Global Health Human Resources

Addressing the ShortagesHortenzia Beciu

World Bank Health Specialist Consultant

Densities of Main Categories of Health Workers In Selected Countries, 2010 estimates

USACanadaSweden

SwitzerlandNorway

DenmarkFrance

FinlandChzeck

Russian FederationHungaryRomaniaArmeniaUkraine

KenyaTanzania

GhanaUgandaNigeria

MozambiqueSouth-Africa

IndiaPhilippines

ThailandChinaCubaChileBrazil

0 2 4 6 8 10 12 14 16 18

Nurses &MidweivesDentistsPharmacistsPhysicians

Where HR would come from?• Production

• Import

• Change in retirement age, and /or reemployment of the retired

• Mitigating the change in profession or other factors affecting attrition

Production

• Expensive and lengthy

• High demand for it and not enough capacity : production abroad (globalized) in the region or outside the region

Comparison in Tertiary Gross Enrollment Ratio in Higher Education by Regions

Trends in Global Higher Education, Tracking a Revolution, UNESCO 2009 World Conference on Higher Education

Pre-Investment Study-Ghana, World Bank Working Paper

Expressed Versus Control Demand In Ghana, 2008

Production Capacity Limited in Developing Countries- Medical Schools Graduates

Types of Higher Education Institutions in South-East Africa, most of the data 2007

Angola

Botswana

DRC

Leso

tho

Madagascar

Ma

Mauritius

Mozambique

Namibia

South-Afri

ca

Swaziland

Tanzia

Zambia

Zimbabwe

0

50

100

150

200

250

11 5

227

621

4

3012

2

80

4 2

32

4

Publicly funded universitiesPublicly funded HE institutions and collegesPrivately funded HE institutions Other Institutions

Percentage of Physicians in Postgraduate Medical Education, 2007

AAMC and AMA,

Developing Countries Need Specialists, America Offers General Practice

AAMC and AMA,

Applicants for First Year Family Medicine Positions 2008

Results of the 2009 National Resident Matching Programme: Family Medicine

Proportion of Physicians trained in SSA but living abroad, 2004

Figure 2

0

0.05

0.1

0.15

0.2

0.25

0.3

0.35

0.4

1990 1992 1994 1996 1998 2000 2002 2004 2006

Year

Pro

po

rtio

n D

octo

rs A

bro

ad

Source: Docquier and Bhargava (2007)

International Immigration in 10 African countries

Migration in Africa: A Review of the Economic Literature on International Migration in 10 Countries, William Shaw Development Prospects Group The World Bank

Top-Receivers of Remittances in 2008

World Bank Migration and Development Look, Outlook for remittances flow 2009-2011, Dilip Ratha, Sanket Mohararta Anil Silval

Remittances Trend 1990- 2009

World Bank Outlook for remittances flow in developing countries, Dilip Ratha , International Conference on Diaspora and Development

Challenges

• Limited Capacity for both pre-service and postgraduate training

• Private provision but need regulation and different financing mechanisms for investments and student support

• Professional bodies need strengthening • Support for Research Activities as a means to

strengthen the quality of the training

Global Initiatives, Opportunities

• The Global Code of Practice on the International Recruitment of Health Personnel

• USA Government (6 years) : US$ 63 billion for HIV/AIDS/TB/Global Funds and US$12 billion for other priorities

• World Bank: Health in Africa Initiative• World Bank Lending Program• Private Investments: IFC , others