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The past year has given us plenty of global health successes to celebrate.
Worldwide, our lifespans are expanding. HIV medications are more widely available than ever. And many countries are meeting their Millennium Development Goals. Ethiopia, for example, a country once near the top of the list for child mortality, reached its Millennium Development Goal 4 ahead of schedule in 2013, reducing deaths of children under five by a whopping two-thirds in less than 25 years.
But we also have a lot of challenges ahead.
Last January, we looked into our crystal ball to focus on 10 key issues that would affect global health and health workers in 2013. Here’s a quick recap:
|1. The growing role of frontline health workers
2. The need for more community health workers
3. The rebirth of family planning
4. Helping even more children to live longer
5. AIDS: Getting to zero
|6. The continuing fight against malaria
7. Eradicating polio
8. The global burden of noncommunicable diseases
9. Safety for health workers during conflicts
10. Mobile health and new technologies
Those same issues will be just as prominent in 2014, and we’ll continue to track them closely. Now here are 10 more that will shape the coming year for IntraHealth International, and for all seven billion of us.
10. Serious games
Serious games—or games created for education and solving real-world problems—are gaining speed. Militaries use them to train soldiers on urban warfare, activists use them to raise awareness about unemployment, and companies use them to train employees on new processes and procedures. In 2014, high school students in Kenya will be playing a serious game called Vital Pursuit, where they’ll learn what it takes to become a nurse—including all the financial and ethical challenges the profession entails. Serious games hold tremendous possibilities for global health, and for reducing the health worker shortage. We’ll see more of them in the coming year.
9. Education, online and off
For the past few years, the higher education industry has looked to online learning—including massive open online courses—as a revolutionary field with unlimited promise for reaching underserved students. But as data and implementation challenges crop up, enthusiasm is waning. The promise, we believe, is still there. In 2014, we hope to learn more about what makes eLearning and mLearning work for health workers in different countries and contexts—and what causes the technology to fail. We also expect to see a return to basics as schools and training colleges work to improve planning, management, curricula, and faculty development and retention.
8. Women in the health workforce
Health care remains one of the most gender-segregated professional sectors in the world. In many countries, up to 75% of the health workforce is made up of women, but their wages are often lower than those of men doing similar work. Women also deal with far more stigma, discrimination, and gender-based violence at work than their male counterparts do. To eliminate the global shortage of health workers, we need to make sure women have a place in the workforce—a place of equal pay, equal respect, and equal rights.
7. Nutrient levels fall, obesity rates rise
Hunger goes hand-in-hand with poverty, and food scarcity is still a huge health care challenge around the world. But in the US and other wealthy nations, we’re seeing the effects of a high-calorie, low-nutrient diet in our rising rates of obesity, diabetes, and heart disease—ailments that overburden our health sectors. The same dangerous food trends (and the noncommunicable diseases that result) are now spreading into poorer nations. Millions of health workers will need training and resources to handle the evolving needs of their communities as diets change.
6. Cancer, heart disease, and diabetes
One of the many benefits of our global health successes over the past several decades is a longer-than-ever lifespan. We also have better diagnostics to detect chronic illness. But most developing countries are not prepared to deal with the rising rates of noncommunicable diseases that can come with age, poor diet, and better detection. One-third of adults over age 25—or about one billion people—suffer from high blood pressure, the world’s number one cause of premature death and disability. Health workers everywhere will be training hard to tackle these killers in 2014 and beyond.
5. Cold, hard data
Any country that wants to beef up its health sector and add personnel to its health workforce needs information. Without hard data, officials can’t make informed decisions about how to spend their limited budgets. For example, how many health workers do they have? What are those workers qualified to do? Are they all licensed? Where are they based? Where are the health care deserts? In 2014, more governments will be collecting these data, and they’ll turn to open source software to uncover the answers.
4. A renewed faith in international aid
The long-term benefits of global aid and development—and the results the US has achieved by devoting just 1% of its federal budget to foreign aid—are staggering. Yet a 2013 survey by the Kaiser Foundation found that Americans have an inflated perception of how many of their tax dollars go toward helping poorer nations. (On average, Americans believed 28% of the federal budget was devoted to aid, rather than 1%.) But as the US economy continues to recover and as we in the development community do more to increase transparency and communicate results, we hope to see optimism renewed in the American public. The myth that foreign aid does not work is simply wrong. And as evidenced by a newly signed US aid budget, the United States is committed to doing its part.
3. Universal health coverage
Universal health coverage: for so long, it has seemed an unreachable Shangri-La of global health. But it is possible, and we’ll get a little bit closer in 2014. Basic health services for all will take cooperation across governments, donors, civil society, nongovernmental organizations, and the private sector. It’ll also take health workers. Until we eliminate the shortage and recognize the health workforce as the key to making care available to all 7 billion of us, the door to this ideal will remain closed.
2. The lasting damage of war
Rebellion in South Sudan. Civil war in Syria. Devastating coups and rebel attacks in Mali and the Central African Republic. Countries around the world—many of whose health sectors were already shaky—suffered ruinous conflicts during 2013. The violence and destruction of war crumble not only buildings, but governments and infrastructures as well. It will take years for those countries to rebuild; 2014 will be just the start. Meanwhile, entire populations will go without consistent health care as diseases spread and health workers’ numbers dwindle, especially in the most dangerous zones.
Today we have the largest population of youth in human history. Of the seven billion people on the planet, more than three billion are under the age of 25. More than 80% percent of 15- to 25-year-olds live in developing countries. And every year more than 14 million births occur among adolescent girls in these countries. Not only do young people represent a huge population in need of health care and education, but they also need to have a voice in the world conversation about global health—including family (or future) planning. Health workers in 2014 will work harder than ever to address this population’s needs. And the face of the health workforce will grow a little more youthful as more young people choose careers in health.