South Africa health minister on migration of skilled health workers
Health minister, Dr Joe Phaahla, says the shortage of healthcare workers is threatening the quality and sustainability of health systems in Africa and worldwide.
“Health care is a fundamental human right. But without health workers, there cannot be health services,” he said on Sunday.
The minister was speaking at an official opening of the 24th Association of Medical Councils of Africa (AMCOA) international conference under the theme ‘The Health Workforce of the Future and its Regulation’ at the Sun City Resort, North West.
AMCOA is a membership-based organisation with over 30 country members from all regions of Africa and strives to promote best practices among the continent’s regulatory authorities and to respond to their current and future needs.
Phaahla told delegates that the world has been grappling with a “serious” shortage of healthcare workers, even before the devastating Covid-19 pandemic.
He said the under-investment in education and training and the mismatch between education and employment strategies in relation to health systems and population needs were some of the contributing factors to this catastrophe.
Phaahla described the “crisis in human resources” as one of the most pressing global health issues of our time.
In addition, Phaahla said the undersupply is concurrent with globalisation and the liberalisation of markets, which allow healthcare workers to offer their services in countries other than those of their origin.
He said workers based in rural and poor areas often move to cities for better working conditions and environments, while the urban-based leave the public sector for the private sector.
“Finally, these professionals and their colleagues in the public sector eventually immigrate to more developed countries to obtain greater pay, better working conditions, the overall better quality of life and improved opportunities for themselves and their families.”
He warned that migration to “greener pastures”, particularly in the case of professionals with exportable skills, has always occurred and will continue.
The minister has since urged regulators to deal with other associated challenges and problems.
Meanwhile, the demand for health services is increasing in light of the ageing population and the prevalence of infectious, non-communicable diseases and multimorbidity.
According to the minister, these have created greater demand for health and care workers in primary health in particular.
These shortages, he said, continue to undermine access to and provision of health services, particularly in primary care settings.
“This is the most critical challenge to achieving universal health coverage,” he said.
“Without the availability of a competent and appropriately skilled health workforce, adequate numbers and proportionately distributed, many citizens of our continent struggle to get access to the services they need.”
In addition, he noted the countries’ shrinking health budgets due to subdued economic growth.
“This certainly puts a lot of pressure on the whole health ecosystem.”
He also highlighted the impacts of the Covid-19 pandemic that has challenged the essential health systems development and provision.
The minister noted that health workers are often the most vulnerable to infectious diseases when outbreaks strike.
In the early months of the pandemic, he said health professionals made up 14% of all new Covid-19 cases, while about 80 000 to 180 000 healthcare workers are said to have died from the virus between January 2020 and May 2021.
He also recognised the importance of gender dynamics in this sector, with women constituting 67% of the health and care workforce globally.
Phaahla said improving gender equity is essential to strengthening workforce numbers, distribution, skill mix, and human resource policy and planning failures.
“We are aware that women still encounter gendered issues such as occupational segregation, pay inequality and underrepresentation in leadership and decision‐making in many countries.”
He has called on the delegates to reflect on these complex matters.
“This conference needs, as I argued before, to reflect on the kind of regulatory mechanisms needed for the scopes of practice to deliver health services in our modern societies.”