Health workers, government and civil society at joint MOH and MSF conference address health professional gaps in Malawi

December 7, 2010

Health workers, government and civil society at joint MOH and MSF conference address health professional gaps in Malawi © Marit Helgerud/MSF

The Ministry of Health and Médecins Sans Frontières (MSF) / Doctors Without Borders come together in hosting the conference on Human Resources for Health (HRH). The meeting on Monday 6 December 2010 in Lilongwe will draw participation from high level government policy makers, including the Ministry of Health, the Department of Public Service and Management, Parliament, local and international non-governmental organisations working in the health sector, community service organisations and training institutions, the international donor community, academics, journalists, and heath practitioners at all levels.

Like many countries in Africa, South Asia and Asia-Pacific, Malawi has been facing a critical shortage of healthcare workers, with an average ratio of two doctors for every 100,000 people. This low number of physicians, as well as nurses, in the health care system means that treating Malawi’s 920,000 people living with HIV, of whom 59% are women, is a massive challenge.

In the past 5 years, Malawi’s long-term HRH policy strategies have addressed these problems by raising salaries, improving working conditions, and reinvesting in training institutions and students. These strategies have resulted in reopened health facilities, expanded HIV programs in prevention of mother to child transmission (PMTCT) and antiretroviral treatment, collaborations with non-governmental partners such as MSF, and human resource innovations such as task-shifting to close gaps by sharing workloads among health workers. Despite recent successes, considerable work remains to be done.

Recent global developments indicate that the health worker gap will widen, with two opposing stresses. First, global funding bodies are anticipating shortages in 2011 for HIV and tuberculosis (TB) programs. This could result in difficulty securing new medicines, reduced prevention and education programs, or difficulties attracting and retaining health worker staff to stay in Malawi. Secondly, new World Health Organization (WHO) guidelines call for the scaling-up of antiretroviral (ARV) treatment of HIV, by getting more HIV-positive people on ARV treatment sooner. The new guidelines require sustainable sources of high quality affordable medicines, health care professionals to implement the guidelines and track the performance of these strategies on their patients’ health, and a vibrant civil society who can effectively deliver messages, reduce stigma, and reinforce strategies at all community levels. While increasing and motivating the health workforce is one issue, the organization of health workers can be optimized to be able to effectively deliver HIV and other medial care and other health care services to the people of Malawi.

The key to addressing current and future critical HRH shortages lays in building strong working relationships among people, academia, institutions, policy makers, funding bodies, the medical community, and civil society. Government departments can create policy landscapes which are conducive to building up health worker compensation, working conditions, and distribution across the country. Academic institutions train our health workers and maintain current knowledge and analyze future challenges. Funders pay for medical supplies, education, program running costs, and infrastructure development. Civil society is the most effective in maintaining ongoing contact with our communities, delivering messages that are easy for people to understand and follow. Meanwhile, local and international non-governmental organizations are effective in bringing new strategies, ideas, knowledge and resources into the country and to their various partners.

MSF has been working in Chiradzulu district of Malawi since 1997, and treating HIV and Tuberculosis in Thyolo district. In recent years, MSF has increasingly been addressing HRH shortages with the main report, “Medicines without Doctors: The shortage of health workers and the scale-up of antiretroviral treatment in Malawi,” published in 2007.

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