As the World Health Organization (WHO) reaches its 75th anniversary in April 2023, it is urgently calling for all nations to protect, support and expand their health workforce in response to the immense challenges exposed by the COVID-19 pandemic. Governments should build on the flexibility that was brought by necessity to the healthcare sector during the pandemic and empower the health and care workforce by ensuring fair pay and decent working conditions for all.
“The world’s health and care workers have worked under extraordinary circumstances over the past three years,” Jim Campbell, Director of Health Workforce at the WHO, told Univadis. “Too many staff became infected with COVID-19 and died. Too many are now suffering from anxiety, stress and burnout. But their human capacity to adapt under such pressure saved countless lives.”
With a projected shortage of 10 million health and care workers worldwide by 2030, particularly in low- and middle-income countries, the WHO is calling for widespread investment, protection and safeguarding for healthcare staff. The healthcare sector is in crisis in many countries, with chronic staff shortages in many services, strikes ongoing over fair pay and demands for improved working conditions, and concerns over the wellbeing and safeguarding of health workers in the workplace. Underinvestment in education, together with a mismatch between education and the skills that are now needed in the workplace, also require focused attention from governments and leaders in the field.
To facilitate discussion and share examples of best practice, the WHO Fifth Global Forum on Human Resources for Health took place during World Health Worker Week on 3-5 April 2023 in Geneva, Switzerland. The hybrid conference was attended by around 4,000 delegates from around the world.
“Encouragingly, forum participants acknowledged that countries at all income levels are witnessing a workforce that is exhausted, and shared legitimate concerns on work conditions, staffing levels and pay,” says Campbell. “There is a pressing need for governments and employers to support the health and care professionals who have given so much to protect us.”
Discussions at the forum centred around three new policy briefs released by the European Observatory on Health Systems and Policies. The briefs cover key lessons from the COVID-19 pandemic, the need to strengthen workforce structures and intersectoral governance to build resilience, and the need for focused investments in smart digital health systems.
The main priority for the next few years in all countries should be enhancing primary care and ensuring health equity for all. The forum shared workforce development ideas and plans for the post-COVID era.
“Many examples of good practice have emerged during the pandemic and are captured in the forum’s policy briefs and discussions on the role of intersectoral governance,” says Campbell. “Good practice entails leadership from heads of government, joint work across government ministries and clear articulation of the co-benefits from protecting and investing in the health and care workforce.”
In many cases, European governments are making good progress in each of these areas, notes Campbell. Healthcare workforce reforms come under the remit of various funds and grants for EU member states, and some countries have actively used their COVID-19 emergency budget to invest in upskilling, and green and digital transitions. Digital tools, particularly those that enable telemedicine and remote consultations, should be used widely to support patient care, and improve continuity. However, care must be taken to avoid exacerbating inequalities in terms of digital access, and robust security must be an integral part of digital healthcare and data collection to safeguard patient privacy.
Women remain the dominant gender in both the healthcare profession and unpaid care worldwide, with many playing vital roles throughout the pandemic. However, their specific needs are regularly overlooked during policy development.
Healthcare policymakers should also build on the flexibility brought by necessity during COVID-19. There is an opportunity to capitalise on team-based, multidisciplinary workforce structures, for example, ensuring that each person’s training and skills are embraced to their full potential. Extensive investment is needed in training and education, with the WHO recommending that each country aims to increase graduation of health personnel so that workers in the healthcare sector represent 8%-12% of the active workforce each year. Working in health and care must be openly recognised and valued for its vital contribution to wider society. Focused attention on these goals should, in turn, encourage retainment of the existing workforce and inspire new staff to join.
“Changes in scope of practice, team roles and the use of technology during the pandemic have proven their value,” says Campbell. “Flexible regulations have also been paramount, particularly in terms of vaccine development and roll-out programs. However, perhaps the most valuable lesson to take from the pandemic is that we must protect each and every health and care worker and ensure that every nation state fulfils its obligations to provide decent work.”