Throughout the Health Sector:Communication Must Influence
and Engage
SCOTT C.RATZAN
As we are midway though this decade, there have been myriad
proclamations to address the challenges presented as Millennium Development
Goals (MDGs). MDGs principally target the major poverty-linked diseases
devastating poor populations, focusing on maternal and child health
care and the control of HIV/AIDS, tuberculosis and malaria. Similarly,
other burgeoning global health burdens are beginning to also garner
interest:namely chronic diseases. These consist of cardiovascular and
metabolic diseases, cancers, injuries, and neurological and psychological
disorders, affecting rich and poor populations alike. And, of course,
health crises – epidemics, natural disasters and conflict recur
at unexpected intervals.
With these ideals, large programs are often put in place
to try to tackle the causes of the ill health in developing countries.
Many of these have considerable funding. Yet, the bottleneck hindering
success is not the finance, but the lack of human resources. The latest
World Health Report – Working together for health contains
an expert assessment of the current crisis in the global health workforce
and ambitious proposals to tackle it over the next ten years, starting
immediately. The report reveals an estimated shortage of almost 4.3
million doctors, midwives, nurses and support workers worldwide. The
shortage is most severe in the poorest countries, especially in sub-Saharan
Africa, where health workers are most needed. This means that 57 countries
have critical shortages of workers.
The focus on health workers as the foundation of public
health and addressing the dearth of health workers at all stages is
paramount. Years of under-investment in health in general, along with
the ravage of infectious disease and migration, now leave many countries
with critical shortages. Further population distribution with professionals
and health facilities in urban rather than suburban and rural areas
raises more considerations.
The WHO ’s technical mandate and policy prowess should
help raise the issue for capacity building in health. Health care is
a labor-intensive service industry. Health service providers are the
personification of a system ’s core values – they heal and
care for people, ease pain and suffering, prevent disease and mitigate
risk – they are the human link that connects knowledge to action.
The World Health report defines health workforce pragmatically:
It includes all paid workers employed in organizations or institutions
whose primary intent is to improve health as well as those whose personal
actions are primarily intended to improve health but who work for other
types of organizations.
Of course, those of us in health communication appreciate
the ‘‘communication ’’ as an element that enhances
health outcomes, focuses resources for ethical health delivery, and
provides people with the ability to make decisions that affect personal,
family, community, and global. A goal in health communication should
go beyond the limitations of providing quality information and systems
to health workers as suggested in the report. Our larger goal is to
engage and influence the health sector or health policy. If the report
accurately shows the human resource limitations on the health workforce,
the communication imperative for a well-informed and developed health
sector ought to be even a larger goal. The WHO definition of the health
sector offered in the Global Health Sector Strategy for HIV/AIDS
2003 –2007, challenges health communicators to influence and
engage in a variety places:
‘‘The health sector is wide-ranging and encompasses organized
public and private health services (including those for health promotion,
disease prevention, diagnosis, treatment and care); health ministries;
nongovernmental organizations; community groups; and professional
associations; as well as institutions which directly input into the
health care system (e.g., the pharmaceutical industry, and teaching
institutions).’’
As the moral and value implications of health ought to
trump other sectors for adding long-term value and real ‘‘wealth
’’(the health is wealth slogan)than we should be even more
concerned with the implications of this World Health Report and address
the exigency for the health of the planet ’s human population.
_____
Scott C. Ratzan MD, MPA, MA is Editor-in-Chief of the Journal of
Health Communication: International Perspectives. He also is Vice
President, Government Affairs, Europe for Johnson & Johnson with
academic appointments at George Washington University School of Public
Health, Tufts University School of Medicine, Yale University School
of Medicine, The College of Europe, and University of Cambridge.
