Key factorsprinciples in training the global health workforce

A critical limiting factor in the response to the formidable global health challenge is the paucity of human and institutional resources. This in turn limits the absorptive capacity vis-à-vis the ability to use the increasing donor nation funds to build effective programs. The education pipeline is inadequate to meet current needs, and shortages of teachers limit the ability to ramp up the output. Help is needed at all levels, from national leadership and planning, to the most downstream interactions of health workers with individuals and communities.

Every country should have a national workforce raining plan, tailored to its situation and responsive to its short-, medium-, and long-term needs. The plan should include an assessment not only of the number and distribution of health-care workers, but also the skills mix needed, the adminisrative and support systems required, the rewards/career opportunities, measures to reduce outmigration to other jobs or locations, and a budget. National governments need to identify the resources to implement their plans. These issues have been well addressed in the 2006 World Health Report: Working Together for Health (WHO Press, Geneva).

We believe that certain key factors/principles are core to the success of health training activities, whether the focus is clinical, research, public health, or administration and infrastructure building, and whether the training sponsor is government, non-government, academic, faith-based, or other entity. This section outlines five key factors/principles for success, and gives examples from public-private partnerships as well as from the Fogarty International Center's (FIC) programs that have developed over the past two decades in response to the HIV/ AIDS crisis in the developing world. Although the FIC programs are focused on building research capacity, we believe these principles also apply broadly to other global health efforts, including the ramping up of prevention and therapeutic care for the approximately 40 million persons in the world currently living with HIV/AIDS.

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Table 17.1 Global health workforce, by density

WHO region

Total health workforce

Health service providers

Health management and support

workers

Number

Density (per

Number

Percentage of total

Number

Percentage of total

1000 population)

health workforce

health workforce

Africa

1.640.000

2.3

1.360.000

83

280.000

17

Eastern

21.000.000

4.0

1.580.000

75

520.000

25

Mediterranean

South-East Asia

7.040.000

4.3

4.730.000

67

23.000.000

33

Western Pacific

10.070.000

5.8

7.810.000

78

2.260.000

23

Europe

16.630.000

1 8.9

11.540.000

68

5.090.000

31

Americas

21.740.000

24.8

12.460.000

57

9.280.000

43

World

59.220.000

9.3

39.470.000

67

19.750.000

33

All data for latest available year. For countries where data on the number of health management and support workers were not available, estimates have been made based on regional averages for countries with complete data. Source: World Health Organization, Global Atlas of the Health Workforce (http://www. who.int/globalatlas/default.asp).

All data for latest available year. For countries where data on the number of health management and support workers were not available, estimates have been made based on regional averages for countries with complete data. Source: World Health Organization, Global Atlas of the Health Workforce (http://www. who.int/globalatlas/default.asp).

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