The Foundation for Advancement of International Medical Education and Research (FAIMER) celebrated 20 years of accomplishment and service to global health through a virtual conference hosted on October 20-22 2021.
During the 5-day conference, ACHEST’s Director of Health Workforce and Development, Dr. Elsie Kiguli-Malwadde was a panelist at a session show casing the projects that some of the fellows had done over the years while the Executive Director Prof. Francis Omaswa made a presentation on the global health workforce crisis which is characterized by the shortages, maldistribution and poor working conditions.
With the global shortage of health workers estimated at 18 million, Prof. Omaswa stated that it is important to have a proper mechanism to build and share a global pool of health workers who are well trained using global accreditation mechanisms and ways which the workforce can be ethically shared using the WHO Code of International Recruitment of Health Personnel.
“This is the future. To have a skilled, supported, motivated health worker in for every person in every village anywhere in the world,” he said, quoting JW Lee the former WHO Director General.
In his presentation, Prof. Omaswa gave the chronology that led to the formation of the WHO Code, starting more than 15 years ago. Prof. Omaswa, the former founding Executive Director of the Global Health Workforce Alliance, recalled that for a long time, the leaders in global health, ministers of health and the World Health Assembly (WHA), were fighting each other using acrimonious language, over the fact that African and Asian Health workers were being recruited by developed countries; sometimes pitching in hotels and just taking health workers away without any discussions with the sending countries.
“Eventually, it was agreed that we should develop a Code which we would use to create a global pool of health workers to be shared using this Code. So, the deliberations to develop the Code started and it took 6 years along the way.” narrated prof. Omaswa.
The Code was finally adopted by the 63rd WHA in 2010. The comprehensive code addresses the interests of all partners and stakeholders, sending countries and receiving countries, migrant health workers themselves and if implemented to scale. “It has the potential to enable the achievement of that goal, training a global pool of health workers to be shared ethically through the Code,” stated Prof. Omaswa.
Every 3 years, every country is required to submit a report to the WHO on the progress in the implementation of the code in their countries. Currently the Code has been under review and will be presented to the next WHA Agenda.
Prof. Omaswa also acknowledged UN High-Level Commission on health employment and economic growth which was established by the Secretary General Ban Ki-MOON. Through its work it led to the establishment of the international platform on health worker mobility which brings together WHO, ILO, OECD, the World Bank , World Economic Forum, World Trade Organization among others. “They are all there to support the WHO Code,” said Prof. Omaswa.
In addition, the existing Global Compact for Safe, Orderly and Regular Migration is available to promote the movement of health workers around the world, based on the Code.
Prof. Omaswa stressed that migration of health workers is inevitable and unstoppable due to the demographic realities: the populations in the south countries have a big pool of young people as opposed to northern countries who have few young people. The number of migrant doctors and nurses working in OECD countries increased by 60% over a 10-year period ending in 2018. “We just need to manage migration better,” stated Prof. Omaswa.
In order to implement the code and in order for health workers to be able to move from one country to another in that global pool, it is essential to have a mechanism to assuring quality, education and training, he noted.
“And that is where ECFMG and FAIMER come in together with the World Federation for Medical Education (WFME). It is important to assure harmonized standards, to assure accreditation and there is no single country or entity which can do this alone. That is why it has been proposed and agreed that we accredit regional entities and agencies. For instance, the East African Community has a common health workforce regulatory agency which can relate to the WFME.”
At a panel that Dr. Elsie Kiguli-Malwadde participated, 6 FAIMER fellows presented short videos of the projects that they had done as part of their fellowship. She noted that it was impressive to have fellows from different disciplines presenting their work as this showed that there would be a ripple effect in the improvement of health professions education. The projects all reflected change management efforts which is one of the core courses offered by FAIMER illustrating the effectiveness of FAIMER. All the projects had SMART doable objectives which helped make the projects easier to implement and actually contributed to their scalability and sustainability. Other panelists also gave their impressions on the projects.
Currently, FAIMER and ECFMG have a partnership with ACHEST to gather comprehensive information on the state of accreditation of undergraduate medical education in Africa. The Global Health Care Education resources project which is underway will be used to inform policy and disseminate best practices in the employment of the WHO Code principles to the full.