August 06, 2009
12:01 a.m. Eastern Time
Sub-Saharan Africa To Face Shortage Of
Nearly 800,000 Health Care Professionals In 2015
Other Studies Look At Dissatisfaction Among Ugandan Health Workers And Obstetrical Surgery By Nonphysicians In Tanzania
Bethesda, MD -- In 2015, thirty-one Sub-Saharan African countries are projected to face a cumulative shortfall of almost 800,000 health care professionals, says a study published today on the Health Affairs Web site. http://content.healthaffairs.org/cgi/content/abstract/hlthaff.28.5.w849
According to the study, one of three papers published today by Health Affairs dealing with the health care workforce in Africa, the 31 countries will face a shortage of 240,000 doctors and 551,000 nurses and midwives. The countries are expected to have a total of 371,000 doctors, nurses, and midwives in 2015 – just 32 percent of the needed 1.163 million health care professionals.
Eliminating this shortfall would require an annual wage bill of approximately $2.6 billion, more than 2.5 times the current wage-bill projections for 2015, say Richard Scheffler, a Distinguished Professor of Health Economics and Public Policy at the University of California, Berkeley, and coauthors. Additional funds would be required to hire health care support staff, train the new professionals and support staff, and pay for expenses such as supplies, pharmaceuticals, equipment, and facilities.
Raising the money required to eliminate the shortfall would be difficult for the countries involved, even under the most optimistic assumptions regarding economic growth and governmental commitments to the health sector. Global aid can help but will still not provide enough resources, the researchers say. They thus recommend three categories of policy options to buttress the capacity of the health care systems in African nations: 1) changes in skill mix, e.g., greater use of health workers with less training than nurses, such as mid-level and community health workers; 2) worker incentives to improve motivation and morale; and 3) increases in the capacity, quality, and efficiency of training for health care workers.
Dissatisfaction Among Ugandan Health Workers. Ugandan health workers are dissatisfied with their jobs, especially their compensation and working conditions, say Amy Hagopian, an assistant professor of health services at the University of Washington, and coauthors in a second paper published online today by Health Affairs. About one in four health workers – including half of all physicians – would like to leave the country. The researchers say strategies for strengthening the health care workforce in Uganda should focus on salary and benefits, especially health coverage; working conditions and workload; facility infrastructure, including water and electricity; management; and workforce camaraderie. http://content.healthaffairs.org/cgi/content/abstract/hlthaff.28.5.w863
The Quality Of Emergency Obstetrical Surgery In Tanzania: Access To Facilities, Not Shortage Of Qualified Staff, Is The Issue. Five countries in sub-Saharan Africa use nonphysicians to perform major emergency obstetrical surgery. In Tanzania, assistant medical officers (AMOs) – secondary school graduates with several years of medical training – perform most of this type of surgery outside the cities. Questions about the quality of surgery performed by nonphysicians have prevented most African countries from following this example. http://content.healthaffairs.org/cgi/content/abstract/hlthaff.28.5.w876
In a third study published today by Health Affairs, Colin McCord, an associate professor of surgery at Columbia University and consultant to the World Lung Foundation, New York, and coauthors compared obstetrical surgery performed by Tanzanian AMOs with surgery performed by Tanzanian medical officers (MOs) – medical school graduates with at least one year of internship and a license to practice medicine and surgery. The researchers found no significant differences between AMOs and MOs in outcomes, risk indicators, or quality of care indicators.
With 1300 AMOs now trained for this kind of surgery, there are enough surgeons to meet the need in Tanzania. But hospitals are widely spaced and transport is difficult, so that fewer than one-third of Tanzanian women in need of major obstetrical surgery make it to a hospital that can do the job.
After the embargo lifts, you can read the article by Scheffler and coauthors at http://content.healthaffairs.org/cgi/content/abstract/hlthaff.28.5.w849
You can read the article by Hagopian and coauthors at http://content.healthaffairs.org/cgi/content/abstract/hlthaff.28.5.w863
You can read the article by McCord and coauthors at http://content.healthaffairs.org/cgi/content/abstract/hlthaff.28.5.w876
ABOUT HEALTH AFFAIRS:
Health Affairs, published by Project HOPE, is the leading journal of health policy. The peer-reviewed journal appears bimonthly in print with additional online-only papers published weekly as Health Affairs Web Exclusives at www.healthaffairs.org.
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