In November 2020, the resumed 73rd World Health Assembly declared the year 2021 as the Year of the Health and Care Workers. This move came in recognition of the crucial role the health and care workforce played at the frontlines in facing the COVID-19 pandemic, as well as a call to action to invest in their education, working conditions and preparedness.
“Health systems can only function with health workers”, the World Health Organization highlights the workforce as a building block and the integral functional unit of health systems. In addition, an available, accessible and well-trained workforce is key for dignified healthcare and a prerequisite for the achievement of universal health coverage and the fulfillment of the right to health. These facts have been greatly emphasized by the COVID-19 pandemic, as the health and care workers rose to this crisis serving as the first line of defense of individual and collective health security.
This blogpost presents IFMSA’s reflections on the past and vision for the future of the healthcare workforce, hoping that the year 2021 would bring concrete actions and progress on the health workforce agenda, and prove to be a turning point in shaping the health agenda for the upcoming years.
Health workers’ education
The year 2020 has taught us many lessons pertaining to medical education, from the impact of and preparedness for health emergencies to discrimination and social justice. Medical education, even though efforts to adapt were made, has been hit hard by a pandemic showing lack of agility and preparedness. While, on the other hand, curricula are still falling short of preparing students to respond to health needs and challenges in society in an equitable and inclusive manner. These lessons should provoke and mobilize the transformation of medical education to more resiliency and social accountability through concrete action to:
- Invest in research on and development of new technologies and distance learning to enhance education, training and management of health professionals;
- Extensively revise and accordingly develop medical curricula to be intersectional and agile to provide students with sufficient and inclusive knowledge about their communities and health challenges, and to provide them with a practical understanding of health inequities and social determinants of health;
- Invest in providing systematic programs and opportunities for continuous professional development of the health and care workers to respond to the ever-changing health needs and.
Health workers in workplace
There is always this fleeting question in the back of our heads, do “health” care workers actually enjoy good “health”? The COVID-19 pandemic has exploited health workers to the fullest, exposing the shortcoming of health systems in guaranteeing optimal working conditions. For example, the highest infection and death rates globally were among health care providers themselves (in certain communities, up to 49% of the positive cases were among health care workers) [1], which can be traced to multiple factors, such as: lack of personal protective equipment, poor infection control measures in facilities, depleted financial resources or unprotected exposure to the cases. Furthermore, the increased exposure to risks, misinformation and hectic working schedules put a huge burden on mental health and emotional wellbeing of health workers. The failure of health systems to promote a safe and healthy working environment, exposed by the COVID-19 pandemic, should be a trigger to rethink the health and safety of health workers and to enact concrete plans and policies to promote safe working conditions, well equipped and prepared facilities, compensation from work-related injuries and harms as well as mental health and psychosocial support for workers.
Protection of healthcare workers
The World Medical Association has recently, through the 73rd World Health Assembly, highlighted violence against health workers as “an international emergency” that “undermines the foundations of health systems and impacts critically on patient’s health” [2]. According to the latest Safeguarding Healthcare in Conflict Coalition annual report, in 2019 at least 151 health workers died and 502 were injured as a result of incidents of violence against health care in around 18 regions experiencing conflict [3]. In non-conflict settings, about 1 in 2 health personnel has experienced any form of workplace violence in their lives [4]. Such incidents compromise health services and the right to health. In this upcoming year, it’s crucial to tackle this pressing issue and ensure the protection of healthcare personnel by taking concrete measure and action such as:
- Establishing reporting and code of conduct mechanisms for cases of violence against healthcare workers;
- Implementing clear and strict accountability mechanisms and end impunity;
- Providing legal, psychological and social support for all the victims subjected to attacks on healthcare.
Health workers in times of crises
Health and care workers, including students, play a vital role in emergencies and crises, the COVID-19 and Ebola epidemics as examples, as first responders. This role comes with high responsibility which puts much pressure and stress on their shoulders to respond to the health needs and expectations of the population. Their role also comes with risks and vulnerabilities as healthcare workers face a high risk of exposure to infectious agents and work hazards [5]. The increased demands and risks in consequence of health emergencies exhaust the health systems, which could already be under-resourced, and this could further overburden the healthcare personnel to perform. Hence, as the world will still be battling the COVID-19 pandemic throughout this upcoming year, it’s of urgent importance to:
- Invest in the preparedness of the health workforce, by providing adequate training, equipment and protective measure to ensure their safety and productivity at all time;
- Have joint decision making on the role of health and care workers and students during emergencies, meaningfully engaging all stakeholders;
- Develop the capacities of the health workforce in managing disasters and emergencies, promoting human resources empowerment at a local, national and international level.
2021 a turning point for the healthcare workforce!
The challenges facing the healthcare workforce are multiple, complex and intersecting. Lessons learned throughout the past year highlight the need to address these challenges as a high priority and through intersectoral collaboration while putting health workers at the core of action as key actors on decisions affecting their practice and working conditions.
An available, accessible, culturally competent and well-trained healthcare workforce is a prerequisite for improving health outcomes and achieving greater equity in health locally, nationally, regionally and globally.
Resources:
- Chou R, Dana T, Selph S, Totten AM, Buckley DI, Fu R. Update Alert 6: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers. Ann Intern Med. 2021;174(1):W18-W19. doi:10.7326/L20-1323
- Statement in the 73rd World Health Assembly, Agenda item 3: Covid-19 pandemic response. World Medical Association. Nov 2020 . Retrieved from: https://www.wma.net/wp-content/uploads/2020/05/WHA73-WMA-statement-on-Covid-19-pandemic-response-.pdf
- Safeguarding Health in Conflict Annual Report 2020. Safeguarding Health in Conflict Coalition. May 2020. Retrieved from: https://www.safeguardinghealth.org/sites/shcc/files/SHCC2020final.pdf
- Liu J, Gan Y, Jiang H, Li L, Dwyer R, Lu K, Yan S, Sampson O, Xu H, Wang C, Zhu Y, Chang Y, Yang Y, Yang T, Chen Y, Song F, Lu Z. Prevalence of workplace violence against healthcare workers: a systematic review and meta-analysis. Occup Environ Med. 2019 Dec;76(12):927-937. doi: 10.1136/oemed-2019-105849. Epub 2019 Oct 13. PMID: 31611310.
- Occupational safety and health in public health emergencies: A manual for protecting health workers and responders. World Health Organization, International Labour Organization. 2018. Retrieved from: https://www.ilo.org/wcmsp5/groups/public/—ed_protect/—protrav/—safework/documents/publication/wcms_633233.pdf
Further readings:
- WHO Health workforce policy and management in the context of the COVID-19 response – HERE
- Policy recommendations for sustainable health workforce teams to respond to COVID-19 – HERE
- Exposed, Silenced, Attacked: Failures to Protect Health and Essential Workers during the COVID-19 Pandemic – HERE
- User’s Guide to the WHO Global Code of Practice on the International Recruitment of Health Personnel – HERE
Relevant IFMSA policies:
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