The U.S. Commitment to Global Health Recommendations for the Public and Private Sectors (2009) / Chapter Skim
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4 Invest in People, Institutions, and Capacity Building with Global Partners
4 Invest in People, Institutions, and Capacity Building with Global Partners
Pages 107-130
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From page 107... ...
LONG-TERM INSTITUTIONAL CAPACITY BUILDING Much of the international community's work in building the capacity of public health practitioners and researchers in low- and middle-income countries has borne noticeable results. Once dominated by health experts from advanced economies, the field of public health now reflects a more diverse and globally representative group of experts and organizations.
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From page 108... ...
have trained the workforces of low- and middle-income countries in good research, laboratory, and clinical practices as a secondary outcome of their clinical trial work. While such efforts have helped to provide trained health workers and researchers, a lack of institutional support within these countries has often driven away the most promising and well-trained practitioners and researchers.
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From page 109... ...
Yet the challenges faced by these nations in delivering quality and equitable health services require capable leaders, managers, analysts, practitioners, and researchers to identify problems and solutions that can influence public health policy. Many low-income countries have neither a critical mass of researchers and health workers nor sufficiently funded institutions to conduct the research capacity to cancer, cerebrovascular disease, lung disease, obesity, lifestyle fac tors, and genetics as related to chronic diseases (FIC, 2008)
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From page 110... ...
In particular, the committee finds that by sup porting these institutions, the United States can help to develop an environment of inquiry, entrepreneurship, and experimentation that brings together researchers, practitioners, and policy makers, across disciplines and borders, to solve some of the pressing health problems facing less wealthy nations. Expand Commitment to Institutional Capacity Building The United States still has much to contribute in building academic and research capacity in low- and middle-income countries, given its expertise in research, science, and technology.
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From page 111... ...
government should continue the tradition of funding capacity building initiatives and expand this commitment to leverage the growing interest of academia, nonprofit organizations, and commercial entities. With increased support, research institutes could adopt innovative methods and technologies for distance learning and collaboration and, thus, help to reshape education and research in global health.
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From page 112... ...
Centers of Expertise are promising, especially in the initial stages of capacity building, because they afford some coordination among multiple, differentiated institutions, which can help to propel and sustain entire professional fields. BOX 4-2 National Public Health Institutes: Integrating Vertical Programs and Enhancing Public Health Capacity National Public Health Institutes (NPHIs)
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From page 113... ...
Numerous institutions in low- and middle-income countries have been able to take advantage of long-term partnerships to build their institutional capacity. Makerere University in Uganda is an example of an institution that has leveraged multiple partnership compacts with universities, commercial industry, foundations, and PDPs to reestablish the uni versity as a leading institution in sub-Saharan Africa (see Box 4-3)
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From page 114... ...
THE U.S. COMMITMENT TO GLOBAL HEALTH BOX 4-3 Rebuilding Uganda's Makerere University Through Institutional Partnerships Makerere University, established in 1922, is one of Africa's oldest universities.
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From page 115... ...
Institutional partnerships should play an explicit role in helping to educate and train leaders, researchers, teaching faculty, health workers, and professionals (such as managers, public health practitioners, and policy ana lysts)
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From page 116... ...
By contributing to solving some of the most pressing global health challenges through a specific focus on, for example, human resource capacity issues, partnerships can have a meaningful and real-time effect on the ongoing delivery of care within a particular country or region. This will enhance the credibility of the local institution, both with local policy makers and with external donors who may be skeptical of the benefits of long-term capacity building investments, and offer opportunities to partner with service delivery programs such as the President's Emergency Plan for AIDS Relief or President's Malaria Initiative.
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From page 117... ...
Global Health Workforce Deficits Are of Crisis Proportions Human resources are critical to improving global health. The density and quality of the health sector workforce directly affects health outcomes, with increased density being associated with reductions in maternal, infant, and under5 child mortality (Anand and Barnighausen, 2007; Chen et al., 2004)
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From page 118... ...
. The same poor working conditions that prevent health workers from performing at the highest level have also "pushed" many health professionals in resource-poor settings out of the public sector entirely, with many choosing to emigrate to higher-income countries that are experiencing a health workforce shortage (Aiken et al., 2004; Arah et al., 2008)
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From page 119... ...
. Health Workforce Plans Depend on Donor Support To address the health workforce crisis, many countries have set out to estab lish human resource plans to deal with clinical workforce deficits, as well as shortages of administrators, managers, policy analysts, public health specialists, and academicians in higher learning institutions -- all of whom are key to ensuring a well-functioning health system (see Box 4-4)
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From page 120... ...
. While wage discrepancies between locally financed positions and internationally financed positions exist and may be especially problematic in areas that receive significant international funding for programs such as HIV/AIDS (Shiffman, 2008)
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From page 121... ...
Donors should be cognizant of the potential effect their efforts to recruit health workers and professionals may have on local public health recruitment efforts. The demand for health workers in the United States and other advanced
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From page 122... ...
Migration is a symptom of more serious issues of chronic lack of reinvestment in the health workforce and health systems of low- and middle-income countries that encourage workers to migrate to wealthier countries. Addressing the human resource crisis in the health sector
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From page 123... ...
Federal executive branch agencies and departments, nongovernmental organizations, universities, and other U.S.-based organiza tions that conduct health programs in low-income countries should align assistance with the priorities of national health sector human resource plans and should commit and sustain funding in support of these plans.
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From page 124... ...
The 2005 Institute of Medicine report Healers Abroad: Americans Responding to the Human Resource Crisis in HIV/AIDS recommended that the federal government create and fund an umbrella organization called the United States Global Health Service (GHS) to mobilize the nation's best healthcare professionals and other experts to help combat HIV/AIDS in severely affected African, Caribbean, and Southeast Asian countries.
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From page 125... ...
workforce to contribute to solutions that partially address health workforce deficits in low- and middle-income countries. This explora tion should include an inquiry into the willingness of Americans to partici pate in a global health service corps; a determination of whether this kind of assistance would be well received by recipient countries; and an examination of whether specific opportunities exist to help migrants from low-income countries return home to work temporarily or permanently.
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From page 126... ...
2007. Health workers and vaccination coverage in developing coun tries: An econometric analysis.
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From page 127... ...
A Call to Action: Ensuring global human resources for health. Paper presented at International Health Workforce Conference, Geneva, Switzerland.
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From page 128... ...
2007. The contri bution of international health volunteers to the health workforce in sub-Saharan Africa.
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From page 129... ...
Geneva, Switzerland: WHO. WHO and GHWA (Global Health Workforce Alliance)
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