CHIANG MAI (THAILAND): There is an acute shortage of health workers globally and Africa is the hardest hit, according to the World Health Organisation (WHO).

There are 59 million health workers worldwide and 4.35 million more are needed urgently, the WHO pointed out, while calling upon the governments to train, retain and sustain their health workforce.

There is approximately a workforce of 7 million in the 11 member countries of the WHO's South-East Asia Region (SEAR), including India. Of these, three million are physicians and nurses.

Variation

However, there is a remarkable variation between individual SEAR countries as far as the total number is concerned. It ranges from the lowest of 15 (in Nepal) to as high as 110 (in Democratic People's Republic of Korea) per 10,000 population. But this ratio, again, does not provide a clear comparability as other indicators vary.

Some countries such as Bangladesh and Myanmar have more physicians than nurses. On an average, there are 29 health service providers per 10,000 population available in the region — well below the global average of 62 per 10,000 population.

While the region has a quarter of the world's population, the health workforce is only 12 per cent of the global workforce. In fact, the region is growing and there is a concern to ensure that the workforce is commensurate with the needs of the population.

In the mid-1960s, doctors and nurses were considered a major health workforce, but the concept gradually shifted to include other categories of health workers. Also, there were those practising alternative systems of medicine such as ayurveda, unani, homoeopathy, rendering healthcare at the grassroots level, Dr. M. Khalilullah from Bangladesh said at a two-day regional workshop aimed to "Enhance Media Awareness on Human Resources for Health" here.

Mushrooming medical schools

According to P.T. Jayawickramrajah of the WHO, in countries of the SEAR, mushrooming of private health professional schools with commercial intent was a serious problem.

There was a proliferation of private medical schools in India, Bangladesh and Nepal. Many of them lacked adequate facilities and the required number of competent teachers.

Also, the entry requirements were more tilted towards the ability to pay, than competitive requirements, he said.

Imbalance

In many countries, human resource in health confronted problems such as inadequate pay, poor working conditions, leading to internal migration of health personnel to locations with adequate work facilities and better environment for families.

The increasing imbalance was also attributed to active recruitment of human resource in health from developing to developed nations. India provided for most of the "brain drain.''

The WHO will dedicate the World Health Day on April 7 to the health workforce to spread the message that educated and well-trained health workers save lives, and that safe and supportive working conditions must be ensured for them.

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