Assessing the legacy of the Global Health Workforce Alliance

The Global Health Workforce Alliance (the Alliance) was created in 2006 with a ten-year mandate to coordinate engagement of multisectoral stakeholders to advocate for Human Resources for Health (HRH). To date, the Alliance has contributed significantly to a range of global, regional and national level initiatives and achievements. These include: expanding the Alliance membership to comprise and engage over 400 organizations, multi-constituency in nature, with a stake in HRH; elevating HRH on various global agendas and in WHO’s mandated program of work; and facilitating policies and action by national governments to address HRH issues. With the end of its ten-year mandate, a review of the legacy of GHWA was commissioned. The review highlights the impact of GHWA’s achievements and provides recommendations for GHWA’s successor, a global Network, in guiding the evolution of HRH.

According to the review, GHWA’s two greatest legacies include first, the wide-scale introduction of thinking and planning in terms of complex adaptive systems to HRH issues and second, the development of network learning and competencies that will serve as the foundation for the next iteration of global HRH efforts. GHWA’s effectiveness in the areas of advocacy and convening has been recognized. GHWA has been the only independent platform at a global level with the mandate and capacity to bring together multisectoral HRH stakeholders (state and non-state) around a common agenda.

The three global fora on HRH have resulted in significant political commitments and policy statements that framed ongoing dialogue about the importance and causative factors of HRH shortages, and how these should be addressed. The First Forum on HRH (Kampala) reignited momentum for a “WHO Global Code of Practice on the International Recruitment of Health Personnel”, which was later adopted by the World Health Assembly (WHA), indicating that high-income countries recognized not only the complexity of their own HRH issues but also their potential to undermine national health system development in low- and medium-income countries.

The Recife Political Declaration was negotiated by Member States during the Third Forum on HRH, and was subsequently endorsed by the World Health Assembly, adding a dimension of political ownership and commitment that went beyond that of the first two global fora. National governments and NGOs issued public commitments to their own HRH goals - a major accomplishment since it required accepting accountability for improvement. It was recommended that WHO develop what later became its “Global Strategy on HRH: Workforce 2030”[1], informed by an inclusive and participatory consultation process led by the GHWA.

s part of the GHWA legacy assessment, five recommendations were made for the new Network model succeeding GHWA, which will act as a “central hub” within WHO:

  • Effective leadership and management and priority setting based on a shared vision, strong administrative capacity, and sufficient budget to facilitate rapid and comprehensive information-sharing.
  • Balance of “tight” and “loose” approaches to the structure and processes of the central hub, with frequent and structured opportunities for trust-building, learning and self-assessment.
  • Development of a vigorous communications strategy to further influence high-level decision makers and engage stakeholders outside the health sector.
  • Focus goals, priorities, and membership for the central hub.
  • Support shared measurement of progress on agreed goals, by strengthening accountability systems, data collection capacities with common language and metrics.

After 10 years of work, GHWA leaves a substantial legacy: widespread understanding of the complexity of HRH issues, a proven framework for country-level action, a wealth of evidence for innovation, and an empowered stakeholder base. Systemic challenges will persist, but the previous recommended considerations will help in establishing an effective new central hub for HRH.

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