WHO: More Than 4M Workers Should Be Hired To Provide HIV/AIDS Services

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The World Health Organization is recommending that more than four million workers be hired toadminister antiretroviral drugs, provide HIV/AIDS counseling and handle othertasks in developing countries as part of its new guidelines on task shifting, Bloomberg/China Post reports (McLure, Bloomberg/ChinaPost, 1/11).

WHO last week at a conference in Addis Ababa, Ethiopia,released new-task shifting guidelines to address health worker shortages andhelp expand access to HIV/AIDS prevention, treatment and care services.According to one recommendation included in the task-shifting recommendations,community health workers -- including people living with HIV/AIDS -- safely andeffectively can provide HIV/AIDS services in a health facility and in thecommunity (Kaiser Daily HIV/AIDS Report, 1/9). According to UN News Service, the plan aims to expand to"free up" time for physicians and nurses by allowing "lessspecialized" health workers to perform tasks. It is estimated to take afew months to one year to train a community health worker, compared with threeto four years for a nurse and up to eight years for a doctor (UN NewsService, 1/10).

According to Bloomberg/China Post, the plan is expected to costabout $7 billion over five years and calls for hiring an additional 2.4 millionphysicians, nurses and midwives in developing countries to meet the UnitedNations' goal of providing universal access to antiretrovirals by 2010 (Bloomberg/ChinaPost, 1/11).

Health ministers and experts from 57 countries worldwide participated in thethree-day conference, which is expected to produce a call for action on taskshifting in an effort to expand access to universal health services. Accordingto Fritz Lherisson, a conference delegate from UNAIDS, 36of the 57 countries worldwide that face critical health care workers shortagesare in Africa (Kaiser Daily HIV/AIDS Report, 1/9).

Related Study

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Many African countries havemore health care professionals working in wealthier nations abroad than theyhave working within their borders, according to a study published in the Jan.10 issue of the journal Human Resources for Health, BBC News reports.

The study, which was conducted by the Center forGlobal Development,examined census data collected between 1999 and 2001. It focused on theemployment of health workers originally from other countries in Australia, Belgium,Canada, France, Portugal,Spain, South Africa, the United Kingdom and the U.S.

The study counted health workers who were born in Africarather than those who were trained on the continent. Concentrating on thetraining location rather than place of birth can substantially underestimatethe effect of shortages on a country's health system, according to theresearchers.

The study found that health care worker losses often occur in countries thatexperience civil strife, political instability and economic stagnation, BBCNews reports. Angola, Congo, Guinea-Bissau, Liberia, Mozambique, Rwandaand Sierra Leone all had civil wars in the 1990s and lost about 40% of theirdoctors by 2000, according to the study. Mozambiqueand Angola have more healthworkers in a single foreign country than domestically, and for every doctorliving in Liberia,there are two working abroad, the study found. In Kenyaand Zimbabwe,which have experienced economic and political problems, more than half ofhealth workers have left to work abroad, the study found. Mozambique has 75% of its doctors workingabroad, followed by Angolawith 70%, Ghana with 56%, Kenya with 51%, Rwandawith 43%, Sudan with 13% andNigerwith 9%.

Meanwhile, African countries that experience greater economic and politicalstability, such as Botswana,retained a higher number of health workers, the researchers found. The same wastrue for poorer countries like Niger,which could be because impoverished countries do not produce many aspiringdoctors with the connections or resources necessary to emigrate, theresearchers said.

Nick Corby, a policy officer at ActionAID, said brain drain is a "hugethreat" to Africa. He added that one ofthe best ways for countries to retain health workers is to pay them highersalaries, but "health systems in many African countries are woefullyunderfunded" (BBC News, 1/10).

Reprintedwith permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, and sign upfor email delivery at kaisernetwork.org/email . The Kaiser Daily HIV/AIDS Reportis published for kaisernetwork.org, a free service of The Henry J. KaiserFamily Foundation.

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