Who is providing care to the now 7 billion people on this planet?

I heard today that the world has now welcomed it’s 7th billion member to the globe. It is staggering to think we have 7 BILLION people living on this planet now. In global health terms, this means we need to provide adequate healthcare to a staggering amount of people. Yet the one population we have not seen enough growth in is the population of health care workers. According to the article Human resources for health: overcoming the crisis by Chen et al., the world is short of 4 million healthcare workers. In Sub-Saharan Africa where population growth continues to climb at alarming rates, it is estimated that they are already short of 1 million health care workers (Chen, 2004).

The shortage of health care works is a global issue, affecting both developed and developing nations all over the world. In the Chen et al. article, they discussed the relation of health care worker density to mortality rates and how the shortage is severely affecting countries that already have the poorest health indicators. Sub-Saharan African nations comprised most of the nations with a low-density of health care workers with a high mortality rate. Within individual countries, there is almost always a maldistribution of health care workers, with a lower prevalence of workers within rural areas. There are many causes of the shortage and imbalance of health care workers ranging from poor working environments, inadequate pay and benefits, to migration and “brain drain” in which wealthy countries are recruiting workers from low income countries.

We have seen huge growth in aid for global health initiatives over the past decade putting the spotlight on diseases such as HIV and TB as well as maternal and child health. However, without addressing the shortage of health care workers, we will never reach the goals of the MDG’s. Vaccines and life saving medications won’t do anything if we don’t have workers to distribute them. We will not decrease maternal mortality by encouraging women to give birth with a skilled birthing attendant if there are no skilled workers to refer the woman in labor to.

The global health world needs to focus its attention on rebuilding the health care workforce. This needs to be done on both a global and local level. Chen et al. states, “For workers to be effective they must have drugs and supplies, and for them to use these inputs efficiently they must be motivated, skilled, and supported”. Low-income countries need to invest time and money into increasing education, salaries and support of their health care workers.  Governments and foreign aid donors need to invest in building and improving health system’s infrastructure to create better working environments and increase worker retention. Also, wealthy countries need to invest in their own health worker education and retention so they stop the “brain drain” of recruiting workers from already hurting countries.  Without interventions, the health of the world’s 7 billion people will fall on a small number of health care workers not able to reach everyone.

 

Chen, L. , Evans, T. , Anand, S. , Boufford, J. , & al, e. (2004). Human resources for health: Overcoming the crisis. The Lancet364(9449), 1984-1990.

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