PRINCE MAHIDOL AWARD CONFERENCE 2014 Achieving Universal Health Coverage: Addressing Health Workforce Inequity Unit of Human Resources for Health Department of Health Systems and Services

Achieving UHC: Addressing Health Workforce Inequity1 Call to Action for a decade of HRH Critical Challenges + 20 Regional Goals  HRH policy framework  Navigation panel  Regional platform for cooperation PHC based health systems UHC Regional Network of HRH Observatories Virtual Campus of Public Health A decade of human resources for health in the Region of the Americas

2 Country HRH Regional Goals Challenge One: Long term HRH policies and plans Achieving UHC: Addressing Health Workforce Inequity GOAL 1 HR density ratio of 25 professionals per 10,000 inhabitants GOAL 2 Proportion of PHC physicians exceeds 40% of total physician workforce GOAL 3 Development of PHC teams with a broad range of competencies GOAL 4 Ratio of at least 1:1 between qualified nurses and physicians GOAL 5 Establishment of a strategic HRH unit 100% 43% 21% 85% 89%

3 Challenge 1. Long term plans and policies Challenge 2. The right people at the right place Challenge 3. Management of migration Challenge 4. Working conditions and performance Challenge 5. Appropriate education and competencies Average Achievement (%) Achieving UHC: Addressing Health Workforce Inequity Source: Regional Observatory of Human Resources, PAHO Note: Countries who participated in both assessments.

44 Goal professionals (doctors, nurses, midwives) per 10,000 habitants Goal 2. Proportion of PHC physicians exceeds 40% of total physician workforce Goal 6 The gap in the distribution of health personnel between urban and rural areas will have been reduced by half Average Achievement (%) Achieving UHC: Addressing Health Workforce Inequity Source: Regional Observatory of Human Resources, PAHO Note: Countries who participated in both assessments. 3 HRH Goals directly linked to UHC Critical obstacles to reach UHC

Some preliminary remarks on the decade Progress has been incremental but steady during the decade with regards to the 5 HRH challenges, but important differences exist on particular goals and between countries; The changes benefited from a favorable combination of economic growth and inclusive social policies in many countries, and are not always attributable to specific programs or interventions; Major recent developments have been the ACA in the US and the “Mais Médicos” Program in Brazil

CHALLENGE 5: EDUCATION Considerable progress in the reorientation of health sciences education towards PHC (Beyond Flexner Movement: Excellence AND Social Responsibility AND Diversity of Student Body) Increasing engagement of National Health Authorities with Institutions of Higher Education in Health Sciences Much deeper reforms are necessary to relocate and decentralize health sciences education in community health centers and hospitals in underserved areas Urgent need to develop elearning and telemedicine network to empower PHC teams in underserved communities

Title of the Presentation7 It takes a health system to train the health workforce