Human resources for health

At Wemos, we wish to see that everyone, everywhere, has access to skilled, motivated and properly supported health workers. However, the global health workforce is unevenly distributed, leading to critical staff shortages in many countries. It is expected that by 2030 there will be a shortage of more than 10 million health workers, particularly in low- and lower-middle income countries.

We therefore analyse health workforce policies and strategies and propose changes to national and EU policymakers to improve them. We also engage with other civil society allies to (jointly) call on national and European policy makers as well as global health donors to create fair and effective health workforce policy.

“‘In Romania you get a job via contacts, in the Netherlands you have to apply and therefore you have an equal chance. I like the availability of resources, and the salary that is better than that in Romania."
Flavius, works in a hospital in Leeuwarden, the Netherlands

Due to insufficient investments in the health workforce, many countries in Europe see their health workers leave to other countries with the intention to seek better working conditions, better job opportunities or higher salaries. These so-called ‘pull factors’ in destination countries, as well as ‘push factors’ in sending countries – such as insufficient job opportunities or sub-optimal working conditions – are fuelling health worker migration and mobility in the EU single market which enables free movement of people. This leaves the sending countries with insufficient health workers and weak health systems, which hampers efforts to achieve resilient health systems and health worker availability for all, particularly for the most vulnerable and marginalised populations.

We advocate that the European Commission should step up its efforts to improve public health and support its individual Member States with tackling the health workforce crisis in Europe, by approaching it as a shared concern that requires joint solutions. National governments cannot solve this crisis on their own. Countries with health workforce shortages relying on the ‘quick fix’ of recruitment from abroad (receiving countries), and countries that see their health workers migrate (sending countries), should all invest in better working and living conditions, and continuous professional development to retain and keep their health workers motivated. We therefore aim to raise awareness on the urgency of improving health worker availability in Europe, collecting and sharing evidence and proposing evidence-based policy solutions through our projects AHEAD and Pillars of Health. We also advocate strengthening human resources for health strategies to address areas that are at risk of becoming medical deserts, often due to outmigration of health workers, resulting in limited health services and unmet health needs in the population.

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Wemos was the lead organization of the project Action for Health and Equity: Addressing medical Deserts (AHEAD), a European Commission-funded partnership that focused on reducing health inequalities by addressing medical deserts in Europe. We set out to better understand medical deserts in Italy, Moldova, the Netherlands, Romania and Serbia, and raise awareness about the need for urgent joint European action, to ultimately contribute to improving access to health care and sufficient, skilled and motivated health workers. We aimed to do this by building knowledge on medical deserts, designing a visual tool to identify medical deserts, and by proposing policy options for medical deserts in participatory consensus-building workshops with local and national stakeholders.

With the project, we put medical deserts on the agenda at EU-level during a policy dialogue event that we organized in the European Parliament, presenting our policy recommendations to tackle medical deserts.

AHEAD consisted of Center for Health Policies and Services (Romania), Cittadinanzattiva (Italy), Media Education Centre (Serbia), National School of Public Health Management (Moldova), VU Athena Institute (Netherlands) and Wemos. The project ran from April 2021 – May 2023.

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Most low- and middle-income countries face severe health workforce shortages. Not enough health workers are trained, and for those who are, there are no steady jobs because there is no funding for their salaries. As a consequence, those health workers who are employed are overburdened and unable to give proper attention and care. While donors and governments agree that expanding the health workforce is urgent, domestic funding often runs short and external funding is too volatile or comes with restrictions that prohibits its use for recurring expenditures like salaries.

In the short to medium term, we advocate continued co-investment and improved quality of funding – predictable, long-term budget-support – from global health actors in low-and middle-income countries’ health workforce. This can boost the quantity and quality of health workers and provide the best conditions for their retention. Within the European Union, we advocate that Member States invest in training, job satisfaction and professional development of health workers, to increase their numbers and improve retention. In some cases, this can be done using existing EU funding instruments. Ultimately, all countries should raise their domestic resources in line with global targets, invest in long-term planning and forecasting, and in the recruitment, development, training, retention and management of their health workforce. For low- and middle-income countries, this will require an overall expansion of their public budgets (see also our section on reforms of the international financial architecture).

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