Achieving Universal Health Coverage Addressing Health Workforce Inequity

Achieving Universal Health Coverage: Addressing Health Workforce Inequity PRINCE MAHIDOL AWARD CONFERENCE 2014 Unit of Human Resources for Health Department of Health Systems and Services

A decade of human resources for health in the Region of the Americas Call to Action for a decade of HRH 2005 -2015 5 Critical Challenges + 20 Regional Goals 2007 -2015 Ø HRH policy framework Ø Navigation panel Ø Regional platform for cooperation Regional Network of HRH Observatories Virtual Campus of Public Health 1 Achieving UHC: Addressing Health Workforce Inequity PHC based health systems UHC

Country HRH Regional Goals Challenge One: Long term HRH policies and plans GOAL 1 HR density ratio of 25 professionals per 10, 000 inhabitants 100% GOAL 5 Establishment of a strategic HRH unit 85% GOAL 2 Proportion of PHC physicians exceeds 40% of total physician workforce 43% 21% 89% GOAL 4 Ratio of at least 1: 1 between qualified nurses and physicians 2 Achieving UHC: Addressing Health Workforce Inequity GOAL 3 Development of PHC teams with a broad range of competencies

Challenge 1. Long term plans and policies Achievement (%) 100 80 Challenge 2. The right people at the right place 60 Challenge 3. Management of migration 40 Challenge 4. Working conditions and performance 20 0 Challenge 5. Appropriate education and competencies 2009 2013 Average Source: Regional Observatory of Human Resources, PAHO Note: Countries who participated in both assessments. 3 Achieving UHC: Addressing Health Workforce Inequity

3 HRH Goals directly linked to UHC Critical obstacles to reach UHC 100 Goal 1. 25 professionals (doctors, nurses, midwives) per 10, 000 habitants Achievement (%) 80 Goal 2. Proportion of PHC physicians exceeds 40% of total physician workforce 60 40 Goal 6 The gap in the distribution of health personnel between urban and rural areas will have been reduced by half 20 0 2009 2013 Average Source: Regional Observatory of Human Resources, PAHO Note: Countries who participated in both assessments. 4 Achieving UHC: Addressing Health Workforce Inequity

Some preliminary remarks on the decade 200515 ü Progress has been incremental but steady during the decade with regards to the 5 HRH challenges, but important differences exist on particular goals and between countries; ü The changes benefited from a favorable combination of economic growth and inclusive social policies in many countries, and are not always attributable to specific programs or interventions; ü Major recent developments have been the ACA in the US and the “Mais Médicos” Program in Brazil

CHALLENGE 5: EDUCATION ü Considerable progress in the reorientation of health sciences education towards PHC (Beyond Flexner Movement: Excellence AND Social Responsibility AND Diversity of Student Body) ü Increasing engagement of National Health Authorities with Institutions of Higher Education in Health Sciences ü Much deeper reforms are necessary to relocate and decentralize health sciences education in community health centers and hospitals in underserved areas ü Urgent need to develop elearning and telemedicine network to empower PHC teams in underserved communities

It takes a health system to train the health workforce 7 Title of the Presentation