7th March, 2008
The African Medical & Research Foundation (AMREF) has called for the inclusion of communities as core decision-makers in the health care they receive, and resultantly the numbers and skills of workers deployed in the health system at the First Global Forum on Human Resources for Health being held in Kampala, Uganda
The forum, designed to address health worker shortages and weak health systems around the world, asked governments to "determine the appropriate health workforce skill mix" required to deliver adequate quality health care in their countries. While the focus has been on the 'push' to train additional health workers with appropriate skills to deliver health care, AMREF believes that it ought to be more about the 'pull' of communities.
"We continue to argue for the central role of communities within the health system itself and in determining the services they need, the quality of those services, and therefore numbers and skills of health professionals that are needed," said Dr Michael Smalley, AMREF Director General.
Migration and retention of health workers were key concerns at the conference, convened by the Global Health Workforce Alliance (GHWA) to discuss a plan of action to tackle the accelerating health human resource crisis around the world. It is estimated that four million additional health workers are needed to deliver essential health care worldwide, one million of these in Africa alone.
In what was dubbed the 'Kampala Declaration and Agenda for Action', developed countries were asked to give priority to training and recruitment of their own health workers to stem the bleeding of vital health personnel from poorer nations. Similarly, both rich and poor countries were asked to establish appropriate mechanisms to encourage retention of their health workforce, including adequate pay and other incentives, safe and enabling working environments with opportunities for career growth, and tailoring of training of health workers to the needs of local communities.
The conference mandated the World Health Organisation to speed up negotiations for a code of practice on the recruitment of personnel worldwide. Suggestions were made for compensation arrangements between source countries and receiving countries, legal agreements and limits to recruitment of foreign health workers, and even arrangements for one country to train health workers to meet the health needs of another.
Dr Michael Smalley noted that failure to comprehensively address the health worker crisis in the last three decades had contributed in many ways to the weak health systems in Africa, hence the importance of the conference.
"AMREF is excited that a global gathering such as this is at last discussing an issue that has been central to our work for 50 years. We have long recognised the critical importance of providing appropriate skills to all health workers, including doctors, nurses and community health workers to ensure a workable and sustainable health system."
He added: "A number of initiatives that AMREF has been involved with have been shown to be relevant this week. These include the training of comprehensive nurses in Uganda to give them skills that are appropriate to community needs and do not pre-equip them to emigrate. There was also great interest in innovative approaches, and in particular in the e-Learning project that AMREF has been managing in Kenya with Accenture (a global management consulting, technology services and outsourcing company), the Nursing Council of Kenya and the Ministry of Health. We are delighted to be able to share our experiences with others at this forum."
He reiterated AMREF's commitment to engaging with the GHWA as part of the AMREF’s strategy to strengthen health systems that are appropriately structured and adequately staffed. Outgoing AMREF Board Chair Prof Miriam Were is on the board of the GHWA, while AMREF Director of Capacity Building, Dr Peter Ngatia, is a member of the African Forum.
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Click here to read about how AMREF was chosen as lead agency to take forward pan-African health network at the forum.