Corresponding national and global health personnel policies
Norwegian politicians have pledged to follow a recruitment policy that does not affect poor countries and that refrains from actively and systematically recruiting staff from poor countries that themselves suffer from a shortage of health workers (2). Norway has been a driving force in the lengthy process of putting in place a global Code of Practice for the recruitment and fair global distribution of health personnel. In May 2010 WHO adopted the Code (3). Since the implementation phase has now started, it is vital that monitoring processes are initiated and that data on development trends within health personnel migration are systematized and published. Norway must continue to play a proactive role in this connection.
In 2007, the Directorate for Health and Social Affairs published the report «Re-crutment of Health Workers: Towards Global Solidarity» (4). The report presented several proposals on how such health workforce policies can be carried out in practice. Two working groups were established as a follow-up to the report. One working group, headed by the Directorate, examined national initiatives targeted at the global health workforce crisis (5). The other working group, headed by the Ministry of Foreign Affairs, examined proposed measures in Norwegian foreign and development assistance policies to counteract the global health personnel crisis (6). The reports of the two groups are viewed in correlation with each other to create the greatest conformity in Norwegian policies on this complex area.
The UN’s adoption of the Millenium Development Goals (MDGs) in 2000 led to a growing recognition that the shortage of health personnel will be a major bottleneck in the work on achieving the health-related goals. At a High-Level Forum meeting on MDGs in Geneva in 2004 it was already clear that international actors would have to join forces to deal with the problem (7). The Global Health Workforce Alliance (GHWA) was established in 2006 with good help from Norway. Two years later the Alliance reached agreement on the Kampala Declaration, a global action plan with the vision that «all people, everywhere, shall have access to a skilled, motivated and facilitated health worker within a robust health system» (8). The action plan has six specific interconnected strategies:
Building coherent national and global leadership for health workforce solutions
Ensuring capacity for an informed response based on evidence and joint learning
Scaling up health worker education and training
Retaining an effective, responsive and equitably distributed health workforce
Managing the pressures of the international health workforce market and its impact on migration
Securing additional and more productive investment in the health workforce
In January 2011, a progress report was published which reviewed what had been achieved through the action plan both in individual countries and worldwide (9). At the national level there are many positive measures and signals, but nevertheless much remains to be done if the vision of the global health workforce alliance and the health-related MDGs are to be achieved by 2015.
It has been acknowledged at both the national and global level that the shortage of health personnel affects many different areas – such as migration, working conditions, education and research.