Harnessing the Critical Role Harnessing the Critical Role of Health Care Workers –of Health Care Workers –

IHP+IHP+By Grace Alice MukasaBy Grace Alice Mukasa

African Medical and Research Foundation (AMREF) UKAfrican Medical and Research Foundation (AMREF) UK

IHP- CSO – Partnership -ForumIHP- CSO – Partnership -ForumGeneva, Switzerland, Geneva, Switzerland, 10 April 202310 April 2023

[Contact: g.mukasa@amrefuk.org][Contact: g.mukasa@amrefuk.org]

Overview of the presentationOverview of the presentation

Magnitude of the Magnitude of the HCWs CrisisHCWs Crisis

Underlying causes of Underlying causes of the crisisthe crisis

Key issues of concern Key issues of concern for HWAIfor HWAI

What IHP+ can do to What IHP+ can do to address the crisisaddress the crisis

Magnitude of the HCWs Capacity Magnitude of the HCWs Capacity CrisisCrisis

Weak health systems, severe Weak health systems, severe shortagesshortages, low , low capacities and capacities and motivationmotivation

There is a There is a Global gap of 4.2m HCWs in 57 Global gap of 4.2m HCWs in 57 countries.countries. Worse In Sub-Saharan Africa Worse In Sub-Saharan Africa

Many countries are without Many countries are without 2.28 2.28 doctors/nurses/midwives per 1,000 population doctors/nurses/midwives per 1,000 population minimum threshold minimum threshold of HCWsof HCWs

Sub-Saharan African shortagesSub-Saharan African shortages

Nurses, Midwives, Doctors Nurses, Midwives, Doctors per 100,000 population per 100,000 population

0

200

400

600

800

1000

1200

1400

1600

Ethiopia Malawi Zimbabwe Sub-Saharan

Africa

Nigeria WHOtarget

SouthAfrica

USA UK

Underlying Causes Of HCW CrisisUnderlying Causes Of HCW Crisis

The The impact of HIV and AIDS impact of HIV and AIDS & & other diseases other diseases

Massive under funding of the Massive under funding of the health sectorhealth sector

Poor Poor Education, Training Education, Training & & DeploymentDeployment

Failure to update Failure to update health health workers’ skills workers’ skills and knowledgeand knowledge

Leadership, Health Service Leadership, Health Service Management and SupervisionManagement and Supervision

Restrictive policiesRestrictive policies

Lack of Lack of respect & respect & recognition for HCWsrecognition for HCWs

Private sector and CSO Private sector and CSO capacity and resources not capacity and resources not harnessedharnessed

Poor Poor Community Community EngagementEngagement with health with health systems and with HCWssystems and with HCWs

Lack of Lack of support and support and supervision to Community supervision to Community Health Workers Health Workers

Low Low Morale, Motivation and Morale, Motivation and Retention of HCWs (all Retention of HCWs (all cadres), cadres),

Key Concerns of Key Concerns of Health Workforce Advocacy InitiativeHealth Workforce Advocacy Initiative

Trends in Trends in Migration Migration and Mobilityand Mobility from from South to North South to North

More than 3,000 nurses More than 3,000 nurses from Africa in UK from Africa in UK

Lack of skilled HCWs in Lack of skilled HCWs in rural, remote and rural, remote and hard to reach areashard to reach areas

Lack of Lack of key skills in key skills in health service health service managementmanagement

Misuse and WastageMisuse and Wastage of of health resourceshealth resources

LowLow financial financial investmentsinvestments and and inefficient useinefficient use

High levels of Morbidity High levels of Morbidity and Mortalityand Mortality

IHP+ Contribution to address the Crisis IHP+ Contribution to address the Crisis 1.1. Health systems investmentHealth systems investment

2.2. Each Compact Each Compact mustmust include a include a comprehensive and comprehensive and costed health worker strategy/plan for costed health worker strategy/plan for Health Health worker-specific investments:worker-specific investments:

3.3. Invest in Invest in inclusive, sustained and meaningful inclusive, sustained and meaningful participationparticipation

4.4. Integrate Integrate Human RightsHuman Rights principles and principles and ObligationsObligations in each country’s health plan – for HCWs in each country’s health plan – for HCWs & Patients & Patients

5.5. Compacts should include a Compacts should include a target to increase the target to increase the proportion of IHP + donor aidproportion of IHP + donor aid - - as pooled as pooled funding funding for recurrent govt. costs & salaries for for recurrent govt. costs & salaries for various cadresvarious cadres

Key Questions from HWAI Key Questions from HWAI to to

IHP+ Signatory Representatives IHP+ Signatory Representatives

1.1. Can you promise that every health plan validated under the IHP+ will have a Can you promise that every health plan validated under the IHP+ will have a comprehensive and fully costed Health Care Worker strategy/Plan?comprehensive and fully costed Health Care Worker strategy/Plan?

2.2. Can you commit to finance that through long-term predictable and increasingly Can you commit to finance that through long-term predictable and increasingly pooled financing?pooled financing?