UNESCO Director-General (DG), Audrey Azoulay, advocated for education as a priority investment for sustainable development
at a conference organized by the French Development Agency (AFD) in Paris on 19 January 2018. The DG identified a second priority which is to better articulate education, health and employment policies, read press release
The African region that still counts 32 million out-of-school children and faces advancing urbanization as well as conflict and crises situations. This will have an impact on the pool of eligibles for entry into health workforce education and training.
The 2017 UN Commission on Health Employment and Economic Growth report calls for the creation of health and social sector jobs as a means to advance inclusive economic growth, paying specific attention to the needs of low- and lower middle income countries, and is supported by an action plan 2017-21.
A policy brief (Chapter 12) from UNESCO in summary of the Commission’s work noted that there is a critical need to transform the health workforce by unleashing the potential of technical and vocational education and training (TVET).
The conventional model of health workforce education, premised upon a narrowing formal schooling pipeline, oriented towards pre-service education and training and founded on a biomedical approach, will be unable to meet the needs of the future health workforce. Significant bottlenecks are the proportion of students attaining upper secondary education and the shortage of qualified teachers, particularly in low-income countries. TVET is a well established and increasingly prominent subsector within education. Its potential for transforming the health workforce has, however, been largely overlooked. TVET, as part of lifelong learning, can facilitate school-to-work transitions, youth apprenticeships, employment and decent work, continuing professional development, recognition of prior learning, and development of the range of skills and competencies required in the health sector.
The shortcomings of the conventional narrowing pipeline model are most serious in low-income countries. Significant bottlenecks are the proportion of the student cohort attaining upper secondary education – projected to be only 26% in low- income countries by 2030 – and shortages of qualified teachers. Projections for sub-Saharan Africa have indicated that an extra 2.5 million teachers for lower secondary education are needed by 2030. Teacher supply for upper secondary education and specialized programmes at the post-secondary and tertiary levels is also a constraining factor.
Communities in rural settings suffer disproportionately . Poorly nourished children are more likely than well nourished children to have lower levels of school enrolment and complete fewer years of schooling. Girls from poor backgrounds are particularly at risk of being out of school. The lack of health workforce students from rural areas is a major reason for the inadequate supply of rural health workers in developing countries. Yet a health workforce that is fit for purpose and fit to practice in rural and remote areas will be crucial to instituting and maintaining universal health coverage with primary health care access.
TVET can take place at different levels and sites, and as such might play a role in helping to connect education subsystems, including health workforce education and training. Schools, colleges, universities and other tertiary education institutions, community-based learning facilities, and health workplaces could gradually become integrated learning centres, which together – as learning networks – would become mutually reinforcing. TVET could also be a strategic modality for addressing inequalities and promoting equality of opportunity in learning and the world of work, thereby promoting gender equality, social inclusion and social cohesion.
TVET within a lifelong learning framework could help to establish diverse learning pathways with multiple entry and exit points, supporting learning and career progression. Learning pathways could enable learners to navigate between different sites or levels and to gain recognized skills and qualifications throughout the life course. Together, such learning networks and learning pathways could form more flexible and responsive lifelong learning systems.