Road Map for Scaling up for Human Health for Improved Health Service Delivery in the African Region 2012-2025

ABSTRACT

Ensuring the availability of sufficient numbers of qualified health workers in the right place is essential for delivering quality health services to the population. Existing weaknesses in health systems including shortage of skilled human resources for health (HRH) 1 in most African countries is recognized as a major impediment to delivery of essential interventions and progress towards achieving health objectives. Of the 46 countries in the Region; 36 have critical shortage of HRH with only about 0.8 physicians; nurses and midwives per 1000 of the population while the minimum acceptable density threshold is 2.3 per 1 000 population. The estimated shortage of doctors; nurses and midwives in the Region was 820 000 in 2006. When all categories of health workers are included; the shortfall is estimated at 1.4 million. Migration of qualified health workers; inadequate remuneration and incentives; poor distribution of the available health workers; under investment in the production of sufficient health workers; inadequate capacity of HRH departments to carry out the main HRH functions and; low implementation of most of the existing plans are identified as the main causes of the present situation that constitutes a key impediment to meeting the needs for health care delivery for all. There are significant disparities between rural areas and urban areas; with shortages in the rural areas. Over 90 of pharmacists and dentists practise in urban areas. The situation is the same for other cadres; as medical specialists (86 ); general physicians (63 ) and nurses and midwives (51) serve mainly urban areas. The challenges facing the countries are uneven and pose a strategic threat to national and regional health systems development and the overall well- being of populations in the Region. A number of major and pressing HRH challenges are identified The road map recognizes that sustained political; institutional and financial commitment with the involvement of different critical stakeholders and partners that influence HRH production; availability and performance is critical to improving HRH development at country level. The road map builds on a number of national; subregional; regional and global efforts and has six strategic areas for achieving the objectives: strengthening health workforce leadership and governance capacity; strengthening HRH regulatory capacity; scaling up education and training of health workers; optimizing the utilization; retention and performance of the active health workforce; improving health workforce information and generation of evidence for decision-making; and strengthening health workforce dialogue and partnership. Each of these strategic areas has a set of identified priority interventions for achieving the objectives. It is recognized that implementation of the road map will require the commitment and collaboration of all stakeholders and partners under the leadership of national governments