Gesundheitspersonal: Globaler Mangel

"Care responsibilities are excluding and holding back millions of women worldwide from taking paid employment, and with climate and demographic changes on course to increase the demand for care, measures to support the care economy are urgently needed, according to a new ILO brief."

• International Labour Organization - ILO

"The active participation and engagement of health and care workers (‎HCWs)‎ in health emergency preparedness, readiness and response is crucial to support risk communication, community engagement and infodemic management (‎RCCE-IM)‎ interventions during emergencies. HCWs hold unique positions in society – repeatedly being identified among the main influencers of people’s behaviours: they are one of the most trusted sources of health information and advice in communities and role models for the acceptance and uptake of protective measures during health emergencies. On the frontline, HCWs have valuable insights and knowledge that can be harnessed to support health emergencies across the entire emergency cycle."

• World Health Organization (WHO)

"The target of Sustainable Development Goal (SDG) 3.c.1 is to “substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries” by 2030 and thus improve health workforce density and distribution. However, the World Health Organization (WHO) estimates a shortfall of 10 million healthcare workers by 2030, mostly in low- and middle-income countries (LMICs). In addition, there is insufficient distribution, skills, and performance of existing healthcare workers to meet primary health needs. So how can we address these gaps, while remaining on track to achieve SDG 3? Country health systems must build resilience to deliver health for all; promote global health security and bolster strategies to mitigate climate impacts; and recognize the lifeblood of their workforces."

• Chemonics

"The International Council of Nurses (ICN) has called on the World Health Organization (WHO) to consider a “time-limited moratorium of active recruitment of nurses” from countries on the WHO Health Workforce Support and Safeguard List. This follows a “dramatic surge” in the recruitment of nurses from low- and middle-income countries (LMICs) by wealthy countries, according to the ICN. The Safeguard List identifies 55 countries that face the most pressing health workforce challenges related to achieving universal health coverage (UHC). Health workers shortages are one of the primary causes of countries’ inability to achieve UHC."

• Health Policy Watch

"Africa’s health worker shortage is projected to reach more than six million by 2030 – and the weaker the system, the more likely health workers are to leave as poor working conditions erode their morale. The non-profit organisation, Seed Global Health works to address this shortage by investing in long-term training and support for health workers in four countries – Malawi, Sierra Leone, Uganda, and Zambia – via partnerships with health ministries. For Seed, long-term means “for as long as our partners will have us”, says CEO Dr Vanessa Kerry, who is also the World Health Organization’s (WHO) Climate Envoy. Seed launched its 2030 strategic plan last week, an ambitious programme that requires the organisation to raise at least $100 million."

• Health Policy Watch

"On 30 May, Wemos and civil society partners held a policy debate on the WHO Global Code of Practice on the International Recruitment of Health Personnel at the 77th World Health Assembly in Geneva. With around 60 representatives from member states’ governments and civil society organizations, attendees and panel speakers shared interesting insights and perspectives on how to make ‘the Code’ an effective instrument that truly promotes the rights of the health and care workforce."

• Wemos
• Medicus Mundi International
• Webinar recording: civil society and 5th reporting round WHO Code of Practice

30.9 Millionen Pflegefachpersonen fehlten weltweit im Jahr 2019, gemäss Schätzungen des International Council of Nurses ICN. Dieser Mangel hat sich durch die Covid-19-Pandemie verschärft und spitzt sich weiter zu – aufgrund der Alterung der Gesellschaft und weil viele Pflegefachpersonen nach der Pandemie den Beruf verlassen haben. Die Schweiz hat bis 2029 einen zusätzlichen Bedarf von 15'900 Pflegefachpersonen. Darüber hinaus müssen 27'500 Pflegefachpersonen ersetzt werden, die in den nächsten Jahren pensioniert werden. Diese Zahlen stammen aus dem nationalen Versorgungsbericht des Schweizerischen Gesundheitsobservatoriums (obsan 2021).

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"International migration and mobility of health workers has increased in volume and complexity in recent decades. If not adequately managed, migration of health workers from low-and middle-income countries can exacerbate shortages and weaken health systems in these countries, widening inequities. This in turn can threaten international health security, with grave repercussions for economies and societies globally. Among the different pathways for movement of health workers, government-to-government agreements hold important potential to ensure that health workers and the health systems of participating countries benefit from health worker migration and mobility. This guidance is a tool for improving the capacity of state actors involved in the development, negotiation, implementation, monitoring and evaluation of agreements related to international health worker migration and mobility (...)."

• World Health Organization
• WHO Global Code of Practice on the International Recruitment of Health Personnel

"Achieving greater equity in health will demand that the health sector assumes a greater leadership role in addressing social inequalities. This requires equipping health and care workers to better understand how the social determinants of health impact patients and communities. Education of the health workforce is thus a key step to advancing action. Integration of the social determinants of health into education and training will prepare the workforce to adjust clinical practice, define appropriate public health programmes and leverage cross-sector policies and mechanisms."

• World Health Organization (WHO)

"Gesundheit für alle weltweit: Das ist die Vision von Medicus Mundi Schweiz. Dieses Jahr wird die Organisation 50 Jahre alt. Was sie erreicht hat, wie sie den Wortschatz des Bundesrats prägt und was der globale Norden vom globalen Süden lernen kann, erklärt Geschäftsführer Martin Leschhorn Strebel im Interview."

• Schweizerische Ärztezeitung

"Belgium, which takes over the presidency of the Council of the European Union in January 2024, plans to make the healthcare workforce crisis a central item on its agenda, the first time the issue will be prioritized at the highest level of EU policymaking in over a decade. “We are actively considering the health workforce and all the challenges around health workforces to be one of the main priorities of the Belgian presidency,” Lieven De Raedt, a strategic advisor on the international unit of the Belgian Federal Ministry of Health, told the European Health Forum in Gastein, Austria, on Thursday."

• Health Policy Watch

"Approximately 20,000 community health workers in the Indian state of Haryana have been on strike for the past three weeks. Known as Accredited Social Health Activists (ASHAs), they are part of a workforce of over one million women across India who are at the frontlines of public health care in rural and urban areas. Despite performing nearly 60 critical tasks— related to preventive, reproductive, maternal and child, and broadly, community care— ASHAs are not recognized by the government as public sector workers. Instead, they are classified as “volunteers” — a precarious category that does not afford these women basic labor rights and protections including a minimum wage, sick leave, or pensions."

• People's Health Dispatch

"The World Health Organization’s Global Strategy on Human Resources for Health: Workforce 2030 identified a pro- jected shortfall of 18 million health workers by 2030, primarily in low- and middle-income countries. The need for investment was re-enforced by the 2016 report and recommendations of the United Nations High-Level Commis- sion on Health Employment and Economic Growth. This exploratory policy tracing study has as objective to map and analyse investments by bilateral, multilateral and other development actors in human resources for health actions, programmes and health jobs more broadly since 2016. This analysis will contribute to the accountability of global human resources for health actions and its commitment by the international community. It provides insights in gaps, priorities and future policies’ needs."

• BioMed Central

"Health workforce challenges hinder progress towards universal health coverage, improved health outcomes and health security. The global health workforce shortage is declining, but progress is slower in the African and Eastern Mediterranean regions and Small Island Developing States. International migration of health workers, when not adequately managed, can exacerbate pre-existing inequalities, further depleting the availability of health workers in countries already affected by shortages."

• Bulletin of the World Health Organization

"An der St. Lukes-Pflegefachschule in Mpanshya hat SolidarMed ein neues Ausbildungsmodell erfolgreich erprobt: Früher konnten Pfleger:innen in Ausbildung nur am direkt assoziierten Spital klinische Erfahrung am Krankenbett gewinnen. Seit Einführung eines dezentralen Ausbildungsmodells rotieren die Auszubildenden während mehrerer Monate zwischen unterschiedlichen Spitälern. Dies hat den Vorteil, dass die Studierenden mehr medizinische Fälle kennenlernen, wodurch die Qualität der Ausbildung steigt. Zudem wird die Zahl der Absolvent:innen vervielfacht, da mehrere Ausbildungsklassen parallel geführt werden können."

• SolidarMed

"The global health workforce crisis is no longer a looming possibility. It is a reality. Pre-pandemic the World Health Organization (WHO) projected a global shortage of 10 million health workers by 2030 and since then the situation has significantly deteriorated. Staff shortages are reported ever more frequently, health workers strike more often and high-income countries increase their incentives for nurses to move from low-income countries. So why is it that recent international documents on global health, including the G7 foreign ministers’ communique on 18 April, fail to acknowledge the crucial role of health workers in the achievement of universal health coverage (UHC)? Why don’t health ministers and heads of state address the real reasons for the emptying rosters, the rock-bottom morale and the sky-high burnout?"

• Health Policy Watch

"Nigeria’s House of Representatives is considering a bill which would block young physicians from emigrating right after university. The proposal points to the widespread problem of mass emigration of health workers from the Global South. (...) Nigeria has recorded startling rates of health workers’ emigration. In the last eight years, 5,600 physicians have left the country for the United Kingdom alone. Baba Aye, Health and Social Sector Officer at Public Services International (PSI), estimates that at one point, there was a daily average of 50 doctors leaving Nigeria. The intensity of the emigration has weakened the system and pushed health care away from the reach of patients."

• People's Health Dispatch

"Schweizer Spitäler suchen zunehmend ennet der Grenze nach Personal. Aber auch dort herrscht vielfach Mangel an Ärzten und Pflegekräften. (...) Das Kantonsspital Aarau führt Castings in Rom durch, die Privatklinikgruppe Hirslanden machte an einer Messe in Berlin Werbung für den Standort Schweiz. Auch die Unispitäler Zürich und Bern suchen ennet der Grenze nach Fachkräften. (...) Rechtlich ist das kein Problem – es gilt die Personenfreizügigkeit. Ethisch allerdings sieht es anders aus. Die Schweiz hat den WHO-Kodex zur Rekrutierung von Gesundheitspersonal unterschrieben, nach dem jedes Land Fachkräfte ausbilden und im Job halten soll. Davon sei die Schweiz weit entfernt, sagt Martin Leschhorn (53), Geschäftsführer von Medicus Mundi."

• Blick
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"Eight more countries in the global south have dangerously low numbers of healthcare workers in the wake of the COVID pandemic, a new WHO report has found. The World Health Organization’s 2023 report on “Health workforce support and safeguards” found that some 55 countries now rank below the global median in terms of their density of doctors, nurses and midwives per capita. (...) The WHO report series tracks countries where the number of professionally trained healthcare workers falls below the global median of 49 per 10,000 population. It also examines countries’ rankings in terms of a Universal Health Service coverage index. The negative health, economic and social impacts of COVID-19, coupled with the increased demand for healthcare workers in high-income countries experienced during the pandemic, likely helped trigger more outward migration of healthcare workers from countries that are already suffering from low health workforce densities, the report found."

• Health Policy Watch
• WHO health workforce support and safeguards list 2023

"(...) Dass die Schweiz auf rumänische Ärzte zurückgreift, stösst auf Kritik. Martin Leschhorn von Medicus Mundi Schweiz, einem Netz von Entwicklungshilfeorganisationen im Gesundheitsbereich, sagt: «Seit deutsche Mediziner weniger leicht zu bekommen sind, bedient sich die Schweiz nun bei den Schwächsten.» Es sei nicht fair, wenn die ärmeren Länder der EU die Ausbildungskosten übernähmen und die Schweiz dann die fertigen Ärztinnen und Ärzte anstelle. Tatsächlich würde es hier – insbesondere nach der Corona Krise – nicht an interessierten Studierenden mangeln. Über 7000 meldeten sich vergangenes Jahr für ein Medizinstudium an, Platz gab es allerdings nur für 2172."

• Tagesanzeiger
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"Women in Global Health’s latest policy report - "Her Story: Ending Sexual Violence and Harassment of Women Health Workers" - is the culmination of our #HealthToo research project and online platform. It reveals the prevalence of sexual exploitation, abuse and harassment (SEAH) experienced by significant numbers of women health workers.  In the absence of comprehensive data on SEAH in health, our report uses the testimony of women as data to bring the reality and nature of sexual violence and harassment to life, as well as the conditions that enable it. Women submitted stories to #HealthToo from 40 countries, in ten languages and we have collected accounts through literature and partners from many other countries."

• Women in Global Health
• Executive summary

"Mit der Annahme der Pflegeinitiative erfüllt die Schweiz eine wichtige Forderung des WHO-Kodexes: Jedes Land soll seinen Bedürfnissen entsprechend im eigenen Land genügend Gesundheitspersonal rekrutieren. Es kommt selten vor, dass eine Volksinitiative eine so deutliche Mehrheit wie die Pflegeinitiative findet. Verschiedene Faktoren haben zu dieser Annahme geführt: Die Furcht davor, dass unsere Gesundheitsversorgung in Zukunft aufgrund des Personalmangels nicht mehr sichergestellt werden kann, die Corona-bedingte Erkenntnis, dass die Pflege ein Schlüsselbereich unseres Gesundheitssystems ist, und die grundsätzliche Sympathie gegenüber den Pflegenden."

• Neue Zürcher Zeitung

"In keiner Branche gibt es so viele offene Stellen wie im Gesundheitswesen. Neueste Zahlen zeigen: 5761 Jobs in der Pflege sind derzeit unbesetzt. Ein Höchststand. Im selben Zeitraum 2019 waren es noch 4716, Anfang desselben Jahres nur 3626. Ausgewertet hat die Daten die Firma x28. Deren Jobsuchmaschine findet praktisch alle offenen Stellen, die auf den Websitesder Arbeitgeber ausgeschrieben sind. Wie konnte es so weit kommen? (...) «Doch statt selber genügend Pflegende auszubilden, bedienen sich die westlichen Staaten bei den Schwächsten», sagt Martin Leschhorn von Medicus Mundi Schweiz, einem Netzwerk von Schweizer Organisationen in der Entwicklungszusammenarbeit.

Sonntagszeitung - Pflege: Front

Sonntagszeitung - Pflege, S. 2

Sonntagszeitung - Pflege, S. 3

• Sonntagszeitung

Krankenschwestern und Krankenpfleger gehören zu den am stärksten von COVID-19 betroffenen Berufsgruppen. Nach Angaben des International Council of Nurses (ICN) haben sich seit Beginn der Pandemie Millionen von Pflegepersonal mit dem Coronavirus infiziert. Die tatsächliche Zahl kann jedoch nicht ermittelt werden, da noch immer keine systematische Erfassung von Daten über Infektions- und Todesfälle beim Gesundheitspersonal stattfindet. Prekäre Arbeitsbedingungen, aber auch Machtungleichheiten, wie die Tatsache, dass Mediziner*innen eher Schutzkleidung und Covid-19 Tests erhielten, als das Pflegepersonal, welches unmittelbarer mit dem Infektionsgeschehen konfrontiert war, haben zu den hohen Todesraten beigetragen. Ziel dieser Analyse war es, zu untersuchen, wie sich strukturelle Determinanten wie schlechte Bezahlung, soziale Ungleichheit und ein Hierarchiegefälle negativ auf die Beschäftigungs- und die Arbeitsbedingungen des Pflegepersonals auswirken und ihre Gesundheit gefährden.

• BioMed Central Human Resources for Health

"Millions of lives of women and newborns are lost, and millions more experience ill health or injury, because the needs of pregnant women and skills of midwives are not recognized or prioritized. The world is currently facing a shortage of 900 000 midwives, which represents a third of the required global midwifery workforce. The COVID-19 crisis has only exacerbated these problems, with the health needs of women and newborns being overshadowed, midwifery services being disrupted and midwives being deployed to other health services."

• World Health Organization
• Joint report by UNFPA; WHO & the International Confederation of Midwives (ICM)

Worldwide, the crisis in global health is rooted in the unequal distribution of and unequal access to skilled health and care workers. As recent pandemics have clearly and brutally shown, health workers themselves are one of the most neglected elements of dismantled and underfinanced public health systems, in virtually every country. Even in weakened health systems, health workers are the linchpin of health care and are key to the provision of available, acceptable, accessible and quality health care.

• HW4All Coalition
• Endorse our political declaration and join the Coalition

Das Gesundheitssystem in Südafrika leidet unter grosser Personalnot. Obwohl die Regierung diesen Zahlen nicht offiziell zustimmt, sind die Hälfte der Ärztestellen und ca. 46% der Stellen des Pflegepersonals unbesetzt. Die Hauptleidtragenden sind neben den PatientInnen, das (noch) vorhandene Personal.

Ein wesentlicher Grund für den dramtischen Ärztemangel sind neben dem bekannten Brain Drain, die Tatsache, dass die Regierung keine Ausländer mehr einstellen möchte. Kamen im Jahr 2000 noch ca. 20% der Ärzte aus dem Ausland, wird dies nun durch verschärfte Zuwanderungsgesetze unterbunden. (Foto © flickr)

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