This Week's News
25-29 January 2010
Weekly news clippings service featuring articles on the Global Health Workforce Alliance and selection of articles from around the world on the issue of the health workforce crisis
The Global Health Workforce Alliance¦Africa & Middle East ¦
Asia & Pacific ¦ North America ¦ Europe ¦ Latin America & Caribbean ¦ News from WHO and partners
This compilation is for your information only and should not be redistributed
Job market for nurses tightens in New York state, study says
The Post-Standard, NY
Report: Retirements could thin ranks of nursing assistants
La Crosse Tribune, Wisconsin
G8 agenda: Focus on human welfare
The Toronto Star
Practical nurses staying in HEU
BC Local News, Canada
Screening in the blood system (Letter)
Globe and Mail, Canada
UWE midwife supports expectant mothers in Sierra Leone
US nurse shortage boost for locum supplier
Financial Times, UK
Budget Must Provide 'Stimulus Package' For Health - Australian Medical Association
Medical News Today, UK
Stillborn babies, births in cars... the real cost of midwife
The Sun, UK
Healthcare providers sometimes take part in torture and ill treatment, report alleges
Maisons de santé : un rapport prône des rémunérations plus incitatives
HAÏTI : 4 axes prioritaires de prise en charge sanitaire
Saint-Gaudens. Centre hospitalier : 34 nouveaux aides-soignants diplômés
Benavente quer reunião "urgente" com ministra da saúde
Agência Lusa, Portugal
El Defensor del Paciente pide que se investigue de oficio el funcionamiento de los quirófanos del General de Castellón
Europa Press, Spain
Latin America & Caribbean
Hospital Darío Contreras repleto de pacientes; dan de alta a niños
Hoy Digital, DR
Faltan especialistas y enfermeras en el IMSSS
La Verdad de Tamaulipas, Mexico
Solicitan la contratación de enfermeras para el Hospital Regional Número seis del IMSS
Fundasalud: Sucre tiene un déficit de 300 médicos especialistas
El Tiempo, Venezuela
Salario del médico en el país es el más bajo del mundo
El Universal, Venezuela
En la glosa del sector salud salió a relucir la falta de insumos y camas
La Jornada Aguascalientes, Mexico
Sin atención especializada los hospitales
Aprueban presupuesto para FOSALUD
Diario CoLatino, El Salvador
News from WHO and partners
Midwifery and Nursing Schools Destroyed by Haiti Earthquake
Tom Daschle and Nigel Crisp discuss Global Health Care
Update: Emergency surgery and planning for the longer term in Haiti
Global Health Workforce Alliance
PEPFAR, IHP+ review action on global health workforce commitments
27 January 2010 | PEPFAR and IHP+ have released today a synthesis document reviewing progress on their collaboration with the respective Ministries of Health in Ethiopia, Kenya, Mozambique and Zambia. This work results from the joint commitments of former President Bush and Prime Minister Brown to increase the health workforce in Africa in April 2008. The initial announcement included PEPFAR funding of $1.2billion for 2008-2013 and DFID pledge of GBP£210 million between 2008-2010 for human resources for health development in these four ‘overlap’ countries. This announcement has been a contributing factor to the high level commitments on HRH made by G8 leaders in 2008 and 2009.
The synthesis paper, entitled Taking Forward Action on Human Resources for Health in Ethiopia, Kenya, Mozambique and Zambia: Synthesis and Measures of Success, outlines six measures of success to strengthen national HRH strategies and reduce the gap in health workforce shortages. These are:
•supporting comprehensive, costed health workforce plans consistent with broader goals;
•strengthening human resources information systems and broader workforce surveillance;
•enabling the training, deployment and retention of a jointly-agreed targeted number of additional health care workers by 2013;
•monitoring the distribution of the active health workforce;
•tracking workforce movement into and out of the national health sector; and
•reviewing fiscal space for health following the principles of the Paris Declaration and the Accra Agenda for Action.
"PEPFAR teams in the countries are supporting workforce development, human resources for health information systems, retention strategies and technical assistance to Ministries of health," said Joan Holloway, a representative of the U.S. Global AIDS Coordinator (OGAC)/PEPFAR.
"As one of the IHP signatories DFID is now acting on the recommendations, including new technical and financial assistance requested by our national partners. This joint work demonstrates the value of partnerships to tackle country-specific HRH challenges and has identified opportunities for improved harmonization and alignment of priority activities and funding at the country level,” said James Campbell, adviser for HRH, DFID. As the four countries lead their next phase of actions there is a greater clarity on the respective advantages of the technical assistance and financing streams from both the IHP+ and PEPFAR.
"Joint analysis by countries and partners in an effort to fulfill the promises by global leaders on HRH, is a welcome sign for more coordinated and comprehensive action," said Dr Mubashar Sheikh, Executive Director of the Alliance. "The Alliance is also encouraged to see the utilization of the Kampala Declaration and Agenda for Global Action as a framework for review of the four country reports. We look forward to full delivery of commitments by donor and national governments and partners for better success in HRH going forward," he added.
:: Taking Forward Action on Human Resources for Health in Ethiopia, Kenya, Mozambique and Zambia: Synthesis and Measures of Success [pdf 147kb]
:: Ethiopia [pdf 1.43Mb]
:: Kenya [pdf 824kb]
:: Mozambique [pdf 1.18Mb]
:: Zambia [pdf 1.38Mb]
:: GHWA welcomes US/UK announcement on increasing health workforce in Africa (21 April 2008
"Doctors and Nurses", BBC full length documentary film available online
Full 22 minutes version of the film available at http://rockhopper.tv/programmes/318. The film can also be seen on the Alliance YouTube channel at www.youtube.com/user/ghwavideos. If you wish to use the film for information, education or advocacy purposes, you can request for DVD copies, by writing to firstname.lastname@example.org.
Editorial Board — RECENT protest by some pregnant women in Osun State against what they described as shoddy services at a general hospital in Asubiaro, Osogbo, is to say the least, a reflection of the frustration of Nigerians with the deplorable state of the nation's public hospitals.
The protesting women, who were at the hospital for antenatal care, were forced to take the action when many of them were not attended to after waiting for several hours, a situation, which they claimed, led to the collapse of two of their colleagues.
The women also alleged that some of the medical workers attending to them had complained of shortage of staff and inadequate power supply.
Although the state commissioner for health, Mr. Lanre Afolabi, said there was no such protest, but that a few pregnant women over reacted to a slight delay when the antenatal cards were being sorted out, his denial, in no way, mitigates the grave import of the pregnant women's action.
Lack of basic infrastructure required to support efficient primary healthcare has remained one of the most visible maladies of the nation's healthcare system.
Government institutions,, including teaching hospitals, have continually suffered this handicap, which usually manifests in insufficiency of beds and space to accommodate patients, as well as lack of essential drugs and medical equipment for diagnosis and treatment.
Added to these is dearth of medical personnel, a situation that is being worsened by the progressive exodus of the existing medical experts to other countries in search of greener pastures.
When they are not going abroad en masse, the doctors in government employment resort to doing private practice, giving scant attention to their official duties.
The consequences of these on maternal and child healthcare are obviously severe, since the pregnant women and children are usually more vulnerable.
It is, indeed, a shame that a country like Nigeria, with all its resources, both human and natural, has continued to top the list of countries with sorry statistics of maternal and infant mortality.
For instance, UNICEF and World Health Organisation (WHO) statistics place Nigeria second, only to India, as the country with the highest maternal mortality rate in the world, contributing over 10 per cent of the total world estimate of maternal deaths.
A breakdown of these disturbing statistics show that between 800 and 1,500 women die in every 100,000 live births as pregnancy-induced death claims one woman every 10 minutes.
Thousands of others experience otherwise preventable injuries, infections, diseases or disabilities that can cause lifelong suffering every year.
Some of these disabilities include obstetric fistulae, ruptured uterus and paralyses as well as complications such as Vesico Vaginal Fistulae (VVF).
Related to maternal mortality is the equally worrisome infant mortality rate. This has remained on the high side, with about 105 deaths in 1,000 live births, and rising under-five mortality rate of about 178 to 1,000 births.
The protesting pregnant women, were therefore, merely stating the obvious - that reduction of maternal mortality, infant mortality and other preventable deaths or disabilities can be achieved if those in authority are committed to provision of quality health care and prevention of systemic corruption.
So far, there is no serious evidence of this resolve, hence the protest of the pregnant women should be seen as a wake up call on all those concerned to redouble efforts to overhaul the public healthcare delivery system of the country.
Doctors and nurses must be trained or attracted back to the country and kept to man the healthcare sector generally but particularly, primary healthcare facilities, especially in the rural areas, where the bulk of these women, most times, lack access.
Part of the problem appears to be the penchant of leaders to seek medicare abroad, most times with corruptly acquired funds, in the process, abandoning the standardization of healthcare facilities in the country.
The various tiers of government must come to terms with the fact that preventable deaths and disabilities, including maternal deaths, are pressing human rights issues for which they would be held accountable. The earlier they understand this, the more lives that will be saved for the nation.
Also, if the contributions of women to the economy are, indeed, central to the well being of the nation, then concrete steps must be taken to stem the tide of maternal and child mortality.
Improvements in maternal health, no doubt, impact positively, not just on the lives of women, but also on those of their children, families, communities and the nation at large.
Interventions must be scaled up so that essential care can be provided throughout pregnancy and childbirth, and also during the post-natal period, so that those who go to give life do not lose theirs in the process.
The protest by the pregnant women in Osun State, has brought these messages of health for pregnant women and health for all to the front burner. To that extent, the action is commendable. The authorities must thus do everything possible to ensure that the conditions that led to the protest are redressed once and for all.
Shortage of doctors hinders service delivery Daily News, Botswana
MOLEPOLOLE - Residents of Goo-Ntloedibe ward in Molepolole say the state of the art Scottish Livingstone Hospital is not living to expectations due to a serious shortage of doctors.
They raised the complaint during kgotla meeting addressed by the Member of Parliament for Molepolole South, Mr Daniel Kwelagobe.
They further said the hospital has serious shortage of water which hampers service delivery, adding that it seems the hospital staff does not care much about attending the patients on time as it is expected of them.
They also indicated that they are often delayed when they come from the other side of the village because they are not able to access the only gate quickly, and therefore they pleaded with the relevant authorities to at least consider opening another gate so as to serve those customers who are from the other side of the village.
Residents further said that there is a serious need for a clinic at their ward so as to ease congestion at the hospital, they even suggested that the old Scottish Hospital building could be used as a clinic.
On other issues residents complained that they do not know their social worker as she is never around to help and she is not accessible, the village development committee (VDC) also indicated that the social worker rarely tells them when she is supposed to go somewhere on duty.
They indicated that the people in that ward are not assisted accordingly to by the social worker as she is not always there as expected.
They also complained about the overcrowding of Lewis Primary School, saying that a teacher is supposed to be teaching a classroom with a capacity of 40 pupils but that is not happening and end up teaching 80 pupils.
Therefore they pleaded with the relevant authorities to increase the number of classrooms so as to accommodate a number of pupils.
They also complained about the stones in their school premises saying that time and again the school proceedings are interrupted as the children are injured and have to be taken to the hospital.
In response, Mr Kwelagobe promised to inform the hospital management about the issues raised as well as the Minister of Health, especially on the shortage of doctors.
He said on the single gate he was once given the explanation that, a single gate was opened to protect the hospital against trespassers who might threaten patients and the hospital equipment and materials.
The social worker from Kweneng District Council Mr Kealeboga Tsietsang said their assumption was that the residents know their social worker because just like in any other ward they receive assessments and reports from Ntloedibe ward.
However he promised to attend to the issue. BOPA
Togo spends US$ 21 million on health in 2009-2013 Afrique en ligne
The Togolese government will spend a total of CFA F 10 billion (about US$ 21 million) on health development in the country between 2009 and 2013, according to a communique of the Council of Ministers, issued here Friday.
The communiqué, published in the state-run daily Togo press Friday, said that under the project, the government would recruit more workers from paramedical schools, organize basic training in the health sector, and encourage people to pursue careers in various medical fields.
The ministers disclosed that the decision followed the shortage of qualified hands in the country's health sector
Hospitals in bid to plug staff shortage Business Daily Africa
By BEATRICE GACHENGE
Seven public hospitals are set to partner with local universities to offer medical training in a move that could help Kenya plug the biting shortage of qualified personnel in the health sector.
The facilities, which have undergone renovation and equipping, are expected to admit their first students in the second half of the year, according to Medical Services minister Anyang’ Nyong’o.
The plan will see Maseno University, Jomo Kenyatta University of Agriculture and Technology, Kisii University College and Catholic University join the list of institutions offering medical training.
University of Nairobi, Moi University, and Kenya Medical Training College are currently the main institutions offering medical training. Ministry of Health officials say the biggest challenge to meeting human capital needs for the health sector has been lack of hospitals that meet the criteria for training.
Kenya is grappling with a shortage of close to 8,000 medical personnel, a shortfall that has been partly blamed on brain drain and a general failure by local institutions to produce a steady stream of trained personnel. Institutions are not allowed to train medical personnel without affiliation to a recognised hospital.
“We want to upgrade all provincial hospitals to referral status, so that they can deal with most of the cases referred to Kenyatta and Moi referral hospitals. That should enable them to enter into partnerships with universities and offer medical training,” said James ole Kiyapi, the Medical Services permanent secretary.
Health experts have warned that failure to fix the human capital shortfall risks throwing to waste the billions of shillings that the country spends on health every year.
The government plans to spend Sh47 billion on the health sector this year, making it the third largest item in the national budget after education and infrastructure. Under the new arrangement, Nyanza Provincial Hospital, Thika District Hospital and Kisii Level 5 Provincial Hospital will partner with Maseno, JKUAT and Kisii University College respectively to offer courses in clinical medicine.
Catholic University has already signed up an affiliation agreement with Mbagathi and Mathari hospitals, to offer degree programmes in nursing while Outspan Medical College will link up with Nyeri and Karatina hospitals under a partnership that is awaiting the ministry’s approval.
Francis Kimani, the Director of Medical Services, told the Business Daily that to qualify as a training institution, a hospital must have specialists in various medical disciplines and proper equipment.
“The doctors must also have the ability to handle complex health cases on referral from other hospitals,” he said . It is estimated that only 380 new doctors join the workforce annually from Nairobi and Moi universities.
UoN, which has partnered with Kenyatta National Hospital accounts for the bulk of the trainees at 300 with the rest coming from Moi University.
“For a population of close to 40 million people, Kenya should have at least 5000 doctors up from the current number of only 2000. The training facilities should be at least 37,” said Prof Nyong’o.
It is only in the last three years that more players have added medical courses in their education program offering.
The first batch of graduates taking degrees in Medical Laboratory Science and Infectious Disease Diagnosis are expected to join the labour market in 2012 from Kenyatta University, which has partnered with Machakos Provincial Hospital to offer the training.
According to the 2009 Economic Survey, the number of registered medical students increased from 3,761 to 5,814 between 2004/2005 and 2008/2009 academic years.
The increase was attributed to introduction of medical courses at Kenya Methodist University, University of East Africa, Baraton, Aga Khan University and KU.
“We expect to reduce exodus of the medical personnel by training more people such that even is the private sector picks some, we shall retain a huge chunk of them,” said Prof Kiyapi.
Nurses shun rural areas New Era, Namibia
by Wezi Tjaronda
WINDHOEK – Health facilities located in Namibia’s remote areas are increasingly finding it tough to attract suitable personnel.
Apart from the acute shortage of nurses that already exists, the situation is compounded by health workers that either decline to be posted to outlying areas or resign after serving the communities for a short time due to the remoteness of the areas in which the health facilities are located.
The Kunene Region is a case in point. It has 36 vacancies for registered nurses and 16 for enrolled nurses. Of the 17 and 16 vacant positions for registered nurses in Opuwo and Khorixas health districts, 14 and 6 respectively are for peripheral clinics and health centres.
The Outjo health district has three vacant positions for registered nurses, six each for Opuwo and Outjo for enrolled nurses and four for the Khorixas health district.
According to statistics made available to New Era from the Kunene Regional Health Directorate, two registered and two enrolled nurses who were offered positions in Opuwo district declined to take up their positions.
“These posts are mostly declined due to the remoteness and long distances between the hospitals and the clinics,” said Kunene Regional Health Director, Linda Nambundunga.
She said the directorate was happy until December last year. Come January when nurses were offered positions in Otjimuhaka, Otjokavare and Sesfontein, the nurses declined to take up the posts.
“The posts are there, but we need the body, ” she added. Due to this situation, nurses work for long hours. Even community leaders pity the nurses saying they work 24 hours with no rest.”
“The worker does not sleep. If he wants to sleep, a patient knocks at the door,” added Jonas Jafet, a member of the Heath Care Committee of the Otjimuhaka Clinic.
Rahenduka Tjambiru, a relief nurse at the clinic, which is along the Namibian-Angolan border, said apart from personnel shortages, the clinics face a host of other challenges including communication, shortage of power and water.
“We have to get water from the river and use torches or candles to attend to patients at night,” he said.
Minister of Health and Social Services, Dr Richard Kamwi, who was on a visit to the region last week to familiarise himself with the extent of the measles outbreak, expressed concern over the shortage of nurses in the area. Measles also broke out in eight districts of other regions but has since been contained.
Kamwi urged the regional health management team to propose incentives to the ministry’s National Management Meeting, as the government designs incentives to attract and retain health workers in remote areas of the country.
“Come up with incentives like cellphone allowances. These nurses are suffering.
Others run away as they work day and night serving people that are as far as 100 km away,” he said.
Kamwi also asked the management at regional level to make use of nurses from Kenya, Zimbabwe and Zambia, whom he said, “do not seek luxury but want to work and earn their money”.
“Let us not allow our people to die because young nurses want to go to Windhoek,” he said.
Ohangwena, Omaheke, Omusati and Karas regions are some of the regions where nurses from Kenya have been posted.
Brink Karutjaiva, an enrolled nurse who has worked at the Epupa Clinic since 2002, said sometimes people were posted to remote areas without consulting them, hence the resignations.
Health workers' welfare in focus The Observer, Uganda
Written by Evelyn Matsamura Kiapi
Civil Society Organisations are calling upon the government to prioritise construction of staff quarters as a means of attracting and retaining health workers, especially in rural areas where the majority of people live.
Uganda is currently facing a health workforce crisis that threatens the quality of care and health rights of the populations because majority of health workers still lack basic accommodation.
This has also exacerbated the problem of absenteeism and vacancies in the health system, and led to an unequal distribution of health workers, the CSOs say.
There are also concerns about the safety of health workers who have to walk long distances to and from their rented houses far from the confines of their respective health centres or hospitals.
For instance, there are reports of midwives being attacked by thugs on their way back home late in the night. Others have failed to show up for emergencies due to lack of transport and long distances between their homes and the health centre.
Civil society groups recommend that all health workers should be housed in the proximity of the respective health centres and hospitals in which they work, for efficiency and effectiveness.
Government is obliged to provide free accommodation for health workers but the recent Ministry of Health Joint Review found that on average only 20-25% of health workers were accommodated at their work places.
“Housing for health workers is not a new idea. In fact, it already exists, but the numbers are inadequate and unevenly distributed,” said Patrick Bateganya, General Secretary of the Uganda Nurses and Midwives Union (UNMU).
“Even more, for the ones that exist, many are not in good condition.”
A well-known example is the 26 overstretched and dilapidated houses at doctors’ village at Mulago Hospital, meant to accommodate post graduate students.
These houses now accommodate more than 300 people - three adult families per house! More to that, some houses caught fire late last year, leaving several families homeless. Currently, 20% of health workers’ salaries are for housing allowance, but considering the high cost of living, the amount is inadequate.
“Furthermore, securing accommodation is also difficult, particularly in rural areas, which has resulted in staff walking long distances and exacerbating the feelings of discontent with their working environment and dissuading potential new recruits,” says Apollo Nyangasi, National Coordinator of the Health Workforce Advocacy Forum Uganda (HWAF –U), a coalition of health professional associations, trade unions and health rights organisations.
They include Action Group for Health, Human Rights and HIV/AIDS (AGHA), Uganda Medical Association, Students for Equity in Health Care, and Voices for Health Rights.
This lack of accommodation has also contributed to migration of health workers for greener pastures. Uganda currently has approximately 0.8 health workers per 1,000 people, almost three times lower than the World Health Organisation minimum recommendation.
There are also approximately 2,500 physicians working in the country, thus a 1:11,000 ratio, records show. The situation is even more desperate in the rural areas where working conditions tend to be poorer than in urban areas, says Nyangasi.
For instance, according to the Annual Health Sector Performance Report 2008-09, while 56% of approved positions were filled, only 15% of districts had filled the minimum agreed positions, because of lack of accommodating facilities.
“Consequently, the lack of health workers seriously hampers the quality of care that patients receive, which in turn has a detrimental impact on the health of the population,” Nyangasi explains.
“Providing staff housing is a simple and sustainable solution that provides health workers the incentive to accept positions in underserved areas.
While government has developed a Motivation and Retention Strategy that addresses the issue of health infrastructure – particularly the minimum level of staff accommodation at health facilities – the challenge remains in the implementation of this strategy.
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Asia & Pacific
Emotional support helps depressed new mums Times of India
The joy of having a baby is often accompanied by depression among new mums. Building up an emotional connect may help healthcare workers combat depression among people , say researchers.
“The health services often fail to recognise women who suffer from postnatal depression or anxiety. Many of the women I interviewed had experienced rejection and a lack of understanding from health personnel,” said associate professor Kristin Akerjordet at the University of Stavanger.
According to her, by training health personnel in emotional intelligence, they will be better equipped to prevent women from developing depressive illnesses. She surveyed 250 postnatal women. Of the 30 women she interviewed, 15 had experienced depressive emotions in connection with pregnancy and birth.
Emotional intelligence (EI) is the ability to identify and manage the emotions of one’s self and others in a constructive manner. Being able to access emotions and to reflect upon them are key elements of this ability.
“EI enables us to form good relationships with other people, thereby improving the quality of our performances as nurses, midwives and doctors. EI is an important factor in promoting good care and effective health service management,” said Akerjordet.
Health personnel could be guiding and supporting individuals or groups of pregnant women in how to utilize their EI as a tool in managing their everyday emotions.
By teaching women EI, they would raise awareness of their reactions to painful experiences. Groups of health workers could teach women a strategy for mastering these feelings, and thereby prevent future depressions, she suggests.
While working on her thesis, Akerjordet developed two scales for evaluating her 250 respondents’ emotional intelligence -- aiming to map out their creativity, self-command, self-knowledge and social skills.
Women with a high degree of EI possess greater self-knowledge and a better understanding of their own depressive emotions than women low a lower EI, the study indicated.
Akerjordet also found that EI enforces the women’s resilience, enabling them to tackle opposition and depressions.
Nepal makes gains in saving newborn lives, on track to meet MDG for child survival Nepal News
Many of the nearly 4 million newborn deaths that occur globally each year could be prevented with simple and cost-effective solutions, according to Invisible Lives, a documentary scheduled to air worldwide January 26 at 20:30 GMT (NST : Wed, January 27, 2010 at 2:15 am) on BBC World. A repeat telecast will be aired every day until 29 January.
The documentary examines how Nepal and Malawi are making progress in saving newborn lives and explores how these countries are among the few on track to meet the United Nation's Millennium Development Goal of reducing deaths of children under 5 years of age by 2/3 by 2015 despite a myriad of obstacles, states a press release issued by Save the Children to inform about the documentary.
The risk of newborn death in Nepal is 33 per 1,000 births; whereas the same risk in Europe and North America is around 3 per 1,000 births. According to Save the Children, a leading international humanitarian agency, it doesn't have to be this way.
"While the numbers are daunting, Nepal has demonstrated major life-saving progress can be made," Dr. Neena Khadka, Director of Programmes of Save the Children, is quoted as saying in the release.
"Nepal is a unique example of what can be accomplished when governments, United Nations agencies, donors and non-governmental organizations work together to support health systems in low-income countries."
Despite poverty and political upheaval and a lack of resources, Nepal has managed to address the three main causes of newborn deaths-complications from pre-term birth, infection and birth complications with different approaches.
"Nepal uses a range of community and facility-based strategies to improve newborn health along-with emphasis on family care and behavior change in communities.
The National Health Strategy endorsed by the government in 2004 is the guiding principle for community based newborn care program which is addressing newborn care to nearly 80 percent of home deliveries in Nepal," says Dr. Khadka.
The strategy is working in Nepal which is one of only two in South Asia countries to be on track to meet the Millennium Development Goal for child survival. "I think consorted effort on the part of the government and others working in neonatal health through the government's network of health services right up to the community level is the key to Nepal's success," states Dr. Khadka.
"With over 80 percent of births taking place at home in Nepal it is difficult to bring newborns to the health facilities because of access, because of tradition and because of taboos. So we must provide health services close to home," says Dr. Pradhan, Director of Health in Nepal.
The documentary highlights Bhagwati, a volunteer community health worker, who is one of many health workers who have played an important role in helping Nepal reduce the number of child deaths by 61 percent over the past decade.
Although volunteers like Bhagwati are not medically qualified, they have been trained to recognize dangerous signs such as infection, which is the leading cause of newborn deaths in Nepal.
They also advise mothers to go to the nearest health post if the baby gets ill. The 48,000 Female Community Health Volunteers (FCHV) are the foundation of child health in Nepal.
"Community based integrated management of Childhood Illness (CBIMCI), the National vitamin "A" programme and expanded Programme of Immunization (EPI) is the key to success for Nepal to be on target to achieve goal 4 of the MDG.
It's the government which leads these programmes with stakeholders and partners supporting the national effort," reads the press elease.
The release further adds, "Invisible Lives" is both a celebration of progress against the odds and a call for urgent action to save more lives. Malawi and Nepal have made remarkable progress, but still too many babies and their mothers are dying needlessly.
We have solutions, and these countries prove that faster progress is possible. The time is now to ensure every baby and mother has the chance to survive and thrive.
The documentary will air on BBC World at these timings:
Wednesday, January 27, 2010 at 2:15 AM
Wednesday, January 27, 2010 at 5:15 PM
Thursday, January 28, 2010 at 9:15 PM
Friday, January 29, 2010 at 8:15 AM
HCM City’s rural influx causes crisis Viet Nam News
HCM CITY — HCM City is facing a slew of social problems caused by a burgeoning population that has reached eight million on the back of unrelenting migration.
Nguyen Van Nam, party committee secretary of District 12’s Hiep Thanh Ward, said: "The expanding population has rendered authorities helpless in checking socio-economic problems and maintaining public order."
Authorities have problems providing health care, education, and infrastructure for all.
Since the beginning of the last school year, the ward’s An Hoi primary school has classes with 70 pupils because of a shortage of space and teachers. The Ministry of Education stipulates a maximum of 40 students per class.
Its teachers have to manage double the normal number of students, but for the same salary.
Schools in Tan Thanh and Tan Phu Wards face a worse situation – they could admit just a third of the students who applied, with thousands of others having to go to schools elsewhere.
Pham Phu Dung, chairman of the Ward 15 People’s Committee, said: "The ward has 52,000 residents, 20,000 of them are migrants. But it has only two primary schools, one kindergarten, and no junior or senior high school."
The growing population has also overloaded the public health system.
The medical station in Hiep Thanh Ward, for instance, has only five workers for a population of nearly 70,000.
Nam said: "On days when there are compulsory vaccinations and medical check-ups for children, the People’s Committee has to deploy ward officials for assistance.
"The five workers have to do medical and physical checks for 1,000 people on a crowded day.
"The city’s infrastructure was built before liberation to serve 3 million people. There are now 8 million besides burgeoning numbers of motorbikes, cars, and lorries, while investment in new infrastructure is modest," Nguyen Van Minh, a city resident since before the liberation in1975, said.
Maintaining law and order is also a major problem. According to Ministry of Public Security regulations, there should be one police officer for every 300 to 700 households. But in a place like Tan Binh District’s Ward 15, each officer has to supervise 1,500 households that have 5,000 people.
In Hiep Thanh, 28 officers have to monitor 70,000 residents.
Tay Thanh Ward has 14,000 rented rooms where more than 15,000 migrants live, and just three officers have to keep track of them.
Wanted criminals and gangsters take advantage of the chaos caused by the mass influx of people to carry out their nefarious activities.
Last year Tay Thanh Ward discovered 32 crimes and arrested 44 people.
Tran Van Trinh, deputy head of the Tan Binh District Police, said: "Due to gaps in Government policies that allow residents to easily buy houses and get residential permits in HCM City, some people have moved into the city for illegal purposes. The Government should soon rectify these policies."
Some house owners on Hoang Bat Dat Street in Tan Binh District have co-operated to convert the area into a room-for-rent quarter. Its nearly 100 rooms of around 10sq.m house six people each.
Ward 15 has an average of 3,000 rooms for rent where around 20,000 people crowd.
Most of them are migrants who have flocked from all over the country to earn a living as hawkers, masons, or tailors.
Pham Van Hai, a temporary resident at 46 Hoang Bat Dat Street, said: "My family moved from the central province of Quang Ngai to the city and lives by hawking hu tieu (southern-style noodles with seasoned and sauted beef) for the last seven years."
Tay Thanh Ward, which had a population of just 30,000 in 2003, has seen the number rising to 47,000 now. In addition, there are 30,000 workers employed in local industrial parks and 15,000 students.
The population of Go Vap District’s Ward 12 has tripled to 120,000 in the last few years, with two thirds of the residents being immigrants.
Located on the outskirts of the district, the ward used to be covered in paddy fields. The fields have almost disappeared because of illegal trading in land and construction of houses.
Hiep Thanh Ward’s population has risen by 10,000 over the last three years to 70,000, with 60 per cent of them being migrants.
The growth is not likely to stop any time soon because two high-rise residential buildings that can house 18,000 people are being built.
The district People’s Committee is planning to build residential areas on 250ha of industrial park and 50ha of reserve land.
Other wards in District 12, like An Phu Dong, Thoi An, Tan Thoi Hiep, are also facing alarming rises in population.
According to the latest report from the General Statistics Office in Ha Noi, HCM City’s population is rising by 208,000 every year and could top 10 million by 2020. — VNS
India plans 1,750 mental health workers a year IGovernment. India
By Sandeep Budki
New Delhi: The Government of India has chalked out an ambitious plan to meet the shortage of health workers mental health disorders, saying India will produce 1,756 such practitioners, including 520 doctors, every year.
"We know there is an acute shortage of human resource and we are putting in place a mental health scheme. The outcome of this scheme is 1,756 mental health professionals annually, which includes 104 psychiatrists and 416 clinical psychologists," Health Minister Ghulam Nabi Azad said.
He said the above list also has 416 psychiatric social workers and 820 psychiatric nurses for handling mental disorder patients.
Azad said nearly seven percent of Indians face common mental health problems but only two percent face acute problem needing proper medical treatment.
He said under the mental health scheme worth Rs 1,000 crore, 11 existing mental health hospitals are being upgraded and strengthened to produce qualified manpower.
"Rs 30 crore per centre will be given for academic block, library, hostel, laboratories, supportive departments and lecture theaters," the Minister said.
An additional 44 post-graduate seats in psychiatry, 176 M Phil seats in clinical psychology and psychiatric social work and 220 seats in diploma in psychiatric nursing will be available every year, he added.
Azad also said that assistance would be provided for setting up and strengthening of 30 units of psychiatry, 30 departments of clinical psychology, 30 departments of psycho-social worker and 30 departments of psychiatric nursing. The central government will provide Rs 5.1 million to Rs 10 million per PG department for the purpose.
Frustration is the diagnosis on the condition of local health Merimbula News Weekly, Australia
STORY DENISE DION
While most members of Save Our Hospital Inc (SOHI) were glad of the opportunity to speak with Greater Southern Area Health Service’s (GSAHS) eastern sector manager, Ken Barnett, all of them admitted to coming away frustrated by the answers to their questions on the return of services to Pambula Hospital and the “spin” in relation to maternity services at Bega Hospital.
The meeting took place at Bega Valley Shire Council chambers on Friday, January 22 and was attended by the committee of SOHI and councillors who questioned Mr Barnett about health services in the area.
GSAHS had recently issued a media release purporting to demonstrate that it had met 12 out of 13 recommendations for health services in the area, but the SOHI committee members hotly disputed all of the points (See story Page 7) and put the update on the 2008 BVS maternity services review report recommendations at the top of their list of questions for Mr Barnett.
Dr Frank Simonson, who is a trained GP obstetrician operating out of Merimbula, was scathing of GSAHS’s media statement.
“You’ve put out a media release to say that you’ve met the conditions of the recommendations and you haven’t. This is spin in the extreme,” Dr Simonson said.
Mr Barnett said that it was “unfortunate” that they hadn’t been able to recruit the right maternity staff for Bega Hospital and had to rely on locums.
He also said that they were trying to get a medical director for maternity services and were using a recruitment company but believed it could take several months.
Asked about the cost of using locums by Councillor Paul Pincini, Mr Barnett admitted that the service had to fly them in from Melbourne or Sydney, at a cost of between $1800 and $2500 a day plus the cost of their accommodation and travel.
Mr Barnett explained that there was a shortage of midwives as well, not just locally but throughout the western world.
“Governments have recognised that they didn’t train enough people 10 to 15 years ago and have put systems in place but it will take five years for people to come through,” Mr Barnett said.
Nurse unit manager at Bega Hospital, Chris Vanderberg, said: “If a midwife walked in through the door we would engage them. We have tried home growing them this year through direct entry courses.”
But Geoff Dove, of SOHI said: “We wouldn’t be in this mess today but for the interference of GSAHS.”
Mr Dove maintained that as GSAHS withdrew services then staff in those areas left.
“It came down to a resource issue. Up to that time maternity had been operating well from since the 1930s.”
Mayor, Tony Allen, had to interject several times during the meeting in an attempt to lower the temperature of discussions.
Mr Barnett said that he would love to see improved services in Bega, “but in reality it won’t happen until the new hospital is built”.
Land purchases in the south of Bega for the new hospital are still under review with no indication of when the process might be completed, Mr Barnett admitted.
But Sharon Tapscott, of SOHI, could not understand why Pambula Hospital was not being utilised.
“My dilemma is that Bega Hospital is under pressure but you have taken the option of taking people past a fully functioning hospital to one under stress. Why transfer more and more people to Bega when it’s not coping,” Ms Tapscott said.
Mr Barnett responded: “You’re not going to like what I’m going to say but it’s incredibly difficult to run two services 20 minutes apart. Very experienced and well-qualified people acknowledged the difficulty of having a GP obstetrician sitting in Pambula but their recommendation was for Bega.”
Mr Barnett said that nurse unit managers found Pambula Hospital difficult to staff and couldn’t guarantee that they would have the staff and that provided uncertainty for mothers.
Frankie J Holden, of SOHI suggested that maybe the committee and Mr Barnett should work together.
“This problem isn’t going to go away. We may be better to work together rather than take an adversarial role if you are fair dinkum about your concerns,” he said.
But later in the discussion he could not but help vent his frustration saying: “If the state has $10 million to blow on fireworks off Sydney Harbour Bridge, we don’t have a money problem.”
After the meeting Dr Simonson told the News Weekly: “It’s frustrating from a doctor’s point of view because nothing is happening; in fact it’s worse because there are no doctors doing maternity. We’ve still got women leaving hospital early, three nursing staff put out of work and an empty theatre at Pambula and an overloaded one at Bega.”
Mr Dove said that GSAHS’s media release left much to be desired in that it subordinated the importance of a key recommendation which was the sustainability of a single birthing service depended on maintaining a GP obstetrician after hours ratio of 1:6 (a GP obstetrician would be called out in one out of six shifts).
After 12 months this still had not been achieved, Mr Dove said.
He went on to add that the second reason for consolidated birth services was Bega’s ability to provide backup intensive care, general surgery, on call surgery and pathology.
“The real reason is highlighted in the 2008 maternity services report and that was the insufficiency of midwifery and GP obstetrician resources. They should have got the resources in place and placed the safety of mothers and babies first,” Mr Dove said. Continued
National Grants to get City Doctors Working in the Bush Australia.to News
Minister for Health and Ageing Nicola Roxon and Minister for Rural and Regional Health, Warren Snowdon today launched a national program that will offer emergency training for up to 150 urban GP’s in exchange for their undertaking a locum placement in a rural or regional areas.
The Rudd Government is providing $790,000 over four years for the Rural Education Assistance Program (Rural LEAP), which aims to give rural and remote doctors a break by providing increased locum services.
Speaking on a tour of Mt Isa and Cloncurry in north-west Queensland, Mr Snowdon said Rural LEAP will help give urban GPs the skills and confidence to undertake a rural locum placement.
“There is evidence that many urban GPs have an interest in rural locum work but do not always feel skilled or confident enough to carry out the many and varied tasks often required of GPs in rural and remote areas.”
“Through Rural LEAP, urban GPs will be able to get training in emergency medicine in return for an agreement to undertake four weeks of paid locum work in rural and remote locations,” Ms Roxon added.
Mr Snowdon said GPs working in towns such as Mt Isa and Cloncurry would benefit from an increased pool of doctors willing and able to be a rural locum, bringing improved opportunities to take a rest or undertake professional development.
“Our current rural workforce is ageing and needs opportunities to refresh; this initiative goes towards helping GPs in the bush get a well-deserved rest.”
Rural LEAP is part of the Rudd Government’s $134.4 million Rural Health Workforce Strategy, announced in the 2009-2010 budget, which aims to improve rural and remote health workforce shortages.
The program will be jointly administered by the Australian College of Rural and Remote Medicine (ACRRM) and the Royal Australian College of General Practitioners (RACGP) through the current Rural Procedural Grants Program.
Urban GPs interested in taking part in Rural LEAP can apply through either ACRRM or RACGP from 1 February 2010. Further information can be found in the attached fact sheet. Rural Locum Education Assistance Program (Rural LEAP)
Rural LEAP enables 150 urban GPs to have access to emergency medicine training, which is a component of the Rural Procedural Grants Program, to gain the skills and confidence to undertake a rural locum placement.
Rural LEAP will increase the pool of doctors willing and able to be rural locums which will bring great benefits to the existing rural workforce, bringing improved opportunities for rural GPs to take a rest or undertake professional development.
Rural LEAP has been developed as a result of the 2009-10 Budget, Rural Health Workforce Strategy announcement, regarding the expansion to the Rural Procedural Grants Program.
The Rudd Government is providing $789,800 (GST inclusive) over four years for Rural LEAP. In 2009-10 a total of $217,800 (GST inclusive) will be made available for the delivery of the program.
To be eligible for payment under the Program applicants need to be:
A General Practitioner; and
currently practicing in an urban locality.
The Australian Standard Geographical Classification – Remoteness Area (ASGC-RA) - is the classification system used to define eligible areas. Urban localities are classified ASGC RA 1 and localities eligible for locum placements are in ASGC RA 2-5 (inner regional to very remote). This is available at www.doctorconnect.gov.au
This is a one-off incentive with participants able to access and obtain financial assistance to undertake emergency medicine training up to a total of $6,000 for a maximum of three days.
How to Apply
To be considered for the program, urban GPs may apply to either the Australian College of Rural and Remote Medicine (ACRRM) or the Royal Australian College of General Practitioners (RACGP) from 1 February 2010.
ACRRM and the RACGP are responsible for assessing the eligibility of GPs and of training.
Applicants will need to outline the following:
When the applicant intends to undertake training;
type of training the applicant intends to undertake; and
when the applicant intends to fulfil their locum commitment.
ACRRM and the RACGP, in consultation with relevant external agencies, assess the eligibility of training for inclusion in the program.
The list below provides examples of training courses. Other courses may be available and further information can be obtained from either ACRRM or RACGP:
Emergency Crisis Resource Management Early Management of Severe Trauma (EMST)
Emergency Life Support (ELS) APLS
Rural Emergency Skills Training (REST) Intermediate and/or Advanced Life Support
Emergency Medicine Crisis Management Intermediate and/or CEMP workshops
HWQLD Rural Emergency Medicine Workshop Soma Health Airway, CPR and Trauma Management Workshop
Participants in the program are to undertake a total of four weeks locum placements within two years of receiving their payment for undertaking emergency medicine training. The four weeks (20 working days) can be broken up into shorter periods; however a total of two weeks (10 working days) needs to be completed in the first 12 months since receiving their payment.
Participants are required to undertake practice-based GP locum positions located in ASGC RA 2-5. These locum placements may be organised by the participant or the participant may seek assistance through various locum agencies.
Once a participant has fulfilled their locum commitment, they are required to advise Medicare Australia. This can be through a statutory declaration from the practice where the locum was provided or a letter from the locum agency as verification.
Administration of the Program
The administration of the program is jointly managed by ACRRM and the RACGP.
Medicare Australia is responsible for maintaining a register of eligible GPs and for making payments to GPs on completion of eligible training. Medicare Australia is also responsible for tracking the two-year period for participants to undertake their locum requirement.