Dr. Mario Roberto Dal Poz, Talk on Human Resource for Health Research Agenda
‘It is critical that existing information is reviewed comprehensively, and utilized for extraction of actionable intelligence, before jumping to introducing new strategies or policies for professionals’, said Dr. Mario Roberto Dal Poz, renowned WHO expert on health workforce planning and crisis management and Professor Global Health and Health Workforce Crisis at the Rio De Janeiro State University, Brazil.
Dr. Mario was talking to faculty members, research experts, students and representatives from Institute of Public Health, King Edward Medical University, Fatima Jinnah Medical University, LUMS, Punjab University, University of Health Sciences, Department of Health, at the Expert Speaker Series organized by the Punjab Public Health Agency, Department of Health, Government of Punjab here in Lahore.
WHO reports that 55 percent population in the lower and middle-income countries (including Pakistan) does not have access to health care because of critical health workforce (HRH) deficit. This figure stands at 23 percent for upper-middle income countries and 0 percent for high income countries. Pakistan has one of the lowest densities of health workers both regionally and globally. In April the National Ministry of Health Services, Regulation and Coordination, Islamabad reported physicians and specialists’ density of 0.96 per 1000 population, and of nurses, lady health visitors (LHVs) and midwives at 0.49 per 1000 population. This is much below the WHO threshold of 4.45 physicians, nurses and midwives per 1,000 population. This is regarded necessary to achieve universal health coverage. Based on the current UN reports, by 2030 the global shortage of health workers is expected to be 18 million, with Pakistan at a shortfall of 1 million health workers.
Senior faculty members and researchers attending the session had an invigorating discussion, identifying the research needed in the area of HRH for guiding policy makers and facilitating evidence based reforms in medical education and for creating an enabling environment for health professionals. The issues discussed included increasing number of medical institutions and the growing number of applicant pool in Punjab; feminization of medical profession; migration of health workers; and investigating the mix of health workforce that will help Pakistan achieve SDGs and UHC by 2030. Dr. Mario while elaborating upon the intricacies of research involving HRH stated that ‘it is also equally important to understand the long-term multi-sectoral consequences of policy decisions, hereby making research in HRH even more critical.’. He emphasized that instead of jumping to monetary incentives, promotions or other allowances, there is a need to utilize the available scientifically validated tools and aids to study and assess the needs of workforce in the country, and their expectations across various parameters. This is expected to facilitate design and introduction of health workers policies that are more likely to be effective in our context.
The ensuing discussions revolved around research related challenges in Punjab, researching capacity deficits and limited focus on health workforce planning. Dr Shabnum Sarfraz, CEO PPHA shared the latest health workers data in Punjab i.e. 1 Physician to 2920 populations; 1 Nurse or Midwife to 3084; 1 allied health professional to 25002 and 1 paramedic to 2542 population. She also informed that Punjab is contributing 5 percent to the overall global HRH deficit.. The situation continues to aggravate due to dearth of contextualized research and evidence to inform policy and programmatic decisions. Dr Ayesha Humayun from Sheikh Zayed emphasized on limited scope of HRH-related research and limited understanding of the labour market dynamics. Dr Mario took this occasion to elaborate upon the health labour market framework, highlighting the critical information gaps with respect to the pool of eligible students, and the need to create knowledge in the area.