Imagine working as a doctor caring for patients with COVID-19 without adequate protective equipment and then falling seriously ill yourself. You don’t have health insurance, and you haven’t been paid in months. You need treatment, but you simply can’t afford it. The predictable result: death. That’s the tragic story of a Kenyan doctor, Stephen Mogusu, who passed away in December 2020.
Mogusu is not alone. Governments and institutions around the world have failed to support and protect health workers since the COVID-19 pandemic. These situations not only are unjust for health workers and their families, but they also exacerbate the shortfall of health workers needed to achieve universal health coverage.
This April, the World Health Organization is calling attention to this crisis during World Health Worker Week, under the theme “protecting, safeguarding and investing in the health and care workforce.” The accompanying 5th Global Forum on Human Resources for Health will bring together global and local experts to consider the range of policy, partnership, and investment options to address this new era of health workforce challenges.
This forum will surface evidence, promising practices, and advocacy priorities for health workforce investment. As the week unfolds, I hope to hear about innovative strategies and new partnerships. I’ll also be listening for approaches similar to what I’ve been learning from my work as a steering committee member of the Frontline Health Workers Coalition and Senior Human Resources for Health Advisor on the USAID Local Health Systems Sustainability (LHSS) Project. These approaches include:
- Strengthening health worker professional associations, especially those led by women or representing majority-women professions, to engage in national policy making and monitoring. Health worker advocacy groups can ensure that the needs and perspectives of different care providers inform policy and health care delivery—and can hold governments accountable. For example, in Uganda the locally led Nurses and Midwives Think Tank successfully advocated to include nurse representatives on the COVID-19 national task force and improve access to personal protective equipment.
- Supporting local financing and governance partnerships to improve working conditions and staffing ratios. Through the LHSS project, we have emerging evidence in Nigeria and Bangladesh that activating local health committees and engaging local governments in planning and funding primary care can increase clinic staffing and improve working conditions. These bottom-up approaches to health workforce strengthening give frontline health workers the authority and resources to remedy staffing shortfalls and lack of infrastructure and supplies in decentralized settings.
- Identifying opportunities for new workforce models that create efficiencies and contribute to improved quality of care. In the Kyrgyz Republic, a policy to expand nurses’ scope of practice—called the “universal nurse model”—sat on the shelf until the COVID-19 pandemic. The large wave of COVID patients and lack of physicians to provide care helped generate the political will to implement a pilot program for this new nursing model. The model calls for nurses to provide comprehensive care for a limited number of patients instead of limited care for a large number of patients. The older model made made care coordination difficult with a large influx of COVID patients. The pilot demonstrated the potential of changing staffing models and scopes of practice during health emergencies, optimizing the existing workforce and contributing to improved patient outcomes. Based on these results, the Kyrgyz Republic is now expanding the model to the primary care level.
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