Mutugi: Health personnel gaps that hinder universal coverage

By Prof Marion Mutugi

Despite the crucial role that the health workforce plays as the backbone of any health system, there is a global shortfall of 2.5 million doctors, nine million nurses and midwives, and six million health professionals according to the World Health Organisation (WHO).

This gap in health care is often most severe in low-income countries, where resources are limited and health workers tend to be concentrated in urban settings.

With a growing, ageing global population and public health emergencies such as the ongoing coronavirus outbreak, the need for skilled professionals in the health sector is drastically increasing.

This is particularly in the areas of promotive, preventive, rehabilitative and palliative health care.

Yet despite this, WHO projects a shortfall of 18 million health workers by 2030, all of whom are needed to accelerate Universal Health Coverage (UHC) over the next decade.

HIGH SCHOOL FEES

The problem does not lie solely in the shortfall of health workers, but also in a shortage of institutions of higher learning that are committed to health sciences as a niche.

Without this commitment, there is a shortage of programmes that respond to the specific health needs of persons living in low-income communities.

Furthermore, there are persistent challenges that hinder youth from pursuing careers in health sciences.

Expensive schooling is a primary deterrent. Additionally, once trained, jobs are not always readily available for graduates, and those that are available offer poor working conditions and are in low-paying and often remote contexts.

These obstacles only magnify the risk of further reducing the number of medical professionals, adding to the burden of already fragile health systems and distancing the world from achievement of UHC goals.

Closing the gap in human resources for health requires a joint effort.

In a globalised setting, it would be prudent for international agencies to appreciate the skewed distribution of health workers in low income countries.

In addition, national and county governments should invest more in the health sector to create opportunities for health professionals and devolve quality health services to citizens.

This includes addressing the root cause of perennial strikes by health workers, improving working conditions, increasing the number of registered health professionals and motivating workers, thus reducing brain drain.

Access to quality and affordable training is also an essential component of reducing the worker shortfall, fortifying country health systems and bringing Kenya closer to achieving UHC.

ACADEMIC NICHE

This is where institutions of higher learning come in.

According to the Kenya Economic Survey 2018, the country’s total number of registered health workers rose from about 147,000 in 2016 to just under 161,000 in 2017.

While there has been an increase in the number of students, this has not been commensurate to population increase.

The net effect is that Kenya is yet to achieve the minimum health staffing norms as envisioned by the Ministry of Health standards.

This is why institutions of higher learning should invest in bridging the gap between public health needs and available resources, by identifying health sciences as an academic niche and training more health professionals.

It is only a new pool of graduates in difefrent health areas that represents hope, not just for the improvement of health care services in Kenya, but for the entire continent.

But even as fresh talent enter the market, we must remain cognizant of the human resource challenges that continue to plague it.

BIG 4 PROJECTS

There is a need for tangible action that addresses challenges, from understaffing and long working hours to pay disparities and lack of career progression opportunities.

In this regard, unlocking of bottlenecks in career development is crucial.

For instance, nurses and physiotherapists should have opportunities to upgrade their training from diplomas all the way to PhDs.

By giving them the support they need to pursue careers throughout the health system, these health workers will be empowered to influence policy, regulation and legislation.

It is encouraging to see the Kenyan Government giving priority to UHC through its Big Four Agenda.

Over the past fieve years or so, the Government has spent an average of seven of its total budget on health.

Although still short of the 15 percent budget allocation recommended by the Abuja Declaration in 2001, it signals progress — albeit slow — towards addressing the challenge of access to quality health care in Kenya.

Investing in the health system, through this agenda will translate into decreased spending on health care and contribute towards increasing Kenya’s economic growth and development.

However, we need to first invest in adequate, well-trained and highly motivated human resources with the requisite knowledge, skills and attitude.

This way UHC will be a reality.

Prof Mutugi is vice-chancellor of Amref University.

Article first published on Business Daily.