world health report 2006_nihar

8/14/2019 World Health Report 2006_Nihar

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World Health Report 2006

CHAPTER : 1

Dr NiharRanjan Ray

Ahmadabad, India

[email protected]


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11/15/2009 World Health Report 2006 2

Objective of the session.

To discuss the global profile of health

workers to knowHow many health workers ?How much is spent for them ?

How they are distributed ?Do they meet the needs ?Shortage..!

How much extra cost is needed ?


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Defining Health Workers

All people engaged in actions whose primaryintention is to enhance health of the community.Ex: MHW,FHW..Doctors

Data available are limited to people engaged inpaid activities.


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Role of Health workers


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The Hurdles In The Way of Health Worker


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CLASSIFICATION OF HEALTHWORKER

definition of a health action for

classification is not straightforward.Action of the individual are most important.The report takes a pragmatic approachand include all paid workers employed inorganizations or institutions whose primaryintent to improve health as well as thosepersonal actions are primarily intended to

improve health.WHO developed standard classifications.


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STANDARD CLASSIFICATIONTwo standard system for classification.

1. international standardclassification of

occupation (ISCO)2. international standard

industrial classification of all economic activities.(ISIC)

According to these systemtwo types of H.W.

Health service

provider

Health

management &supportworkers

Professional

doctor,NurseLab. Tech.Traditional

practitioner

Accountant

Administrator Clericalworker Driver

painter


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LIMITATIONS

Data do not allow reporting on the people

working for part of their time to improvehealth . Eg. Social worker Official count of workforce often omitpeople who provide their service outsidethe health organization.An accurate count of such workers isdifficult to obtain but they are between 14

to 37 %.


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How many health workers ?Global atlas of Health work force: Chart

Dist r ibu tio n : He th Wo rkf o r e

020

0600

100

f r i c a

a s t e r n m

e d R

W e s t a

c i f i c

r o p

e

m e r i c a

s

W o r l d

% g e

Health ervice roviders Health mana ement pport


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How many.Data are more complete in health providers thanmanagement & support workers59 million workers ,67% health service providers globally57% in developed countries and 70% in developingcountriesSome times the comparison numbers are ambiguous like

doctors : nursesDentist: Pharmacist


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Doctors:Nurses

Canada & USA 04

Chile, Mexico & Peru More doctors than nurses

Europe 01

Norway & UK 05

Africa highest


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How much is spend ?

Health work force is higher in richer countries thanin poor one.Payment of salaries and other benefits to healthworkers are also include in total government healthexpenditure.A typical country devotes just over 42% of total

general government health expenditure to payingits health force.


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Where are the health workers

In developing countries more health

workers in urban area than rural.75% of doctors live in urban areas,60% of nurses,58% of health workers livein urban areasOn other hand 70% of population live inrural areas.Health services so poor in rural than

urban.


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ARE THERE ENOUGH HEALTH WORKERS ?

Data shows uneven geographicalDistribution of health workers in country itself.Coverage rate of key interventionscomparable are lower in area with low number

of health workers.


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Global distribution of health workersData shows countries with higher density of health workers

attain higher level of measles vaccination and ANC coverage.No standard method for assessing health staff sufficiency.


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Enough health workers?

One figure says by WHO estimation ashortage of more than 4 million doctors,nurses and midwives across countriesIn Africa-in HIV-AIDS for delivery of ARVtherapy to AIDS patient 20 to 50percentage of total health staff requires butthis is also less of 10 percentage of requirement.overall 2.3 million shortage of health

workers globally.


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Enough health workers..?

In absolute terms grater shortage occur in

south east Asia, dominated by Bangladesh,India and Indonesia and the largest is of sub Saharan Africa area,


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Does the numbers mater ?To meet the needs due to aging populations,

increasing population growth rates, and a growing

burden of chronic and non-communicable diseases.

WHO' says the shortage affects to tackle diseasessuch as HIV/Aids.

1.3 billion people worldwide lack access to the mostbasic healthcare, often because there is no healthworker.Sub-Saharan Africa has 11% of the world's population

and 24% of the global burden of disease but only 3%of the world's health workers.


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Does the numbers mater ?

Life expectancies in the poorest countries are half of those

in the richest nations.


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Addressing the shortageMore than 59 million health workers are working worldwide,4.3 million short of the total needed .South East Asia has the greatest absolute shortage .Sub-Saharan Africa bears more than 24% of the globalburden of disease, but has access to only 3% of the world's

health workers.Shortage of health workers has considerably constrainedachievement of the millennium development goals .Density of health workers is generally highest in urbanareas .55% of people live in urban areas, more than 75% of doctors, 60% of nurses, and 58% of other health workerslive in urban areas.


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Some Figures of Shortage

Fifty-seven countries, 36 of which are in sub-Saharan Africa, have severe shortages of health workers!In sub-Saharan Africa, at a conservative minimum of 720,000 doctors and 600,000 nurses needed. (UNFPA)


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Countries with fatal shortage.


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Causes of shortage.

Brain drain from SEAR and Sub Saharan countries.

Better opportunity there and lack of basic requirementshere.Better job exposuresTraining mismatches with demandInter professional comparison. Engg vs DocsCapacity building & Proper management.


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Is there any solution..????

additional national and international resources, but betterleadership and management are key to using these resourceseffectively .

Task shifting to tackleHRH shortage.

Training and capacitybuilding

Proper management


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And thanking you all.

world health report 2006_nihar

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