How long might the health workforce crisis last?

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Q: How long might the health workforce crisis last?

A: Health systems are not easily or rapidly strengthened or reformed. Scaling up 'production' (educating and training more health workers) is the initial stage but this can take time: a nursing qualification usually takes three years of training, and a physician at least five. Innovative methods (distance learning, 'task shifting' or community health worker programmes) can shorten this delay effect, but there is no "quick fix" to this problem: community health workers, nurses and physicians need each other to work effectively as teams.

More schools and teachers are also needed to really 'scale up', although technical advances (distance learning, IT) and increased twinning between schools can and should be used to enable this surge of students. Significant financial support and technical cooperation are also necessary for improving a decaying infrastructure, as well as institutional development for improving the quality of education.

The next step is employment, which brings challenges of its own: many countries affected by the health worker shortage already have scores of unemployed health workers: public spending on health may be capped (due to macroeconomic constraints), and private enterprise may not be an option for individual health workers. Many countries thus lack the capacity to employ the workforce they have trained.

If nothing is done, the crisis will worsen. If action is taken – as recommended by WHO, The Alliance and many field experts – with strong country ownership and leadership, stakeholder consultation, national and international funding, the crisis could be at least partially solved by 2015, thereby enabling the fulfilment of the health-related Millennium Development Goals.

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