South Africa April 2006 |
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| Rural areas in need of health workers, (Sapa, 2006-04-07):-Much needs to be done at rural health facilities in South Africa to improve safety, infrastructure and resources - in order to retain health workers in remote areas. This is according to the World Health Organisation's (WHO) assistant director-general, Tim Evans, who spoke at the release of the WHO's World Health Report in Zambia on Friday. "It is difficult to attract and retain health workers in rural areas in SA. Most workers are females. There is not enough financial assistance, resources are limited and safety is often a concern, " Evans said. "Not enough health workers are being trained or recruited where they are most needed (rural areas) and increasing numbers are joining a brain drain of qualified professionals who are migrating to better paid jobs in richer countries." Evans said although South African health workers were migrating, South Africa was not one of the 36 countries in sub-Saharan Africa facing a critical shortage of health workers. This was mainly because of the number of such workers relative to the population. There are 185 000 nurses and 45 000 doctors in the country. "The numbers are sufficient, but there are major constraints. There is a huge mal-distribution of workers in the country and most health workers are found in urban areas," said Evans. He added that little could be done to stop health worker migration as health workers had a right to work where they wanted to. "While South Africa lost some workers to other countries, it also gained workers from other African countries. This is because working conditions are more favourable in this country than other African countries," Evans said. "However, plans have been put into place to ensure that workers are retained in South Africa as well as in other African countries. South Africa and Ghana were the two African countries that approached the WHO assembly in 2004 to tackle the issue." South Africa had also signed bilateral agreements with Brazil and Canada to ensure that migration occurred through the correct channels. Evans said African countries were willing to tackle the problem of migration. Malawi, Zambia and South Africa would launch five-year plans on Friday, World Health Day, to deal with the issue. "To tackle this crisis, more direct investment in the training and support of health workers is needed. Health budgets will have to increase by at least $10 (R60) per person per year in the next 20 years." Evans said a shortage of health workers was not just a problem experienced in African countries. Shortages in the health workforce in 57 countries across the world was impairing provision of essential, life-saving interventions such as childhood immunisation, safe pregnancy and obstetric services for mothers, treatment for HIV/Aids, malaria and tuberculosis. "The shortage combined with a lack of training and knowledge is also a major obstacle for health systems as they attempt to respond effectively to chronic diseases, avian influenza and other health challenges," said Evans. "More than four million additional doctors, nurses, midwives, managers and public health workers are urgently needed in these 57 countries." Other countries with critical shortages of health workers are in south-east Asia, the eastern Mediterranean and the western Pacific. However, Africa had the lowest number of health workers. Africa has 24 percent of the global burden of disease, but only three percent of health workers, and less than one percent of world health expenditure. "In contrast, while the Americas have 10 percent of the global burden of disease, they have 37 percent of the world's health workers who are spending more than 50 percent of the world's health financing." In Africa there are two health workers per 1000 people, while there are 25 health workers per 1000 people in the Americas, said Evans. Many workers in sub-Saharan Africa faced daunting work circumstances such as poor wages, un-supportive management, insufficient social recognition and weak career development. Evans said infectious diseases and complications of pregnancy and delivery caused at least 10 million deaths each year, but better access to health workers could prevent many of those deaths. The report states that at least 1.3 billion people world-wide lack access to the most basic health care, often because there is no health worker. While there are 16 million health workers globally, Evans said there were enormous inequalities of distribution of health resources and workers. As in South Africa, many health workers around the world were concentrated in urban areas rather than in rural areas, where they are needed the most. The World Health Report recommends that in order to achieve the goal of getting "the right workers with the rights skills in the right place doing the right things," countries should develop plans that include: better working conditions for health workers, improved safety and better access to treatment and care; a well-developed plan to train the health workforce of the future; development of leadership and management and the accreditation and licensing for quality improvement. Evans said it was important for governments to work towards tackling the issue as there was evidence that as the ratio of health workers to population increased, so in turn did infant, child and maternal survival. | |
South African Migration Project (SAMP) - Queen's University - http://www.queensu.ca/samp |