Post-MDG Themes

December 2012 by Kate Tulenko
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TAGS: Health Workers, MDGs, Universal Access

This post was originally part of a discussion on the Global Health Workforce Alliance’s Member Platform.

The two themes I see emerging post-Millennium Development Goals are:

  • Universal access to health care
  • Aging/chronic disease.

I see incredible opportunity for the health workforce community to contribute to these goals. It’s quite clear that in order to achieve universal access to health care there must be increased investment in health workers including:

  • Developing more cost-effective health teams that extend from the community to the referral hospital to ensure continuity of high quality care
  • Locally training more of the right type of health worker with the right skills and motivations
  • Linking health workers to each other and to their patients via user-friendly eHealth tools that help them do their jobs better and more efficiently and help their patients adhere to their care plans.

In the field of aging/chronic disease there is much more of a natural inclination for the health community to turn to solutions in the form of new drugs or biological therapies. Many of our clinical colleagues forget that the main problem that seniors and people with chronic disease face all over the world is not the lack of effective therapies for their conditions but the lack of those existing therapies provided close to their homes in a language that they can understand (barriers being the actual language such as Spanish or Wolof and the terminology and explanations used).

Specific health workforce concerns for aging/chronic disease include:

  • Coordination of complex care: Which member(s) of the health care team coordinates care, what job aids do they used, and how do they get reimbursed? (Care coordination is a challenge in fee-for-service systems because various payers usually do not want to pay for it.)
  • Adherence to care plans: Although many seniors will be able to use eHealth to improve their adherence, many seniors will not be able to and they will need to be supported in a more direct way with health workers rather than technology.
  • Provision of supportive care and assistance with Activities of Daily Living (bathing, dressing, eating, etc.). This will include the creation and professionalization of new types of health workers including health workers working directly in the home.

Generally as we move beyond the 2015 MDGs we need to maintain the global dialogue on the health workforce both as one of the six pillars of health systems and also as a cross-cutting theme (for example, the promise of proper governance, finance, and access to drugs will not be achieved unless health workers are trained in these fields and participate in them). We also need as a community to agree upon unified messages to communicate the value of the health workforce to our public health colleagues, many of who find health workforce too complicated to bother to address. We also need to continue to refine health workforce indicators to document our achievements.

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