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If Not Now, When? Making a Long-Term Investment in the Global Health Workforce

To all who work tirelessly for the health and well-being of others…That’s how Transforming the Global Health Workforce, a new book on the global health workforce, is dedicated, and its inclusiveness—all—speaks to the reality that so many roles are involved in helping frontline health workers deliver high-quality care to people in need.

From November 10-13 about 2,000 of those who work for the health and well-being of others gathered at the Third Global Forum on Human Resources for Health in Recife, Brazil, where countries and organizations presented their commitments to strengthening the health workforce. And we came together as a global community to make a case for investing in health workers.

Health workforce investments do not typically show results overnight, and in today’s world of instant gratification, advocating for long-term investments can be a challenge. It may take years before we see the benefits of, for example, increasing the capacity of health training institutions to produce more health workers, or advocating for increased health sector expenditure, or creating incentive packages to improve retention. But there is growing evidence that strategies like these make a difference. And at the forum, I was happy to hear countries committing to these types of long-term efforts. It can be hard to build the momentum to begin a strategy that may not pay off soon. But as Marilyn A. DeLuca (coeditor of Transforming the Health Workforce along with Agnes Soucat) said when I talked with her before the forum, “If not now, when?”Dr. DeLuca went on to say, “There are many things aligning, including the run up to the target dates for achieving the Millennium Development Goals and the current cry from many countries and leaders for universal health coverage. This is a very fertile time for change.”

But historically, private funders have been reluctant to invest in health workers. “Technology has been much more alluring than investing in health workers,” she says. “And while technology is important, the essential component to deliver health care is the health workforce—and it has not been adequately attended to.”

Over the course of ten chapters in Transforming the Health Workforce, readers enjoy the benefit of 40 different authors’ perspectives on why we need more investments in the health workforce and which specific investments are most promising.

“The bottom line is that unless we have workers that are competent, retained, and accessible, we will not be able to provide the care that is needed, from prevention to treatment to palliative care,” Dr. DeLuca says. “And while we’re experiencing rapid technological advances and realizing a great deal of success in preventing and curing illness, without long-term commitments to strengthening health systems we’re going to retard the promise our past achievements hold, especially as chronic diseases continue to escalate.”

And while donors and the international community can shift focus and resources toward the health workforce, it is ultimately countries—governments, local organizations, the private sector, and civil society—that must commit to the long haul.

Country ownership has been a rallying cry for some time now, and Dr. DeLuca sees an opportunity for new health workforce commitments and investments to be fully country-driven.

“Countries have to be at the center, and stakeholders have to work with them—not around them,” she says. “And obviously, both transparency and data have to improve. Gone are the days when donors gave without expectations to learn the impact of their funding. We need to understand what donor commitments are producing. However, the process is iterative. Transparency will not happen overnight.”

Join the conversation by following IntraHealth on Twitter. A chapter in Transforming the Health Workforce by IntraHealth experts Laura Hoemeke, Barbara Stilwell, Kate Tulenko, and others highlights some health workforce policy options that countries can adopt to improve the health of their populations.

Read more:Health Workforce Policies Can Dictate Health Outcomes, According to New PublicationPromising choices: How health workforce policy choices dictate health outcomesThird Global Forum on Human Resources for Health