Health workforce development in the Eastern Mediterranean Region

63rd Session of the WHO Regional Committee for the Eastern Mediterranean

3-6 OCTOBER 2016, Cairo

EMR has low density of health workers…

South-East Asia Africa Eastern Mediterranean

Americas Western Pacific Europe0

10

20

30

40

50

60

70

80

Average density of physicians, nurses, midwives in WHO regions

Source: WHO Global Health Observatory

Somalia

Afghanistan

Djibouti

Yemen

Sudan

Pakistan

Morocco

Egypt

Iraq

Iran

Syria

Palestine

Tunisia

Jordan

Lebanon

Libya

UAE

Oman

Bahrain

Saudi Arabia

Kuwait

Qatar

0 10 20 30 40 50 60 70 80 90 100

Moving from MDGs…….Density of physicians, nurses and midwives, 2014 (or latest available year)

Source: EMR Health Observatory

SDGs and health workforce

3c substantially increase … the recruitment, development, training and retention of the health workforce in developing countries

Increased production capacity……

Trends in establishment of medical schools in EMR

Before 1950 1950-1974 1975-2000 After 20000

20

40

60

80

100

120

Public Private

Trends in medical schools by public and private sectors

0

5

10

15

20

25

30

2007 2008 2009 2010 2011 2012 2013 2014

Dens

ity /

10,

000

Popu

latio

n

Group 1

Group 2

Group 3

2007 2008 2009 2010 2011 2012 2013 20140

10

20

30

40

50

60

Group 1Group 2Group 3

Dens

ity /

10,

000

Popu

latio

n

Density of nurses and midwives per 10,000 population in EMR

….. but not sufficient to keep pace with population growth

Density of physicians per 10,000 population in EMR

Source: EMR Health Observatory

Ratio of nurses & midwives to physicians, 2014 (or latest available year)

Skill mix varies among countries……

Source: EMR Health Observatory

Pakist

an Iran

Jordan

Leban

on

Palesti

ne

Afghanist

an

Morocco Syria

Egyp

t

Bahrai

n

Tunisia

Saudi A

rabia

UAEIra

qOman

Sudan

Yemen

Djibouti

Kuwait

Somalia

Qatar

Libya

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

Imbalances in skill mix is increasing …

Afghan

istan

Bahrai

n

Djibouti

Egypt

Iran

Iraq

Jordan

Kuwait

Leban

onLib

ya

Morocco

Oman

Pakista

n

Palestine

Qatar

Saudi A

rabia

Somalia

Sudan

Syria

Tunisia UAE

Yemen

-2.0

-1.5

-1.0

-0.5

0.0

0.5

1.0

Change in the ratio of nurses&midwives/physicians in the EMR Member States from 2007 to 2014

Source: EMR Health Observatory

Working conditions?

Job satisfaction of nurses in EMR 47% expressed satisfaction on

working conditions

satisfied

Source: EMR Nursing and Midwifery Survey, 2014

Protracted crisis and health workforce…• Out-migration of health workforce, interrupted

health professional education

• 594 reported acts of violence to health facilities and health workers in 2014-2015 (82% in EMR)

• 2520 health workers injured or killed ( 86% in EMR)

Source: Report on attacks on health care in emergencies, WHO, 2016

Overall shortagesHealth workforce mobility Imbalanced skill mix and distribution Inadequate/imbalanced production capacities Limited with employment capacitiesChallenges with HRH governance capacities and information Increasing involvement of non-state actors, insufficient

regulatory frameworks and capacities

Diverse countries with diverse health workforce challenges in EMR..

Global Momentum and response• Global Strategy on Human Resources for Health:

Workforce 2030

• UN High Level Commission on Health Employment and Economic Growth

• Draft Regional Framework for Action for Health Workforce Development

Draft Regional Framework for Action for Health Workforce development

To ensuring access of all people in EMR to an adequate, competent, well balanced, motivated, and responsive health workforce functioning within robust health systems towards universal health coverage and SDGs

The way forward• Develop and implement national health workforce strategic plans

• Increase investment in health workforce education and employment

• Establish mechanisms for multi stakeholder collaboration, engagement and policy dialogue (i.e. health workforce committee/board)

• Establish/strengthen health workforce observatories (or similar mechanisms) to improve health workforce information and monitoring

• Regional sharing and cooperation to move forward health workforce agenda

16

Thank you