“No Health Without A Workforce” Report Reveals Crucial Need for Inclusion of Frontline Health Workers in Global Health Workforce Crisis Response

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RECIFE, Brazil, November 11, 2013 – The Frontline Health Workers Coalition (FHWC) commends the World Health Organization, the Global Health Workforce Alliance and contributors to the “A Universal Truth: No Health Without a Workforce Report” and calls upon world leaders to focus on inclusion of frontline health workers in the formal health system as a central mechanism for addressing current and future deficits of health workers worldwide.

The report – presented today at the Third Global Forum on Human Resources For Health in Recife, Brazil – finds that the world needs at least 7.2 million more doctors, nurses and midwives than it currently has to provide essential health services – projecting forward to a deficit of 12.9 million health workers by 2035. Eighty-three countries fall below the lowest threshold of doctors, nurses and midwives needed to provide basic health services (23 per 10,000 population). The report does not include estimated counts and gaps in the number of community health workers and others on the frontlines of care in developing countries.

“This report lays out a stark human resources challenge for the global health community to face with less than 1,000 days until the target date for achieving the Millennium Development Goals (MDGs) and post-2015 planning underway,” FHWC Director Mandy Folse said. “Yet, several countries such as Ethiopia, Malawi and Nepal have recently demonstrated that a focused effort on training, supporting and integrating a cadre of community-based health workers into the formal health system delivers dramatic results in saving lives and improving health.”

In Ethiopia, the Health Extension Program launched in 2003 has trained and supported more than 34,000 government-salaried women frontline health workers in communities throughout the country. The country’s health minister, Dr. Kesetebirhan Admasu – speaking to the Guardian in reaction to the recent announcement of Ethiopia’s early achievement of its MDG target on slashing child deaths – said these frontline workers are the key drivers for Ethiopia’s 67% reduction in child mortality since 1990. In Nepal, a well-established cadre of 50,000 female community health volunteers has helped overcome a continued deficit of doctors, nurses and midwives to nearly halve maternal mortality and slash the child death rate by 64% from 1990 to 2008.

Malawi – whose President Joyce Banda in September announced the country is expanding its frontline health workforce from 10,000 to 27,000 by 2015 – already has seen its child mortality rate cut by more than half since 1990.

However, despite the growing evidence that inclusion of frontline health workers in health workforce strengthening efforts are a crucial component to global health progress, there is not data to ascertain an accurate accounting and impact of frontline health workers in many countries.

“For far too long community health workers have not been counted, supported or celebrated,” said FHWC Chair Mary Beth Powers, Newborn and Child Survival Campaign Chief at Save the Children. “The doctor, nurse and midwife deficit as outlined in the report points out the need to supplement the health workforce with new skilled cadres of workers, ideally located closer to the communities in need. But without even having a good estimate of how many community health workers are out there, we really don’t know the number of communities without access to the basic health care that they can provide.”

FHWC commends the leadership efforts at the Third Global Forum by representatives of the United States government and other countries to address the global health workforce crisis with a particular focus on addressing the need for more skilled and better supported frontline health workers. We strongly urge inclusion of the inputs of non-state actors – including health workers themselves, civil society organizations and private sector businesses – in ongoing strategic discussions.

The Frontline Health Workers Coalition is an alliance of United States-based organizations working together to urge greater and more strategic U.S. investment in frontline health workers in developing countries as a cost-effective way to save lives and foster a healthier, safer and more prosperous world.