Wanted: more and better-trained health workers

November 2013

An innovative programme developed with WHO is educating a new generation of leaders committed to expanding Africa’s health workforce.

Shewangezhew Moges, a community health worker in Debre Zeit, Ethiopia, makes a home visit to give immunisations.
GAVI/Jiro Ose

As a newly graduated physician, Dr Amir Aman Hagos envisioned a future dedicated to reducing the impact of preventable communicable diseases. For the first two years after he finished his training at the University of Addis Ababa in 2009, that is precisely what he did as medical director of the Limu Genet Hospital in Ethiopia’s Oromia region.

But two years later a life-changing moment led to a complete shift in his vision and plans. In 2011, Amir enrolled in a recently-created online Masters in Public Health (MPH) focusing on health workforce development.

Health leaders and managers

“The experience made me rethink everything,” he says. Through his studies and the research he did for a thesis on how to retain community health workers, Amir recognized he could have a far greater impact on the health of all Ethiopians than he was achieving as a hospital director. He requested a transfer to the Ministry of Health’s human resources department and in short order rose from acting director to State Minister. In that role, he is transforming his Ministry’s approach to increasing the numbers and skills of the country’s health workers.

“Through this programme, we hope… [to fix] the critical shortage of doctors, nurses and other health workers in Africa.”

Dr Erica Wheeler, WHO technical officer.

The MPH programme from which Dr Amir graduated was developed with WHO and operates with support from the Bill & Melinda Gates Foundation. “Through this programme, we hope to generate leaders who will spearhead the production and management of a larger, better educated health workforce, thereby addressing the critical shortage of doctors, nurses and other health workers in Africa,” explains Dr Erica Wheeler, a WHO technical officer whose work focuses on the health workforce.

Shortage of health workers

These shortages are in the spotlight with the launch of a new report, "A Universal Truth: No Health without a Workforce", in Recife, Brazil in November 2013. The report, commissioned by WHO and the Global Health Workforce Alliance, finds that 31 African countries still do not have enough health workers: a minimum of 22.8 per 10 000 population. In those countries, at least one in five women still gives birth without help from a skilled health worker. Seven countries in South-East Asia also have critical health worker shortages.

A great many countries have been making efforts to build their health workforces since WHO published the "World Health Report 2006, Working together for health", which raised the alarm about then-current and future shortages. However, despite overall increases in the numbers and densities of physicians, nurses, and midwives since 2006, the new report estimates that the world will experience a shortage of 12.9 million skilled health workers by 2035.

New leadership and evidence from research are two of the most important elements for filling this gap. The specialized MPH programme – which is run through a partnership between the University of the Western Cape, South Africa; the National University of Rwanda; Eduardo Mondlane University, Mozambique; and Addis Ababa University, Ethiopia – is generating both while setting a needed example that other universities can follow.