Health Policy and Financing International

Africa Needs An Estimated 3 Million Nurses And Midwives For Universal Health Coverage

The 72nd World Health Assembly has designated 2020 as the International Year of The Nurse and The Midwife. WHO Director-General, Dr. Tedros Adhanom Ghebreyesus, gave a hint as to why the Executive Board of WHO may have made the recommendation:

“Nurses and midwives are the backbone of every health system: in 2020 we’re calling on all countries to invest in nurses and midwives as part of their commitment to health for all.”

As Africa looks ahead towards the attainment of Sustainable Development Goals (SDGs) by the year 2030, the critical role of nurses in the attainment of SDG 3 – the health-related SDG – cannot be overemphasized.

SDG3: Ensure healthy lives and promote well-being for all at all ages.

Consequently, the United Nations Health Agency, WHO, is working on the first-ever The State of the World’s Nursing report which will be launched in 2020, prior to the 73rd World Health Assembly. Also, WHO is a partner in the compilation of The State of the World’s Midwifery 2020 report.

Globally, there is a shortage of health workforce but nurses and midwives constitute more than 50% of the global shortage and these two reports are meant to bring global attention to the critical role of Nurses and Midwives in the attainment of Universal Health Coverage (UHC).

UHC – “Universal health coverage is defined as ensuring that all people have access to needed health services (including prevention, promotion, treatment, rehabilitation and palliation) of sufficient quality to be effective while also ensuring that the use of these services does not expose the user the financial hardship.” – WHO 

“Nurses and midwives are essential to the achievement for universal heath coverage. The campaign and the two technical reports are particularly important given that nurses and midwives constitute more than 50% of the health workforce in many countries, and also more than 50% of the shortfall in the global health workforce to 2030. Strengthening nursing will have the additional benefits of promoting gender equity (SDG5), contributing to economic development (SDG8) and supporting other Sustainable Development Goals,” notes WHO.

But what does this mean for Africa? The African Regional Framework For The Implementation Of The Global
Strategy On Human Resources For Health: Workforce 2030 Report
noted that only 11 of the WHO Member States in Africa have been able to meet the recommended 2.3 doctors, nurses, and midwives per 1000 population.

Although there has been a general increase in the overall number of health workers in 54% of the 57 WHO Member States in Africa, the report noted that only 23% met the minimum threshold requirement of 2.3 per 1000 population as of 2015.

Furthermore, the report also pointed out that the health workforce shortage in Africa is expected to hit 6.1 million by 2030. This represents 42% of the total global shortage of 14.5 million.

Of this figure, nurses and midwives would contribute an estimated 3.05 million to the shortage in Africa, given the WHO figure that this category of health workforce represents more than 50% of the health workforce shortage.

This is quite concerning as brain drain continues in Africa. Health workers of all categories, including nurses and midwives, are exiting the continent to Europe and North America in search of greener pastures. And with Brexit, things may get worse – employment opportunities for the profession which hitherto were left for those from the EU may now be thrown open to those from Africa.

“Brain drain is particularly acute in sub-Saharan Africa,” according to the World Economic Outlook (October 2016), a report published by the International Monetary Fund (IMF). “The migration of young and educated workers takes a large toll on a region whose human capital is already scarce. The concentration of migrants among those who are educated is higher than in other developing economies. The migration of highly-skilled workers entails a high social cost, as is evidenced by the departure of doctors and nurses from Malawi and Zimbabwe, which may mean welfare losses beyond those that are purely economic.”

According to Mo Ibrahim Foundation, Africa loses about $2.0 billion annually to brain drain in the health sector alone. This is a great loss for a continent that is largely poor and struggling to keep afloat.

Yet, brain drain is one of the many reasons there is a shortage of nurses and midwives in Africa – and the African Regional Framework For The Implementation Of The Global
Strategy On Human Resources For Health: Workforce 2030 Report is clear about strategies to retain health workers in Africa.

Also, the Revised Migration Policy Framework For Africa and Plan of Action (2018-2027) also outlines specific pathways to stop this hemorrhaging of Africa’s best brains.

However, only true and unselfish commitment and determination beyond common rhetorics on the part of African countries can bring about the desired improvement in the shortage of nurses and midwives on the continent.

As the world celebrates nurses and midwives in 2020, it is also a wake-up call to action by African leaders to put their selfish interests aside and work to improve the health system of their countries. Only then can they place the continent on the path of progress.

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