Health Workers for a New Century
“Health is about people—those with needs and those who are entrusted to respond to those needs,” said Dr. Julio Frenk, Harvard School of Public Health dean and cochair of Education of Health Professionals for the 21st century: A Global Independent Commission.
Dr. Frenk presented the Commission’s new report, "Health professionals for a new century: Transforming education to strengthen health systems in an interdependent world," at the World Bank recently, noting that this report represents a change in basic thinking about health education.
A new vision
To provide background, Dr. Frenk discussed how professional health education was dramatically affected in the 1900s by analytical work, and supported by donor funding, it focused on teaching medical science in a uniform manner worldwide. Then, in the 1970s there was a shift to a problem-based approach. Today, with advances in scientific knowledge and the emergence of new diseases and health disciplines (e.g., health economists, health information specialists, etc.), health education needs a systems-based, teamwork approach.
“The people’s needs should be the basis of health education with curriculum the end point, not the beginning,” said Dr. Frenk. “[Furthermore], teamwork is a competency that has to be developed.”
Approaches and success
A critical factor in improving health outcomes is the composition, quality, and capacity of a health workforce, which must be relevant to the health needs of the society it serves and take into account the costs of providing appropriate health care.
What is needed going forward is a fundamental shift in health workforce culture, with an emphasis on the team approach—in other words, moving away from the clinician as the center and sole decider of diagnosis, treatment, and care. In both developing and developed countries, this will require a radical change in health workforce training institutions’ methodology and content, as well as how they envision success. Also, it will require attitudinal changes by physicians, nurses, and other practitioners at different levels of health service delivery in deciding how they measure success.
Particularly for developing countries, the health community, development institutions, and donors must now be more proactive in thinking about the content of health workforce education and in recognizing that financing for the global health workforce has lagged far behind need. New investments will have significant positive impact for future health outcomes, and the inverse is true as well—failing to address the health workforce challenge will undermine other investments in health systems.
What next?
Now in book form, the report will be translated into five languages, and Commission members intend to disseminate it widely to decision-making and practitioner audiences.
CapacityPlus’s Kate Tulenko asked about the strategy in scaling up the Commission’s recommendation. The plan is to identify countries interested in customizing the approach to country situations and develop multiple prototypes to avoid application of a global, one-size-fits-all model. Commission members also recognize the need to mobilize funds and will engage in this effort.
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Photo by Trevor Snapp. (Health professional students at El Hadj Ibrahma Niaso Kaolack Hospital, Senegal)
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