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Skip to 0 minutes and 17 seconds DR JIM CAMPBELL: So, the key findings in The Lancet series on maternal health really bring a new attention to better understanding the skill mix, the composition, the capacity of the workforce, if we want to ensure that we have resilient, responsive health care systems that meet local population needs and are able to provide high quality care. What does that mean in terms of the skill mix, the competencies? For many years we have looked at the planning of the workforce either through a population lens or through a facility lens. Now two examples. What does population lens mean? It means that some of our metrics and some of our thinking is very specific to per 1,000 population, per 10,000 population.

Skip to 1 minute and 12 seconds And so we’ve seen a lot of the metrics talking about we need “x” amount of health workers per 10,000 population. At a facility level this brings it down slightly different, with a number of assumptions that all facilities are the same, that all facilities are equal. That they serve a population catchment area and through that we therefore say how many health workers do we need per in that facility to serve that population. So, again it’s quite a simple set of arithmetic, a simple set of assumptions around therefore you need “x” nurses, midwives, obstetricians, gynaecologists, anesthesiologists per facility to provide a certain service and care.

Skip to 2 minutes and 3 seconds What we said in The Lancet Series in Maternal Health is that we need to go beyond that. And we need to be much more mature in our policy discussion to actually understand what the facilities are capable of and the skill mix, the competencies of the workforce within. As a national plan and good practice we’ve been quite fortunate over the last couple of years with the WHO Global Strategy on Human Resources for Health and the work of the High Level Commission on Health Employment and Economic Growth established by the former UN Secretary-General Ban Ki-moon that we’ve consolidated the evidence. So for a national planner, what is good practice? First of all, strengthen the evidence. Who is currently in your workforce?

Skip to 2 minutes and 49 seconds Who is currently working? What are their education, skills, and competencies that they have? And so really understanding today’s workforce. Improving quality care means understanding who’s working today first and foremost. They will make the difference to the people-centred integrated care system immediately we have, through that process, to drive what the concept of a national health workforce account. Secondly, with that evidence and data have a policy dialogue and a policy dialogue which really is inclusive. And so it’s a social policy dialogue. This is a labour issue. This is a community issue. This is an issue with health care professional associations and others.

Skip to 3 minutes and 40 seconds Have a dialogue around what will be needed to really optimise the workforce that you have today and to anticipate future needs in a way that the workforce will be fit for purpose. Once through that process of dialogue, really look then at articulating the return on investment case. So, how can you demonstrate that the investment in the education training and development of the workforce will have the social return on investment? Yes, it will improve the quality of the care. That has a potential of a benefit on health outcomes for the population, in this case, the women of reproductive years. But it also has an even broader societal benefit, healthy women equals healthy communities. It means they can go back to work.

Skip to 4 minutes and 30 seconds We are also creating jobs, that as a benefit. So it’s a women’s economic empowerment issue, as well. And put forward that case, so that your future workforce staffing needs are not just a simple equation, but are actually very specific to the context, to the needs of the community, to the benefits of the community, and the social return in the longer term. And hopefully that will then be able to inform the necessary investment that’s needed to produce quality health care services. So since the Lancet Series, there were some excellent work going on with colleagues and partners around understanding how do we look at quality, equity, dignity? How do we ensure that no one is left behind?

Skip to 5 minutes and 15 seconds And how do we make sure that our investments in the health professional education is therefore realised into the employment, into the health labour market? So that we’re not producing a supply of future health workers but not creating the necessary salaried jobs and the infrastructure to do that. And we have to therefore bring this economics of health professional education with the economics of the labour market together for the purpose of quality, equity, dignity for the beneficiaries of those services.

Skip to 5 minutes and 51 seconds And that then with as I mentioned earlier the WHO was Global Strategy, the results of the Working for Health programme, the adoption of National Health Workforce Accounts, and continuing work on looking at the dynamics in the health labour market are providing these policy tools and guidance for national planners, for partners, to really take this work forward. I am optimistic that we will be building a science, a workforce science, over the next few years, which will benefit the people who are looking to access quality maternal, newborn, child, and adolescent health care services for the future.

Staffing Maternal Health Services

What is the skill mix, composition and capacity of the workforce needed to meet maternal health care needs?

In this step Dr Jim Campbell (WHO) lays out new evidence and approaches to planning a health workforce and highlights the critical role of national planners. Key policy and guidance tools are presented, in addition to emerging evidence to inform development of resilient and responsive health care systems to meet local maternal health needs with high quality care.

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This video is from the free online course:

The Lancet Maternal Health Series: Global Research and Evidence

London School of Hygiene & Tropical Medicine