Home | Blog

SUMMATION; Side event “Transforming health workforce education to meet evolving needs and achieve Universal Health Coverage”

September 24, 2019
julian fisher

SUMMATION; Side event “Transforming health workforce education to meet evolving needs and achieve Universal Health Coverage”

Tuesday, September 24, 2019

Yesterday a milestone declaration on UHC was agreed by Member States, which we all celebrate.

·       People are now linking climate change and planetary health with their own health and that of their communities.  The World Bank (2010) has identified that baseline health status of a country, or a community, is the single largest determinant of the likely impact of climate change and the cost of adapting to it.

·       As Greta Thunberg said in an emotional speech yesterday “yes global agreements are essential, what really matters is action on the ground”.

·       And it is taking place.

We heard from our panelists today; if we are to prepare and be ready to take on these challenges then investing in health workforce education must be everyone’s priority. Dr. Francis Omaswa reminded us that education and training are the single most important link between people and health. It is where we set the behaviors and attitudes that make health possible.

Minister of Health and Social Care Bent Höye at an event Saturday highlighted the return on investment in the education and employment of health workers, where there is a 1 to 9 win, and called for a fund of a billion dollars dedicated to investing in health workers. Yet so often the focus is on short term cheaper options, this must stop. We must work closely with the education sector to maximize both the investment and the return on the investment.  

We have challenges: Dr. Vanessa Kerry (SEED Global) spoke about access is critical but so is quality. Recent NASEM study showed that between 5 to 8 Million people who do have access to health care die every year due to lack of quality. Our efforts can not be just about numbers. Yes we have an 18 million health workers shortfall, but UHC must be about the quality the health care people they receive, which means we have to ensure inclusive quality health workforce education.   Our panelists today have highlighted the importance of to provide quality and relevant health workforce education and training to effectively address the needs of the population with the greatest needs.

The SDGs are a common language across goals and targets which is helping to address hammered by fragmentation. But there is a lot of work to address the translation deficit at all levels of the system, from global and national through to institutions and communities.

And solutions or at least mechanisms that will help us. As Dr. Moineau and others mentioned, accreditation bodies of health professions education are a key lever and fulcrum to ensure quality inclusive education. Significant educational reforms are needed to shift from fragmented accreditation mechanisms to accreditation systems within a lifelong learning framework.

As the UHC political declaration emphasised we need Social Accountability in pre-service education and training as well as service delivery.   SA means working with stakeholders including the communities serve to become more impact-oriented. In simple terms, for institutions to measure their success by the outcomes and impacts that positively improve health system performance and health equity. Along with the principles of social accountability, we have also heard the need for more concerted, coordinated strategies to move the education and training from the classroom to where the health workers are expected to practice (the clinics and communities where the needs are the greatest). For this to happen we heard the importance of integrating the educational and health care delivery systems (PANEL 1) and Bistra Zheleva reminded us to focus on what communities need. Education of the various health professions is suffering from fragmented approaches. Interdisciplinary education and practices are essential for strengthening primary health care (refer to Alma Ata 2-Kazakstan). We are only as strong as our teams are said Dr. Erica Burton.

This ambitious reform agenda requires an enabling policy environment at the educational, institutional and governmental level.

Yesterday we heard a call for a  Multi-Partner Health Fund to invest in health workers. Norway is committed.

  • How do we get others on board? Most funding for global health still focus on diseases.
  • How, can we help build an intersectoral platform to invest in the education, employment and lifelong learning for health workers?

We need to invest in collection of meaningful and actionable data to guide policy making and to know whether we are making an impact. And as USAID’s Kelly Saldana said: “we need to focus on the use of data as much as we focus on data collection.” And there is progress on data collection. WHO’s Jim Campbell told us that to date 134 countries have reported data to the National Health Workforce Accounts.

For this to happen we need enabling policies and accreditation to help transform education to improve quality and equity in health service

To deliver on promises we need all hands on deck. This requires more than engaging with ministries of health and education, but labor and finance, international financial institutions, donor agencies and philanthropic organizations.

  • most importantly we need to work closely with the communities we are service and the health workers who are serving them.   delivery major educational reform and most importantly to support the work outlined by the panelists

We at THEnet are committed to engaging with the broader community with others such as the ones in this room, to mobilize action.

  • We can’t afford to reinvent the wheel. A key first step is to map out what is being done to meet global milestone and transform education.
  • We do this work through or cross-institutional research, by sharing our findings and evaluation tools, by developing capacity and by creating a peer to peer support network.

 

However, we shouldn’t forget the importance of accountability to ensure that everyone receives high-quality education and service delivery where equity, is at the heart of the matter whether we are talking gender equity or who gets access to education. The WHO’s National Health Workforce Accounts are a tool to measure progress and hold stakeholders accountable. We in the health workforce community need to work with groups such as the Civil Society Engagement Mechanism for UHC and connect the many important initiatives and events with the same goals. There is, for example, a Global Symposium on Health Workforce Accreditation and Regulation which can help shape accountability mechanisms.

Quick take-aways

  • Investing in health workers if it not matched by spending in education will degrade and limit ROI / what is possible;
  • We must collect, analyse and use data to guide and inform multisectoral action. WHO National Health Workforce Accounts and UNESCO National Education Accounts can help drive this work;
  • We need to learn from and with others (IPE for collaborative practice) life-long and life-wide;
  • Get out and learn living histories of people through community based – engaged – distributed learning.

THEnet and our partners are committed to engaging with the broader community with others such as the ones in this room, to mobilize action, map out what is being done to meet global milestones and monitor progress to transform education.

We need to be guided by what I learned from Dr. Akiko Maeda at a recent TUFH conference Ikigai: purpose or meaning and Kizuna “meaning bonds or connections among people”.

Let’s make UHC and Leave no one behind a reality.