From Vienna: The Health Workforce Crisis: Opening the Bottleneck
The health workforce shortage has been well documented. A number of "push" and "pull" factors result in what one speaker referred to this morning as "The Leaky Bucket" -- 13.9% of the health workforce in sub-Saharan Africa is lost to countries in the North and West.
The most obvious, long-term solution includes opening the pipeline by training more providers. One of the speakers advocated for socially accountable educational scale-up which emphasizes work in-country and not emigration as the goal. This will require many investments including monies for classrooms, libraries, computing labs as well as highly trained faculty. In addition, we have to consider building environments which include advanced training opportunities and better working conditions to reduce the "push," and informing policies in the US and other countries to minimize the "pull" in order to retain the providers we currently have.
At the same time, we have to become more efficient with our current health workforce.
One of the speakers highlighted the need for task-shifting and using lay workers to supplement the workforce. A recent randomized, non-inferiority trial done in South Africa found that nurses and doctors provide similar levels of care quality in managing patients receiving HIV treatment -- findings similar to our research in Mozambique.
However, we need to continue asking how we can better improve the quality of services as approximately 45% of patients in the South African study experienced treatment failure. These are unacceptable failure rates regardless of whether it's a nurse or a doctor providing services.
But, perhaps one of the biggest things that we could do to reduce the burden on health workers would be reducing the visit frequency of patients. Quality Improvement methodologies can help us identify where we could bundle services, simplify visit flows and do away with redundant activities.
See the session information and presentations, and the webcast provided by the Kaiser Family Foundation.
Food for thought from Vienna!
Attendees wait to ask questions at one of the sessions (Photo: IAS/Marcus Rose/Workers' Photos)
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