Addressing the Health Workforce Crisis

Human resources in healthcare has been a focus of the conference thus far, as has healthcare system reform. AIDS has become a stepping stone to a generalized focus on the state of human health globally. Upscaling HIV and AIDS treatment improves healthcare systems and capacity. Improving the primary health care systems addresses HIV and AIDS related care and transmission prevention. These interlinked themes have all been continually referred to throughout the opening ceremonies and the first conference day.

I attended a session that was focused on “task-shifting” and the development of non-physician clinicians to address the global health workforce crisis and improve primary care capacity. This model is particularly interesting to me and I’ve been following it closely since working in Tanzania last summer with their “clinical officers”. These are not nurses and not physicians, but some in between breed that provides basic health services under the supervision of an MD. The framework for these non physician healthworkers varies country-to-country, and the regulations also differ drastically between nations.

So task-shifting is alleviating strain on nurses and physicians by introducing a quicker-to-train, effective brand of health provider that can see patients independently and refer to physicians when needed. The issues in task-shifting are quality assurance, the regulatory framework, sustainability and the involvement of service users in the process of implementation.

This concept of task shifting is supposedly cost effective, improves coverage, maintains quality of services and is widely accepted by patients in countries that use these providers (26 in sub-saharan africa alone). It can help solve rural-urban maldistribution issues. It decreases brain drain of medical professionals from south to north.

Speakers on this issue included Dr. Kate Tulenko from the World Bank, Dr. Francesca Celleti from WHO Geneva and Dr. Louise Ivers from Partners in Health (a huge advocate of community health workers, another brand of non-physician healthcare provider).

I wonder how much Canada could benefit from a new model of non-physician healthcare providers, or is this was nurse practitioners are doing?


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