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Ensuring a Legacy: The Health Workforce Component of the Global Health Initiative

When we talk about the “health workforce crisis” or “human resources for health,” this abstract language can obscure the suffering of people in need. A woman dies in labor because she can’t reach a properly trained and supported health worker. A child succumbs to pneumonia. A farmer is felled by malaria. A minor injury at work becomes a badly infected wound. The cost in death, pain, disrupted families, and lost productivity mounts.

All of this can be prevented or treated by introducing a skilled health worker.

The US Government’s Global Health Initiative has commendable goals and targets, including “Increased numbers of trained health workers and community workers appropriately deployed in the country.” And Secretary of State Hillary Clinton recently spoke eloquently of our national commitment to global health, saying that “Few investments are more consistent with all of our values and few are more sound.” But our goals and values will not be realized where there is no health worker.

The GHI can be achieved only if health workers are present. The basic tenets of a health workforce strategy are clear and feasible. The cost to the US of making health workers accessible is not great. Making health workers available to communities will help ensure the GHI’s enduring legacy.

I’ve been reflecting on the health workforce component of the GHI (see my first and second posts) in the interest of contributing to the conversation. Let me conclude with the following suggestions:

  • The US should set a goal of increasing the global health workforce by 232,000 by 2014 and 580,000 by 2020. This should be accompanied by improvements in equitable access to health workers, health school capacity, health worker retention, and health worker productivity.
  • The US should focus its human resources for health (HRH) program on countries that have a health workforce crisis and in which the US is making a substantial investment to improve health.
  • Management of the HRH program should be vested in an HRH coordinator at USAID, who would have oversight, coordination, and budget authority, though responsibility for program implementation would remain with USAID programs and other US agencies currently engaged in HRH projects and activities.