Health workers: more human resources to improve RMNCH in Africa
25-27 June 2012 | Nairobi - The Consultation on Improving Access to Health Workers at the Frontline for Better Maternal and Child Survival was organised in Kenya by the Norwegian Agency for Development Cooperation (NORAD) together with the Regional Network for Equity in Health in East and Southern Africa (EQUINET), IntraHealth International, UK Department for International Development (DFID), Save the Children, Global Health Workforce Alliance (GHWA), East, Central and Southern African Health Community (ECSA HC), UNAIDS, Partnership on Maternal, Newborn and Child Health (PMNCH), UNH4+, African Platform on Human Resources for Health (APHRH), African Centre for Global Health and Social Transformation (ACHEST), African Medical and Research Foundation (AMREF) and a number of other stakeholders who supported the initiative in various ways.
The overarching objective of the consultation was to speed up and scale up country responses to the human resource needs of the UN Global Strategy for Women’s and Children’s Health (Every Woman Every Child) and the Global Plan towards the Elimination of New HIV Infections Among Children by 2015 and Keeping their Mothers Alive (Global Plan) with a particular focus on 10 African countriesi with a high burden of HIV and maternal and child mortality. The two global initiatives recognise the importance of strong health workforces and call for additional commitments on human resources to be made.
The theme for the consultation was “Acting on what we know”, in recognition of the fact that there is already a lot of information available on what works in terms of improving access to frontline health workers. Similarly, the consultation recognised the need to build on existing initiatives in the African Continent including the Maputo Plan of Action, Campaign for the Accelerated Reduction of Maternal Mortality in Africa (CARMMA), WHO-AFRO-led HRH Roadmap and the on-going work of the African Platform on HRH.
The consultation therefore aimed to fast-track solutions by sharing knowledge, good practices and innovations; encouraging greater collaboration between partners; identifying unresolved issues and barriers; and recommending actions for accelerating country responses.
Prof Miriam Were represented the iERG at the meeting. In her address “Where is Africa in the countdown for child and maternal health towards 2015?”, she reflected on the progress towards attainment of the MDGs in the priority countries, and in all instances it was clear that a lot remained to be done. She noted that Africa with about 10% of the global population provides 51% of maternal deaths and 51% of child deaths (UNICEF 2009 data base). Most of these deaths occur in communities in rural areas or in communities situated in urban/peri-urban slums. To change this situation, people need to access good quality health care services in their communities through their involvement, saying, “If it doesn't happen in the community, it doesn't happen.”
Prof Were reported on encouraging progress in countries such as Eritrea and Malawi where significant achievements had been made in both maternal and child survival. She emphasized the need for hope to remain alive so that all can contribute to the realization of the dreams for a healthy Africa. Miriam Were was nostalgic about the optimism that characterized the 1970s and to some extent the 1980s when “Health for All” was the rallying call. Prof Were affirmed that it was possible to rekindle that spirit.
Prof Miriam Were on behalf of Kenya, was impressed by the passion and dedication shown by the participants, and echoed her dream for healthy African populations through increasing access to health workers at the frontline. She emphasised that most cadres had clearly defined roles and responsibilities within the health system, it was only the community health worker whose status and role were not so clear. Hence, as participants prepared to act on the outcomes of the Consultation, she challenged them to think of how to clarify the role of, and improve the working environments for the CHWs who remain critical to service delivery at the frontline.