What steps can improve and promote investment in the health and care workforce? enhancing efficiency of spending and rethinking domestic and international financing

Investing in the protection of all existing workers is crucial if the HCWF is to be retained, which means: - paying for decent working conditions;- taking steps to support the mental and physical health of the HCWF;- managing staff performance and supporting career development;- removing the gender...

Full description

Bibliographic Details
Main Authors: McPake, Barbara, Dayal, Prarthna (Author), Zimmermann, Julia (Author), Williams, Gemma A. (Author)
Corporate Authors: World Health Organization Regional Office for Europe, European Observatory on Health Systems and Policies
Format: eBook
Language:English
Published: Copenhagen, Denmark World Health Organization, Regional Office for Europe 2023, [2023]
Series:Policy brief
Online Access:
Collection: National Center for Biotechnology Information - Collection details see MPG.ReNa
Description
Summary:Investing in the protection of all existing workers is crucial if the HCWF is to be retained, which means: - paying for decent working conditions;- taking steps to support the mental and physical health of the HCWF;- managing staff performance and supporting career development;- removing the gender pay gap, where it exists, delivering equal pay and targeting gender inequalities.1.3. The HCWF is not sustainable if adequate employment opportunities are not available.1.4. At the half-way point of the SDGs there are inequities and paradoxes: - the HCWF accounts for 10% of total employment in high-income countries (but only a little over 1% in LMICs);- LMICs experience both a shortage of HCWF relative to population needs, and unemployment or underemployment of health and care workers (HCWs)1.5.
Policy-makers at all levels need to mobilize sufficient resources to attract, retain and motivate the HCWF and allow them to perform and this requires: - All governments to consider the cross-cutting benefits of effective education and retention policies for the HCWF in their spending decisions, (recognizing their contribution to gender equality, managing migration, economic participation and rural economies).- Governments to recognize the counter cyclical value of health employment.- Development assistance for the HCWF to be increased (from just 5%), including through intersectoral allocations from education, gender and job creation budgets.- Investment, including international development funding, should focus on creating a sustainable HCWF, with ideas to scale-up revenue for education and employment including more extensive debt cancellation and greater use of blended financing options
The lessons of resource mobilization during the COVID-19 pandemic show what is possible. There is an urgent need for countries and international actors to apply those lessons to secure sufficient funding for health and care workforce (HCWF) education, employment and retention. Investment needs to 2030 are negligible in comparison to government spending during COVID-19. There is powerful evidence that developing a sustainable HCWF will help deliver on the ambitions of universal health coverage (UHC), health security and the Sustainable Development Goals (SDGs) and generate exceptional dividends and co-benefits. If governments are to take forward the policies and practices that work, they should know the following.1. Oversupply of health and care workers is the only solution to current challenges and only top-level political leaders' commitment can secure investment in the HCWF on the scale needed 1.1. Political leaders proved during COVID-19 that remarkable things are possible.1.2.
Key measures include investing in: - secondary education and in science and technology skills, particularly for girls, to provide candidates for the HCWF and create human capital;- education infrastructure, faculty, competency-based education models and online learning to support HCWF development and economies more widely;- continuing professional development (CPD) and lifelong learning, aligned with international standards to respond to changing needs;- the multidisciplinary teams and skills necessary to deliver primary care and fill gaps in underserved and hard-to-reach areas efficiently and effectively.3. Investment will be wasted if the HCWF is not supported and protected and workers leave the sector 1.1. The pandemic demonstrated that a range of measures can effectively protect the HCWF and sustain them.1.2.
Coordinated investments - both domestic and international are needed to stimulate health labour markets and HCW employment opportunities including by: - adjusting labour market investments to stimulate job creation.- initiatives to offset demand issues;- fair remuneration.1.6. Adequate financial and non-financial incentives need to be combined with policies that support and protect HCWs, especially women and youth.4. Solidarity and cooperation at the multilateral, regional and domestic levels is needed to secure sufficient and sustained investment 1.1. Securing long-term domestic financing for recurrent HCWF costs relies on demonstrating efficiency, but an underfunded HCWF cannot be effective and optimize performance.1.2.
Now only top-level political leadership can ensure the financial commitment necessary to break the cycle of shortages and attrition. Leaders need to recognize: - decades of underinvestment have led to a workforce crisis that requires urgent action;- low- and middle-income countries (LMICs) face significant shortages and high-income countries with rising population demand are a long way from self-sufficiency;- the macroeconomic outlook and threat of economic stagnation in many countries is a challenge but cannot be allowed to undermine collective action.1.3. The evidence from the pandemic - that the HCWF generates invaluable contributions to the economy, decent employment, gender rights, societal health and well-being and health security - needs to be used to convince finance ministries that the HCWF matters.1.4. Health must be at the decision-making table when finances are allocated to get investments to where they need to be.2.
Investing in education supports the HCWF, creates human capital and expands access 1.1. The pandemic showed how adaptable the HCWF can be and how important it is to develop their competencies, skills and adaptability.1.2. Societies need to invest in education and training that develops health systems' capacity for health and care services and public health functions, and that drives wider benefits in health sciences, technologies and research.
Physical Description:1 PDF file (40 pages) illustrations