Health is often defined as the art of preventing disease and prolonging life and promoting health via the organized efforts and informed choices of society, organizations, the private and public communities and individuals. The core role of public health is mainly to manage and prevent diseases, injuries and other conditions through the observation of cases and through promoting healthy lifestyles, communities and surroundings.
Health helps boost a country`s economy and population by increasing its life expectancy and reducing its mortality rates. It is a vital sector in the economy of a country. Government tends to regulate the health industry and is more or less its biggest financial payer.
Most shortages of health workers are found in countries with the worst and poorest health backgrounds. The term shortage refers to a situation where there no enough physicians and nurses and or midwives to attend to patients. It refers to the situation where the demand for health workers exceeds supply. Countries facing such a crisis lack the ability to provide the necessary life saving interventions and the ability to fight diseases.
Basing the World Health Organization (WHO) statistics the sub Saharan countries facing this crisis, would need a 140% scale up so as to reach the millennium declaration targets in terms of attaining international health development. This problem is so serious such that in some cases there is usually insufficient human capacity to absorb or even efficiently use the additional funds that are in most cases viewed as necessary in the improvement of health in these countries.
Shortage of allied workers in the present
One of the causes of health worker shortages in the sub-Saharan Africa includes; the past investment shortfalls in pre service training this refers to the instruction that takes place before one begins the actual task or job. This training has a number of benefits. The trainee will be able to focus all his/her attention on learning without having any other distractions or outer responsibilities; this enables one to put into practice the skills acquired in school. This training should be undertaken and a certificate awarded thereafter as evidence of full mastery and total understanding of the course done.
Another cause of these shortages is the international migration. This is where people cross boundaries and stay in the host country for a period of time for a different reasons. Some people could migrate education this for students who want pursue their studies abroad. Most of these do not return to their home countries where they are needed the most. Other reasons for migration could include political conditions, forced migration, business migrants etc. some of these international are permanent while others could be temporary; they both have significant effects on both country’s economies.
Another reason is premature retirement; this is where one retires before attaining the absolute retirement age that has been sent by the government to a public servant. Most health workers resign before their actual retirement age and the cause of this would be fatigue caused by overworks or job tiredness, others could resign so as to join other professions and for this reason there will be a shortage in the medical industry. Another cause of shortage is the changes in careers among health workers; these changes could be triggered by the following reasons. Poor pay/wages, this is where one moves to a profession where he/she receives a better salary. In some countries the health workers get very low salaries thus are forced to find other better paying jobs. Others might leave the health profession since its too demanding and too time consuming. Others might quit since they’ve had a change of lifestyle or change in ones future dreams, This is when a health workers cease to be interested in medical profession and no longer experience job satisfaction. This is what is known as job burnouts.
Another reason for job shortage could be premature mortality and morbidity. Morbidity refers to the state of being unhealthy while mortality refers to the condition of being susceptible to death. This is where health workers quit since they are more exposed to contagious and deadly diseases therefore some may quit out of fear of death, while others might just quit out of illness or deterioration in their health status.
This shortage limits the capacity of national governments to design and implement appropriate intervention programmes. Health workers shortage can be measured when the nurse to patient/population ratio or the number of jobs available still requires an additional number of nurses than currently available. This is mainly the case in developing and developed nations around the world.
The cause of this shortage is not mainly lack of supply of health workers in an area and in some instances it increases with increase in number of student’s medical school. Therefore, another possible cause of this type of shortage could include inadequate worker retention incentives. This refers to a situation where workers are not properly motivated to stay in the profession and the other aspiring ones also lose interest in it. There also the absence of placement programs for the newly trained nurses and physicians. Another cause of shortage could be due to technological advancement, where some countries lack qualified health workers who have the technological knowhow.
The US has an aging population, and this type of population usually creates an increased demand for health care services. This means that there is very high demand for health care and little supply. Most people are in need of care and there are few people to provide it due to retirements. This results to shortages. This shortages limit the number of patients that can be accommodated in a hospital`s critical care and surgical unit, this sometimes forces these hospitals to transfer some patients to adequately staffed hospitals.
These shortages usually prevent hospitals from expanding their services so as to meet the society`s demand. Other shortages, an example of radiology, make high tech diagnostics services and others like radio surgery unavailable to patients. This shortage also contribute to the increase in number of patient deaths this is because of long working hours and low staff levels which contribute to errors. This type of shortage automatically affects a region`s economic development. The health sector is one of the highest income generators. It also makes an area attractive to investors and educational institutions. These areas need to direct more finances to the health sector. Health workers are the cornerstone of the health systems, therefore their under functioning has led to the current health worker crisis. World Health Organization aims for national leadership supported by global solidarity so as to face this crisis.
The wage ceilings should not prevent the workforce expansion it thus advocates that a status of exception should be given to public spending, it exhorts donors to ensure long term financing, and great emphasis should be given on the support for the health workforce coordinated and aligned with emergency national strategies. The wealthy nations should enhance the adoption of ethical recruitment codes so as to controls migration.
The World Bank and International introduced structural adjustments policies (saps) so as to foster economic stability. These saps bring about cuts in the public expenditure that decrease government’s ability to expand and maintain infrastructure so as to provide necessary supplies and equipment and to train and sustain competitive salaries for the health workers. Also so as to exacerbate matters since the World Bank displays workers as being lazy and prone to absenteeism.
Causes of health workers shortages in the past
One cause of the health worker shortage in the past was the underinvestment in health worker education, its training, wages management and working environment. These factors made people disinterested in the profession. Only the few bright and rich students could pursue medical courses and nurses and were highly respected. Another reason was the lack of formal education where education was passed by word of mouth therefore most information was lost with time and some of it lost meaning and became distorted as it moved from one generation to generation.
This was so because there was informal education, most health workers comprised of midwives and medicine men; this before the introduction of science and technology thus medical backwardness. During this period not anybody would become a medicine man, one had to be from a specific family lineage. Also in the past most people did not view medicine as a source of livelihood so most put opted for farming and mercantile for their livelihood. Medicine was left to the missionaries.
Also there is the issue of poor infrastructure and language barrier which made it hard to spread education. Most areas were inaccessible medicine was not much of an interesting field of study at the time.
The poor technology also contributed to the shortage of health workers, this is mainly because there were only few hospitals and even these hospitals lacked the necessary machinery to foster health care. In some developing countries the study of medicine was viewed as an outside culture thus they did not to adapt it. They believed in traditional doctors, the likes of medicine men and witch doctors. Another cause of shortage is migration, most communities in the past had nomadic lifestyles especially in the sub Saharan countries thus they lacked enough time to study diseases in depth.
Another reason is that in the past most of the European countries had their focus on colonization thus they concentrated more on developing countries and getting power thus they concentrated more on the sub Saharan countries rather than issues like medicine and health care.
Another factor that led to the shortage of health workers in the past is the civil unrests persistent within the western countries during the colonization period most their focus was on wars and most of their funds was directed to the purchase of ammunitions. They put little or no focus on health.
In comparison of the past to the present, the number health worker has increased with a significant number. There are more health workers today than there were in the past, due to the encouragement from various government projects, increased funds directed to the health sector and to medical study more finances and time is also directed to medical research and science projects. Generally medicine has been taken more than it ever was in the past.Also the factors that hinder people from joining the health sector have been dealt with and people now receive better salaries now and medicine is viewed as a profitable career profession.
More students are pursuing medical courses now as compared to the past. Also the level of technology has improved today as compared to the past therefore this has contributed a lot to the improvement of health today and the increase in the number of health workers. There also greater improvements in infrastructure thus almost areas have become accessible. Medicine is also viewed as a prestigious profession today so doctors are viewed as respectable members of society; fewer people seek medical advice from medicine men at present times. Also there is the economic growth thus people in the health sector are well paid today as compared to the past thus more are flocking to the health sector than they did in the past this is mainly because today everyone is striving to earn a living. The increase in number of health workers has been triggered by the increase in level of literacy which was very low in the past and has improved greatly with time. The government is using more efforts to encourage the citizens to venture into health sector.
Though the number of health workers has decreased today, it is still significantly higher than it was in the past.The health worker shortage has jeopardized the attainment millennium development goals in the developing countries and has affected their standards living in these countries this is mainly due to the increase in child mortality rate resulting from the poor medical conditions and the shortage of experienced midwives and poor maternal health; this also results from the decrease in life expectancy. There is a significant rise in the number of women who die while giving birth and the number of still births and/or those who die within the first days of birth out of preventable diseases and conditions. However, there is a significant decline in the health worker shortage; this is because a number of strategies have been adopted. There is a commission responsible for the recruitment of health workers, their salaries and their motivation. This commission is also responsible for recruitment of overseas health workers and receives technical assistance.