilize leaders

Expand education

Strength en managem ent Deploy where needed

Educating health workers


Ethiopia
Massive expansion of health extension workers
34,000 health extension workers dispatched to 15,000 health posts

Mali
The right health worker trained in the right place
Gao Nursing School in rural north

Solutions to the health worker crisis


Mobilize leaders

Expand education

Strength en managem ent


Deploy where needed

Deploying health workers


Rwanda
Community health workers
deploying 60,000 health workers; dramatic improvements in child survival, maternal health and use of family planning

Uganda
Rural health worker attraction and retention
using discrete choice experiment to figure out what motivates health workers

Solutions to the health worker crisis


Mobilize leaders

Expand education

Strengthen management

Deploy where needed

Managing health workers


Kenya
Emergency Hiring Plan
830 nurses hired and placed in 200 health facilities in six months

Tanzania
Productivity improvement
making health facilities more client-friendly and more health worker-friendly

Solutions to the health worker crisis


Mobilize leaders

Expand education

Strengthen management

Deploy where needed

Agenda for action


Advocacy |Assets |Accountability

www.intrahealth.org

Laura Hoemeke, Director of Strategic Communications,

lhoemeke@intrahealth.org

Visit us at Booth 416 during GHC