Managing human resources for accelerating reduction of maternal and neonatal mortalities

Abstract

The Fifty-eighth session of the Regional Committee in 2005 endorsed a resolution on Skilled care at every birth that urges Member countries, among others: “to review the gaps in human resources for skilled care at birth and, as appropriate, to develop or modify human resource policies for skilled care at birth, which includes planning, production, placement, retention and career development”. Human resources for maternal and newborn health (‎MNH)‎ include formal health-care providers or health professionals and informal health-care providers. The formal providers include community-based health providers for MNH, community-based midwife, professional nurse/nurse-midwife/midwife, medical doctors, specialists obstetrics and in neonatology and other supporting providers.In some countries of the South-East Asia (‎SEA)‎ Region, community-based health providers for MNH are often insufficient in numbers, as well as in their midwifery skills. As a result, there is limited accessto skilled care at birth, especially for marginalized communities. Also, specialists are very limited in number and are usually concentrated in urban areas. This has resulted in inequities for the ruralcommunity in accessing emergency obstetric and special newborn care, when needed.The proposed way forward for Member countries in the SEA Region at the policy level includes: strengthening national database on human resources for MNH; development of a long-term national plan to address the gaps for each category and ensure adequate resources and effectiveimplementation; strengthening of human resource management for MNH services; and working with partners, nongovernmental organizations and stakeholders in developing a clear policy and plan on skilled birth attendants. The following steps need to be taken at the entry level: building stronginstitutions for education; assuring educational quality; and revitalizing recruitment capabilities. At the workforce level, the following measures need to be taken: bolstering the system of supervision;strengthening critical support systems; ensuring lifelong learning; and improving the collaboration between MNH health providers at community level and informal heath providers. At the exit level,migration of health workers needs to be managed, while retirement and succession planning needs to be enhanced.The role of WHO is to advocate for increasing the investment in human resources for MNH and to work together with Member countries at the policy level; assist them in strengthening human resource management for MNH services; promote the use and implementation of evidence-basedpolicies, standards and tools for improving human resources for MNH; facilitate collaboration among stakeholders; catalyse knowledge and learning exchange; and support studies/research in the area ofhuman resources for MNH.The attached working paper is submitted to the Meeting of the Advisory Committee (‎ACM)‎ for review and recommendations on this agenda item. These recommendations will be submitted to the Sixtyfirst Session of the Regional Committee for its consideration.