In 2006 the World Health Assembly issued its landmark report that focused world attention on the critical shortage of skilled health workers (midwifes, nurses, physicians) in 57 countries and linked the shortage to attainment of the Millennium Development Goals (MDGs). They reported that where the density of skilled health workers is higher, the probability of maternal, child and infant survival is higher. The most recent WHO report on the health workforce and services (Draft Global Strategy on Human Resources for Health: Workforce 2030), notes some success in mitigating human resources for health (HRH) shortages and the importance of embracing a more holistic approach to health as encompassed by Sustainable Development Goal 3: Ensure healthy lives and promote wellbeing for all at all ages.
In response to the reported dire shortage of nurses, midwives and physicians in resource constrained settings the Global Health Service Partnership (GHSP), a unique public private partnership between Seed Global Health, the US Peace Corps and the President’s Emergency Plan for AIDS Relief (PEPFAR) was launched and aims to improve clinical education, expand the base of nurse and physician educators and build healthcare capacity in countries that face critical shortages of health care providers. GHSP places nurse and physician educators to serve as visiting faculty for one year alongside local faculty counterparts. In collaboration with local faculty, GHSP educators implement innovative teaching strategies and clinical best practices through formal classroom instruction and bedside clinical teaching with a goal of preparing competent, practice ready graduates. GHSP is entering its fourth year in Malawi, Tanzania and Uganda and in 2016 will expand to Liberia and Swaziland. In the first two years of the program 38 GHSP nurse educators served nine nursing schools, provided 36,736 service hours, and taught 173 courses and trainings to 3,619 trainees. Qualitative data from in-country student and faculty interviews suggest that the GHSP educators added value to the learning environment (emphasis on critical thinking, increased confidence and motivation, enhanced clinical instruction), contributed to enhanced self-reported empowerment (confidence, pride in profession, see themselves as part of/responsible for solutions, interest in continuing education) and engagement in scholarship (practice improvement projects, grant proposals, community outreach and care, resource development). These qualitative outcomes provide a measure of impact since empowerment, confidence, critical thinking and engaged scholarship have all been linked in the literature to care that is more likely to be evidence based, safe and effective. Taken together these data suggest that embedding visiting faculty in a culturally appropriate and locally tailored manner to serve in partnership with country faculty can contribute to the production of midwives, nurses and physicians who are skilled and practice-ready when they graduate.
The recent lessons of pandemics make it even clearer that we need to invest in a skilled health workforce around the world. Global health security is dependent on individual health security, which in turn is dependent on access to safe, effective, affordable health care. Without a skilled health workforce individuals lack access to safe, effective health care. Programs that invest in educating future health professionals who are competent and practice-ready are critical to ensuring healthy lives and promoting well-being for all at all ages and for building individual and global health security.
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WHO. (2016). Health workforce 2030: towards a global strategy on human resources for health. Geneva: World Health Organization; Retrieved from: http://www.who.int/hrh/resources/16059_Global_strategyWorkforce2030.pdf?ua=1; (Accessed 6/30/2016)
The Lancet. (2016). No health workforce, no global health security, The Lancet, 387: 2063. Retrieved from: http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)30598-0.pdf