- Editorial
- Open access
- Published:
- Michelle McIsaac1,
- James Buchan2,
- Ayat Abu-Agla3,
- Rania Kawar1 &
- …
- James Campbell1
Human Resources for Health volume22, Articlenumber:68 (2024) Cite this article
-
237 Accesses
-
Metrics details
In May 2016, the Sixty-Ninth World Health Assembly adopted the Global Strategy on Human Resources for Health: Workforce 2030. The Strategy set forth an ambitious policy agenda aiming to accelerate progress towards Universal Health Coverage (UHC) and related Sustainable Development Goals (SDGs) by increasing access to health workers and strengthening health systems. The strategy highlighted shortages of health workers, along with skill-mix imbalances, maldistribution, barriers to inter-professional collaboration, inefficient use of resources, poor working conditions, and gender inequalities among health and care workers and outlined policy options and recommendations to address these issues. The Strategy outlined the need to adequately finance health systems and boost political will to mobilise resources needed to redress workforce gaps.
The Global Strategy on Human Resources for Health: Workforce 2030 called for a greater focus on the preparation of the entire health workforce for emergencies, such as their involvement in preparedness and response, training, and planning for staffing requirements and surge capacity. However, many countries were unprepared for the COVID-19 pandemic. Pressure on health workers—as individuals and as a core component of the health system response and the spotlight as the impact of insufficient human resources for health was felt globally and acutely. It is clear that COVID-19 has had an impact on health and care workers, with many reporting burnout [1].
The Special Series Global Strategy on Human Resources for Health: Workforce 2030—A Five-Year Check-In [2] comes at a time of crises and change [3]. A time when the assessment of the progress on milestones identified by the Global Strategy on Human Resources for Health: Workforce 2030 [4] has taken on greater urgency in the drive to accelerate progress towards the global sustainable development goals. Although it is clear we need to do much more to achieve UHC, we can see that some progress has been made. An increase in the global workforce stock has meant that the shortfall, projected at the time of the Strategy to be 18 million by 2030 has been revised to 10 million [5]. The long-term impact of COVID-19 on these trends are yet to be fully understood. Yet, it is clear that the response to COVID 19 must pivot societies towards investing in what matters most to people and economies: health.
The papers in this Special Series are both a testament to advances made since 2016 and a warning of how much further we still need to progress in order to attain universal accessibility, acceptability, coverage and quality health workforce within strengthened health systems. This can only be achieved through adequate investments and the implementation of effective policies at national, regional and global levels.
Foremost, we have seen progress on the foundations for sound policy making: data collection and information exchange. The paper by McQuide et al. on health information systems speaks to both the great importance of data as a public good and the progress made over the past two decades [6]. Several papers in this series highlight the use of this enhanced capacity and improved evidence to inform policy. Garg et al. show the importance of evidence to filling thousands of additional full-time jobs in areas where needs were previously unmet [7]. Yet, it is not just about collecting more data, but also using better data, and Newman et al. underscore the importance (and feasibility) of collecting gender data to counteract systemic structural gender discrimination and inequality in the health and care workforce [8].
The papers in this series also highlight progress on the capacity, coordination and governance structures that are so essential to the achievement of UHC. Martineau et al. highlight the examples of Malawi, Nepal and Sudan where HRH units and intersectoral coordination mechanisms have been instrumental in advancing the health workforce policy and investment agenda [9]. Kolie et al. outline the coordination needed for more equitable distribution of health workers in Sub-Saharan Africa [10].
Taken together, we are optimistic that progress is being made towards UHC through effective implementation of evidence based HRH policies. However, in the context of system damage and policy upheaval caused by the COVID-19 pandemic, and discussed in the paper by Bustamante Izquierdo et al., we are concerned that there is a patchiness to this progress [11]. The paper by Dedeilia et al. discusses how the COVID-19 pandemic has severely disrupted health worker education [12]. Enabulele et al. reflect on lessons and the enabling factors for improved course completion rates in Commonwealth countries [13]. Both papers offer considerations for countries looking to scale up health workforce production. This is also reflected in the use of health workforce assessment tools and mechanisms by bilateral and multilateral partners in the paper by Nove et al. [14]
Beyond what the papers in the series tell us, there are also some critical gaps in the narrative of progress. As suggested by van de Pas et al., there has been limited progress in generating fiscal space for health, the development of health workforce partnerships and its global agenda or the governance of international health workforce migration [15]. The paper by Nurruzzaman et al. highlights that in Bangladesh, the public sector comprises only an estimated 18% of the total health workforce [16]. The private sector is a large employer of health workers in many countries, yet dialogue on partnerships for public purpose or oversight of the private sector is limited. The paper by Leslie et al. provides further insights on regulation that can be used by policymakers, governments, and regulators to inform regulatory design and practice in line with the Global Strategy [17].
While the overall health workforce shortage in relation to at least 80% of population accessing UHC is shrinking, inequality appears to be increasing [5]. This includes distributional inequality, but also inequalities among workers, such as the inequalities faced by foreign-trained health workers outlined by Harun and Walton-Roberts [18] and those faced by women as Newman et al. [8] outline. The many more jobs being created in the health and care economy are important, but with growth skewed to high- and middle-income countries, there is concern about who is being left behind.
Micah et al. show that the majority of developmental assistance to human resources for health is being directed towards in-service training. [19]Toure et al. find that health worker remuneration accounted for a quarter of country health expenditure in low-income countries and a third in middle-income countries [20]. It is perhaps not surprising then, that most multilateral and bilateral agencies that provide financial and technical assistance to countries for human resources for health since 2016 do not identify it as a key focus; few have published a specific policy or strategy to guide health workforce investments [14]. With the increasingly connected and global nature of health labour markets, coordinated global action is needed to drive investment, not just in education, but also towards employment and decent work in countries struggling to do this with domestic resources alone.
The value of this Special Series lies not only in its rich and varied content which shows the breadth and scope of the Global Strategy on Human Resources for Health, but also its influence on policy fora. Articles in this series resonated across sessions at the 5th Global Forum on Human Resources for Health held in April 2023. The data and evidence from these papers informed the dialogue at the Forum and resulted in a clear action agenda [21]. Urgent action to prioritise and scale investments to address the global health and care workforce shortage, on three critical aspects:
Protect We must protect the existing workforce and reduce attrition with decent work and improved working conditions.
Invest We must position and prioritise investments and action on tackling the health and care workforce shortage at the top of the agenda.
Together We must act in solidarity, and with all sectors and partners.
Translating this into the action necessary in each and every country is needed. Research, particularly research on implementation, will continue to play a central role in this era of action.
Availability of data and materials
Not applicable.
References
Abdul Rahim HF, Fendt-Newlin M, Al-Harahsheh ST, Campbell J. Our duty of care: a global call to action to protect the mental health of health and care workers. Doha Qatar: World Innov Summit for Health. 2022;1:5.
Abu-Agla A, Campbell J, McIsaac M. Global Strategy on Human Resources for Health: Workforce 2030 – A Five-Year Check-In. 2022. https://www.biomedcentral.com/collections/workforce2030. Accessed 5 Feb 2024.
Independent Group of Scientists appointed by the Secretary-General, Global Sustainable Development Report 2023: Times of crisis, times of change: Science for accelerating transformations to sustainable development, (United Nations, New York, 2023). https://sdgs.un.org/sites/default/files/2023-09/FINAL%20GSDR%202023-Digital%20-110923_1.pdf. Accessed 5 Feb 2024
World Health Organization. Global strategy on human resources for health: workforce 2030. Geneva: World Health Organization; 2016.
Boniol M, Kunjumen T, Nair TS, Siyam A, Campbell J, Diallo K. The global health workforce stock and distribution in 2020 and 2030: a threat to equity and “universal” health coverage? BMJ Glob Health. 2022;7(6): e009316. https://doi.org/10.1136/bmjgh-2022-009316.
McQuide P, Brown AN, Diallo K, Siyam A. The transition of human resources for health information systems from the MDGs into the SDGs and the post-pandemic era: reviewing the evidence from 2000–2022. Human Resour Health (Forthcoming). 2023;21(1):93.
Garg S, Tripathi N, McIsaac M, Zurn P, Mairembam DS, Singh NB, de Graeve H. Implementing a health labour market analysis to address health workforce gaps in a rural region of India. Hum Resour Health. 2022;20:50.
Newman C, Nayebare A, NdiateNdiayeGacko NM, Okello P, Gueye A, Bijou S, Ba S, Gaye S, Coumba N, Gueye B, Dial Y, N’doye M. Systemic structural gender discrimination and inequality in the health workforce: theoretical lenses for gender analysis, multi-country evidence and implications for implementation and HRH policy. Human Resour Health. 2023;21:37.
Martineau T, Ozano K, Raven J, Mansour W, Bay F, Nkhoma D, Badr E, Baral S, Regmi S, Caffrey M. Improving health workforce governance: the role of multi-stakeholder coordination mechanisms and human resources for health units in ministries of health. Human Resour Health. 2022;20(1):47.
Kolié D, Van De Pas R, Codjia L, Zurn lP. Increasing the availability of health workers in rural sub-Saharan Africa: a scoping review of rural pipeline programmes. Human Resour Health. 2023;21(1):20.
Bustamante Izquierdo JP, Puertas EB, Hernández Hernández D, Sepúlveda H. COVID-19 and human resources for health: analysis of planning, policy responses and actions in Latin American and Caribbean countries. Hum Resour Health. 2023;21:21.
Dedeilia A, Papapanou M, Papadopoulos AN, Karela NR, Androutsou A, Mitsopoulou D, Nikolakea M, Konstantinidis C, Papageorgakopoulou M, Sideris M, Johnson EO, Fitzpatrick S, Cometto G, Campbell J, Sotiropoulos MG. Health worker education during the COVID-19 pandemic: global disruption, responses and lessons for the future—a systematic review and meta-analysis. Hum Resour Health. 2023;21:13.
Enabulele O, Enabulele JE. Pre-service medical education course completion and drop-out rates. Hum Resour Health. 2022;20:88.
Nove A, Ajuebor O, Diallo K, Campbell J, Cometto G. The roles and involvement of global health partners in the health workforce: an exploratory analysis. Hum Resour Health. 2023;21:41.
van de Pas R, Mans L, Koutsoumpa M. An exploratory review of investments by development actors in health workforce programmes and job creation. Hum Resour Health. 2023;21:54.
Nuruzzaman M, Zapata T, McIsaac M, Wangmo S, Joynul Islam M, Almamun M, Alam S, Humayun Kabir Talukder M, Dussault G. Informing investment in health workforce in Bangladesh: a health labour market analysis. Human Resour Health. 2022;20:73.
Leslie K, Bourgeault IL, Carlton AL, Balasubramanian M, Mirshahi R, Short SD, Carè J, Cometto G, Lin V. Design, delivery and effectiveness of health practitioner regulation systems: an integrative review. Hum Resour Health. 2023;21:72.
Harun R, Walton-Roberts M. Assessing the contribution of immigrants to Canada’s nursing and health care support occupations: a multi-scalar analysis. Hum Resour Health. 2022;20:53.
Micah AE, Solorio J, Stutzman H, Zhao Y, Tsakalos G, Dieleman JL. Development assistance for human resources for health, 1990–2020. Hum Resour Health. 2022;20:51.
Toure H, Aranguren Garcia M, Bustamante Izquierdo JP, Coulibaly S, Nganda B, Zurn P. Health expenditure: how much is spent on health and care worker remuneration? an analysis of 33 low- and middle-income African countries. Hum Resour Health. 2023;21:96.
World Health Organization. Fifth Global Forum on Human Resources for Health: Key areas for action and the way forward. https://www.who.int/publications/m/item/5gf-outcomes. Accessed 5 Feb 2024.
Funding
Not applicable.
Author information
Authors and Affiliations
Health Workforce Department, World Health Organization, Geneva, Switzerland
Michelle McIsaac,Rania Kawar&James Campbell
Health Foundation/ Editor Emeritus Human Resource for Health Journal, London, UK
James Buchan
Health Service Management Centre Dubai, University of Birmingham, Dubai, United Arab Emirates
Ayat Abu-Agla
Authors
- Michelle McIsaac
View author publications
You can also search for this author in PubMedGoogle Scholar
- James Buchan
View author publications
You can also search for this author in PubMedGoogle Scholar
- Ayat Abu-Agla
View author publications
You can also search for this author in PubMedGoogle Scholar
- Rania Kawar
View author publications
You can also search for this author in PubMedGoogle Scholar
- James Campbell
View author publications
You can also search for this author in PubMedGoogle Scholar
Contributions
All the authors contributed in writing the manuscript, and all the authors read and approved the final manuscript.
Corresponding author
Correspondence to Michelle McIsaac.
Ethics declarations
Ethics approval and consent to participate
Not applicable.
Consent for publication
Not applicable.
Competing interests
Michelle McIsaac is on the Editorial Board for Human Resources for Health. James Buchan is an Editor Emeritus for Human Resources for Health.
James Campbell is on the Senior Advisory Group and Editorial Board for Human Resources for Health. Ayat Abu-Agla and Rania Kawar declare that they have no competing interests.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
About this article
Cite this article
McIsaac, M., Buchan, J., Abu-Agla, A. et al. Global Strategy on Human Resources for Health: Workforce 2030—A Five-Year Check-In. Hum Resour Health 22, 68 (2024). https://doi.org/10.1186/s12960-024-00940-x
Published:
DOI: https://doi.org/10.1186/s12960-024-00940-x