Alliance notes G8 focus on training medical personnel, but urges recognition for equitable access

2 July 2010 | Geneva – The Alliance is pleased to note that the G8 Muskoka Initiative for reducing maternal, newborn and child heath will focus efforts on training medical personnel, but urges for recognition of the critical need to ensure scaling up, retention and equitable distribution of health personnel in order to adequately respond to maternal and child health needs.

The G8 nations, led by its Canadian host at the Muskoka 2010 Summit, announced the Muskoka Initiative, pledging to mobilize US$ 5 billion additional funding over the next five years to accelerate progress on MDG 4 and 5. It calls upon other governments and foundations to join the Initiative by committing additional funding and expects to mobilize over US$ 10 billion in the period 2010-2015. The initiative is expected to add momentum to the UN led Joint Action Plan to Improve the Health of Women and Children and the growing coalition of advocates at the UN MDG summit in September 2010.

While the initiative lays emphasis on training medical personnel, equal attention needs to be paid to the retention and equitable distribution of health personnel across urban and rural areas, not to mention circumventing migration to developed countries by trained personnel in developing countries. It is significant that the WHO Code of practice on the international recruitment of health personnel was unanimously adopted at the World Health Assembly in May 2010, and is expected to be a major step in reversing 'brain drain' of trained medical personnel. The Alliance urges the world's wealthiest nations to implement the Code in letter and spirit.

Additionally, without a clear strategy and funding support for ensuring scaling up, retention, and equitable distribution of health personnel, including those with midwifery skills, the 3.5 million health workers needed in 49 low-income countries will not be achieved (1). Nor will we have the 334,000 midwives needed to fill the gaps in high mortality countries by 2015 (2).

Equitable distribution of health personnel remains a severely neglected aspect in health workforce planning. "While more than 80% of the wealthiest fifth of women are likely to receive skilled birth attendance, only about 30% of the poorest women will do so. In countries with high maternal and child mortality with available data, there are four times more doctors, nurses and midwives per population in urban areas than in rural areas (3). The impact of this inequity on maternal and newborn mortality cannot be emphasized enough", stresses Executive Director of the Global Health Workforce Alliance, Dr Mubashar Sheikh.

While the Alliance welcomes the pledge for an additional US$ 5 billion over 5 years, it notes that this is far less than the minimum of an additional US$ 4 billion needed per year needed from OECD countries as estimated by the draft UN-led Joint Action Plan for Women’s and Children’s Health (4), which is based on WHO figures. The Alliance calls for an allocation to human resources within this pledge, and looks forward to tracking the dollars spent on health workers within the proposed accountability framework of the G8.

The Alliance urges its members, partners and all stakeholders to join forces and infuse fresh energy in mobilizing policy attention and action towards ensuring equitable access to this life saving workforce especially in the run up to the UN MDG Summit in September 2010.


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"While more than 80% of women who are in the wealthiest fifth of their countries’ populations receive skilled birth attendance, only about 30% of the poorest women will do so".

Dr Mubashar Sheikh, Executive Director of the Global Health Workforce Alliance