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Health workforce development in the Eastern Mediterranean Region
63rd Session of the WHO Regional Committee for the Eastern Mediterranean
3-6 OCTOBER 2016, Cairo
EMR has low density of health workers…
South-East Asia Africa Eastern Mediterranean
Americas Western Pacific Europe0
10
20
30
40
50
60
70
80
Average density of physicians, nurses, midwives in WHO regions
Source: WHO Global Health Observatory
Somalia
Afghanistan
Djibouti
Yemen
Sudan
Pakistan
Morocco
Egypt
Iraq
Iran
Syria
Palestine
Tunisia
Jordan
Lebanon
Libya
UAE
Oman
Bahrain
Saudi Arabia
Kuwait
Qatar
0 10 20 30 40 50 60 70 80 90 100
Moving from MDGs…….Density of physicians, nurses and midwives, 2014 (or latest available year)
Source: EMR Health Observatory
SDGs and health workforce
3c substantially increase … the recruitment, development, training and retention of the health workforce in developing countries
Increased production capacity……
Trends in establishment of medical schools in EMR
Before 1950 1950-1974 1975-2000 After 20000
20
40
60
80
100
120
Public Private
Trends in medical schools by public and private sectors
0
5
10
15
20
25
30
2007 2008 2009 2010 2011 2012 2013 2014
Dens
ity /
10,
000
Popu
latio
n
Group 1
Group 2
Group 3
2007 2008 2009 2010 2011 2012 2013 20140
10
20
30
40
50
60
Group 1Group 2Group 3
Dens
ity /
10,
000
Popu
latio
n
Density of nurses and midwives per 10,000 population in EMR
….. but not sufficient to keep pace with population growth
Density of physicians per 10,000 population in EMR
Source: EMR Health Observatory
Ratio of nurses & midwives to physicians, 2014 (or latest available year)
Skill mix varies among countries……
Source: EMR Health Observatory
Pakist
an Iran
Jordan
Leban
on
Palesti
ne
Afghanist
an
Morocco Syria
Egyp
t
Bahrai
n
Tunisia
Saudi A
rabia
UAEIra
qOman
Sudan
Yemen
Djibouti
Kuwait
Somalia
Qatar
Libya
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
Imbalances in skill mix is increasing …
Afghan
istan
Bahrai
n
Djibouti
Egypt
Iran
Iraq
Jordan
Kuwait
Leban
onLib
ya
Morocco
Oman
Pakista
n
Palestine
Qatar
Saudi A
rabia
Somalia
Sudan
Syria
Tunisia UAE
Yemen
-2.0
-1.5
-1.0
-0.5
0.0
0.5
1.0
Change in the ratio of nurses&midwives/physicians in the EMR Member States from 2007 to 2014
Source: EMR Health Observatory
Working conditions?
Job satisfaction of nurses in EMR 47% expressed satisfaction on
working conditions
satisfied
Source: EMR Nursing and Midwifery Survey, 2014
Protracted crisis and health workforce…• Out-migration of health workforce, interrupted
health professional education
• 594 reported acts of violence to health facilities and health workers in 2014-2015 (82% in EMR)
• 2520 health workers injured or killed ( 86% in EMR)
Source: Report on attacks on health care in emergencies, WHO, 2016
Overall shortagesHealth workforce mobility Imbalanced skill mix and distribution Inadequate/imbalanced production capacities Limited with employment capacitiesChallenges with HRH governance capacities and information Increasing involvement of non-state actors, insufficient
regulatory frameworks and capacities
Diverse countries with diverse health workforce challenges in EMR..
Global Momentum and response• Global Strategy on Human Resources for Health:
Workforce 2030
• UN High Level Commission on Health Employment and Economic Growth
• Draft Regional Framework for Action for Health Workforce Development
Draft Regional Framework for Action for Health Workforce development
To ensuring access of all people in EMR to an adequate, competent, well balanced, motivated, and responsive health workforce functioning within robust health systems towards universal health coverage and SDGs
The way forward• Develop and implement national health workforce strategic plans
• Increase investment in health workforce education and employment
• Establish mechanisms for multi stakeholder collaboration, engagement and policy dialogue (i.e. health workforce committee/board)
• Establish/strengthen health workforce observatories (or similar mechanisms) to improve health workforce information and monitoring
• Regional sharing and cooperation to move forward health workforce agenda
16
Thank you