The ACHEST Executive Director, Prof Francis Omaswa, was one of the speakers at the Uganda UK Health Alliance(UUKHA) symposium hosted virtually on November 30, 2021, under the theme “The role of global health partnerships in ensuring equitable recovery from the COVID-19 Pandemic.” response and recovery efforts.
Prof. Omaswa was on the panel that discussed health workforce and agenda 2030, Other panelists were the Chair Prof. Nelson Sewankambo, the former Principal of Makerere University College of Health Sciences; Dr. Kit Chalmers the Head of Policy and Learning at Tropical Health and Education Trust (THET); and Mr. Patrick Okello, the Commissioner of Human Resources in the Ministry of Health.
In his message, Prof. Omaswa, who is also the former Director-General Health Services in the Ministry of Health, recalled an occasion in 2004 when Prof. Sewankambo handed him a copy of the Joint Learning Initiative report, which drew attention to the global health workforce crisis characterized by widespread shortages, maldistribution, and poor working conditions.
Before this, there was a period of neglect in the sense that the high-income countries had told the Africa and LMCIs that the health workforce was a country-led agenda that could not be attended to by donors. They argued that it was not sustainable. However, with the HIV crisis which hit countries hard, the donors realized they were not able to achieve their targets without skilled health workers and there was a whole new appreciation of health workers. Recruiters from high-income countries started pitching in hotels, taking away health workers without any discussions with their native countries.
Prof. Omaswa, the former founding Executive Director of the Global Health Workforce Alliance, narrated 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. Eventually, it was decided that the WHO Code on International Recruitment of Health Personnel be adopted.
Meanwhile, GHWA which was based under the WHO headquarters in Geneva to develop the health workforce agenda was already registering milestones. These included: developing tools to support countries such as Country Coordination and Facilitation (CCF) structures in countries. This is an inter-ministerial committee on health workforce planning including the health sector, finance, and labour to work together to develop the health workforce. CCF develops plans and documents for assessing health workforce needs against the population diseases burden. GHWA also set up and funded an observatory in WHO-AFRO.
However, along the way the international support to GHWA declined, and WHO had to close its health workforce department.
“Presently, there is not enough support for the health workforce agenda. I wish we could go back to the GHWA, or something independent of the WHO. The current Global Health Workforce Network is different and unfunded. How can we rekindle increased investment in human resources for health? That is the question I would like to ask all of us.,” stated Prof. Omaswa
Speaking at the UKKHA symposium, Prof. Omaswa urged the international community to strengthen countries more in developing their HWF development agendas; to propagate those tools so that countries can have skilled managers who know how to link disease burden to health workforce needs and skills.
He also urged them to support the WHO Code and reminded them that migration is “taking place whether we want it or not.” Remarkably, THET and ACHEST in conjunction recently held a series of symposia, highlighting how UK is taking the lead in implementing the Code for mutual benefit. The report is available here: https://achestdatabase.achest.org/sites/default/files/publications/From-Drain-to-Gain_Sustainable-Workforce-Symposia-Report_0.pdf
In conclusion Prof. Omaswa also made five 5 proposals that Uganda should consider:
1. A country Coordination and Facilitation Committee where the ministry of health, education, finance and public service are sitting together with professional associations to plan for the health workforce in Uganda. The current committee with the Ministries of Health and Education should be expanded.
2. Appoint Assistant Commissioner for Human Resources for Health Development. The position has been vacant for over 10 years now.
3. A health workforce observatory should be established to monitor who has gone for training, left training, got employed etc. to show where the country stands with health worker availability. This Observatory could be located outside the ministry of health; maybe a university or an organization like ACHEST
4. A new HWF recruitment system should be put in place. Right now, recruiting health workers for districts is decentralized. This is a major cause of problems. There are many unfilled posts for health services but there are also so many unemployed health workers. And yet there is a budget for it
5. Can the UK and Uganda enter into a bilateral agreement on sharing health workers. This would be mutually beneficial- having Ugandans go to the UK and gaining skills while delivering services abroad and UK can also be sending people to learn or work with Uganda but also take a very rich experience on how low-income countries health systems work.
Compiled by Carol Natukunda, Communications Specialist, ACHEST