Recife Top Ten: Together Toward Health for All

Recife Top Ten: Together Toward Health for All

The Third Global Forum on Human Resources for Health convened in Recife, Brazil from November 10-13, 2013.The Third Global Forum on Human Resources for Health convened in Recife, Brazil from November 10-13, 2013.

The Third Global Forum on Human Resources for Health (HRH Forum) brought together some 2,000 representatives of government, academia, professional associations, and civil society from 93 World Health Organization (WHO) Member States. Participants took stock of the current state of the global health workforce and committed to working toward universal health coverage (UHC), culminating in adoption of the Recife Declaration (PDF). "Country after country has outlined actions that will ultimately transform and improve the landscape for health workers, and prioritize their needs in a world with ever growing demands being placed on them," said Dr. Marie-Paule Kieny, WHO Assistant Director-General for Health Systems and Innovation and Executive Director a.i. of the Global Health Workforce Alliance.

For countries committed to improving the climate of the global health workforce and achieving universal health coverage, MSH recommends:

  1. Implement and adapt the Recife Declaration according to country/regional context.

    As WHO noted: "Each country will have to take appropriate measures according to its own situation, keeping in mind that funding is only one part of the problem."
  2. Engage health workers in the solutions

    Engage health workers at all levels of the health system in developing and implementing the solutions for human resources for health (HRH), such as directly engaging health leaders through the Leadership Development Program (LDP) and new LDP Plus (LDP+).

  3. Address growing health staff shortages.

    The global gap in health workforce is now estimated at 7.3 million, and could climb to about 13 million in the next 20 years. Even at this point, institutions in developing countries charged with addressing this don’t have the capacity to meet the challenge. Help countries build the infrastructure they need by developing strong leaders and managers at all levels of the health system.
  4. Expand roles of community health workers (CHW).

    CHWs help increase access to health services at the primary care level and save lives with scarce resources. A joint partner commission defined outcomes from a side session on CHWs and frontline health workers.
  5. Strengthen leadership, management, and governance (L+M+G) among the health workforce.

    The Recife HRH Forum, unlike the others, highlighted L+M+G as a key building block to strengthen health systems and improve health services; however, the HRH Forum glossed over the need to professionalize HRH management. You can’t increase a health workforce by a million or more, without competently increasing the leadership, governance, and management levels. In addition to training community health workers, and professionalizing HRH management, we also have to build the community capacity to manage health priorities.
  6. Provide interdisciplinary training for the health workforce.

    Interdisclinary training includes integrating the leadership, management, and governance curricula into the courses of study, such as with nurses in Guyana.
  7. Increase access and availability to quality care in rural areas.

    Developing strong retention strategies with a focus on rural areas, political will for governing resources, and developing leadership and management will make the difference to this ongoing challenge. For example, through integrated community case management (iCCM) for childhood illnesses, CHWs can reduce under-five child mortality.
  8. Collaborate across sectors.

    Public-private partnerships (PPP) are becoming increasingly necessary for governments with limited resources to expand health care, as well as increase the health workforce. Up to half of health services are provided by the private sector in some countries. The public sector needs to engage in partnerships with the private sector and develop the capacity to manage these contracts. Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program is a great example of a successful public/private partnership.
  9. Work toward gender equity.

    Strong women health leaders build strong health systems. Yet much remains to be done. “We have witnessed the need for more fundamental shifts in how women are represented," notes Xavier Alterescu in a post from Recife. "They are--and will continue being--at the forefront of the advocacy and action for the reduction of inequalities.” Listen to the perspectives of women leaders.
  10. Align HRH with the UHC agenda.

    "It’s an ideal moment for the HRH movement to latch onto the movement toward UHC," says Jon Jay. "Since human resources are an essential UHC input, the HRH community can both ride the UHC momentum and help drive the [post-2015 development] agenda."

We are heartened by the number of calls for strengthening leadership and management to govern the health system of the future, operating in cross-sector partnership to provide an opportunity for a healthy life for all!

MSH staff contributed to this content.

Mary O’Neil is the MSH global technical lead for human resources for health.

Read more from MSH at the HRH Forum

Read the Recife Declaration (PDF)