WEBVTT

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[MUSIC PLAYING]

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ASSEFA SEME DERESSE:
I'm going to talk

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about some introductory remarks
of human resource for health.

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Globally, more than
59 million persons

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are employed as health workers
according to the WHO, the World

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Health Organization.

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On average,
countries devote just

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under 50% of total
health expenditure

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to paying its health workforce.

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Health workers personify
system's core value.

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They do provide health
care for people.

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They ease pain and suffering
that the people face.

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And also, they are
there to prevent disease

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and to mitigate risk.

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It's known that
health workforce are

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so critical to the functioning
of the health systems.

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Countries require motivated,
competent, well-distributed,

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and supported human
resource for health

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to achieve health care
targets in any nation.

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Health workforce is one of the
elements of the core building

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block of the health system.

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At the heart of each
and every health system,

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the workforce is central
to advancing health.

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This is a critical
resource for health system

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as without competent
health worker,

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health system
becomes dysfunctional

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or non-functional.

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Health system without
competent health workforce

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is equated as a car
without an engine.

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Let's look at a fit for
purpose model with regard

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to human resource for health.

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What does that mean?

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A fit for purpose
health workforce

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should have the competencies
and quality standards required

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to meet the current
population needs

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and achieve the intended
policy outcomes.

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The fit for purpose
model is a new concept

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that translate to whether the
availability, accessibility,

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acceptability, and the
quality of health workforce

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are collectively able to
deliver effective coverage

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of the service required.

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What do we mean by availability
of human resource for health?

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That is to mean the supply
appropriate stock of health

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workers with the relevant
competencies and skill

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mix that corresponds to the
health needs of the population.

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On the other hand, accessibility
to human resource for health

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mean the equitable distribution
of health workers in terms

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of travel time and
transport, opening hours,

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and cross-bonding
workforce attendance,

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the infrastructure's
attributes--

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that is to mean the physical
accessibility for people,

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like disabled
friendly buildings--

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referral mechanisms, and
the direct and indirect cost

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service, both
formal and informal,

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which is to mean
financial accessibility.

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Acceptability of human resource
for health, on the other hand,

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characterizes the
ability of the workforce

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to treat the patient
with dignity,

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create trust, and enable or
promote demand for services.

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This may take different
forms, such as same sex

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provider or a provider who
understand and thus speaks

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one's language and whose
behavior is respectful

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according to the age,
religion, social,

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and cultural values of the
communities they serve.

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The last important aspect
of the fit for model

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is quality of human
resource for health.

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By equality for human
resource for health,

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for we mean competencies skills
knowledge and the behavior

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of the health worker
as assessed according

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to the professional norms
based on some guiding

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standards of each country
and as perceived by the user

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themselves.

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Why indeed?

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Without sufficient availability,
accessibility to health workers

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cannot be guaranteed.

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And even if availability and
accessibility are adequate,

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without acceptability,
the population

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may not use the health service.

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Finally, when the quality of
health workers is inadequate,

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whatever availability,
accessibility,

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and acceptability
there, the effect

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on the service in terms of
improving health outcomes

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will be suboptimal.

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Next, I'm going to
show you the map

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of the world that shows the
workforce to population ratio

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density.

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From the map, you can understand
that developing countries,

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like sub-Saharan African
and Southeast Asia

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have the least
density of workforce

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for the population it
serves while the high income

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countries, including
USA, Europe, and Russia

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have the highest density
of the population workforce

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to serve their population.

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As we said earlier, at the
heart of each and every health

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system, the workforce is
central to advancing health.

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There is ample evidence that
worker numbers and quality

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positively associated with
immunization coverage, outreach

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of primary care, infant,
child, and maternal survival.

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The quality of doctors and the
density of their distribution

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have been shown to correlate
with positive outcomes

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in cardiovascular disease.

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Conversely, child
malnutrition has

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worsened with the staff cutbacks
during health sector reform.

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This graph shows here that as
the density of health workers

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increase, which
is on the x-axis,

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the probability of infant,
child, and maternal survival

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increases, as you can
see on the y-axis.

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As I mentioned
earlier, some countries

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have critical shortage of
health service providers--

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like doctors, nurses, midwives.

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Expanding labor markets
have intensified

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professional concentration in
urban areas and accelerated

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international migration from
the poorest of the wealthiest

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countries.

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The consequent workforce
crisis in many of the poorest

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countries is characterized
by a severe shortage,

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inappropriate skill mix, and
gaps in service coverage.

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The World Health Organization
has identified a threshold

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in workforce density
below which high coverage

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of essential
interventions, including

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those necessary to meet
goals, is very unlikely.

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Based on these estimates,
there are currently

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57 countries with
critical shortage

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equivalent to a global deficit
of 2.4 million doctors,

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nurses, and midwives.

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The proportional
shortfall for are

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greatest in sub-Saharan
Africa and Southesast Asia,

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as you would see on these maps.

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Paradoxically,
this insufficiency

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is often co-existing
in a country

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with large number of unemployed
health professionals.

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Poverty, imperfect
private labor market,

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lack of public funds,
bureaucratic red tape,

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and political
interference produce

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this paradox of shortage in the
midst of underutilized talent.

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On this graph, we
see the relationship

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between the number of
vaccinators and the outcomes.

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This figure summarizes
by years the relationship

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between the estimated
number of polio cases

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reported active flaccid
paralysis cases, individuals

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participating in national
immunization days,

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and health workers
conducting active

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flaccid paralysis surveillance
during the period 1988 to 2003.

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It demonstrates in particular
the market increase

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that was required in the
voluntary immunization

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workforce as the
eradication strategies began

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to be implemented throughout
Asia and sub-Saharan Africa.

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The trend in polio
cases reflects

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the impact of
national immunization

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days in those areas.

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[MUSIC PLAYING]

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