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Health Workforce -- Crisis and Opportunity

Health Workforce -- Crisis and Opportunity. Fitzhugh Mullan George Washington University XVIII International AIDS Conference Vienna, Austria July 20, 2010. Countries with a critical shortage of health service providers (doctors, nurses, and midwives).

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Health Workforce -- Crisis and Opportunity

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  1. Health Workforce --Crisis and Opportunity Fitzhugh Mullan George Washington University XVIII International AIDS Conference Vienna, Austria July 20, 2010

  2. Countries with a critical shortage of health service providers (doctors, nurses, and midwives) Source: World Health Organization (2006) Working Together for Health. The World Health Report 2006: WHO Press.

  3. Density of Health Workers

  4. Unequal Distribution of Health Workers

  5. Physician Density per 100,000 Population Source: World Health Organization (2006) Working Together for Health. The World Health Report 2006: WHO Press.

  6. Southern Challenge • Inadequate Educational Budgets • Modest Educational Capacity • Minimal Advanced Training Opportunities • Limited Practice Conditions

  7. Push Factors from the South • Lack of Post Graduate Training Opportunities • Insufficient practice Opportunities • Poor Remuneration • Security Concerns • HIV/AIDS

  8. Pull Factors to the North and West • Training Opportunities • Practice Opportunities • Better Remuneration • Better Technology • Family Opportunities

  9. Rebooting the System Educational scale up… Socially accountable education…

  10. 3 16

  11. Sub-Saharan African Medical Schools Twenty do not yet have graduates Private schools have started in the last 20 years

  12. Educational Innovations Global Health Workforce Alliance Sub-Saharan African Medical School Study Medical and Nursing Educational Partnership Initiatives (PEPFAR, NIH, HRSA) Transformative Medical and Nursing Education Initiative (WHO)

  13. Health Worker Migration The Leaky Bucket…

  14. Characteristics of Physician Workforces of US, UK, Canada, and Australia Source: Mullan, F. (2005). The Metrics of the Physician Brain Drain. NEJM: 353:1810-1818.

  15. Regional Emigration Factors in 8 Regions Around the World Source: Mullan, F. (2005). The Metrics of the Physician Brain Drain. NEJM: 353:1810-1818.

  16. Source Countries of Nurses Immigrating to Selected OECD Countries

  17. In the South -- To Do • Task shifting • Community health workers • Non-physician clinicians • Focus on socially accountable education and retention • Strategic approaches – “sandwich programs” and partnering

  18. In the North -- To Do • Maintain support for quality and quantity scale up of health professional education • Train for Self Sufficiency

  19. The best thing to do is to have planted a tree twenty years ago… The next best thing to do is to plant a tree today. African Proverb…

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