Teodoro Herbosa | Jamaica, Philippines partnering for a better health workforce

There is no more critical topic in the health sector than addressing the health workforce crisis globally. While discussions between sending and receiving countries have been taking place bilaterally among various countries, the need for a larger and inclusive dialogue has been evident for some time.

We now bring the discourse into a wider audience of health professionals, policymakers, young professionals and the next generation. For this, I congratulate the Jamaican Government, and the Ministry of Health and Wellness, for organising Jamaica’s first Health & Wellness Career Expo and Employment Fair.

The health workforce is the backbone of any health system, and its effectiveness, capacity, and well-being directly shape the system’s ability to deliver high-quality, equitable care to the populations. For me, healthcare delivery is not only about the infrastructure, but it is about services delivered by a competent and compassionate health workforce. Without them, any health system would fail.

Globally, the World Health Organization estimates a projected shortfall of 10 million health workers by 2030, mostly in low- and lower middle-income countries. The chronic under-investment in education and training of healthcare workers in some countries, and the mismatch between education and employment strategies concerning health systems and population needs are contributing to this continuous shortage.

We understand that countries must not only focus on the quantitative global growth of healthcare worker employment but also address persistent challenges, such as aligning supply with demand, creating the right skill mix, and ensuring equitable distribution of healthcare professionals.

Additionally, the increasing international migration of healthcare workers exacerbates these shortfalls, especially in our countries, deepening the paradox of health worker unemployment alongside significant unmet health needs of our populations.

PHILIPPINE EXPERIENCE

For decades, the emigration of Filipino healthcare workers – doctors, nurses, caregivers, and allied health professionals – has become a defining phenomenon of the global healthcare landscape. The Philippines has long been one of the largest exporters of healthcare talent in the world, contributing over a hundred thousand nurses and medical workers each year to foreign healthcare systems.

With our proficiency in English, a globally respected training system, and a cultural emphasis on empathy and service, rooted in Filipino traditions and values, the Filipino workforce is often regarded as the backbone of healthcare institutions in countries where demand far exceeds supply. Our unique perspective on caregiving, shaped by these traditions, makes us highly sought after in the global healthcare sector.

The Philippines realised the importance of this migration from an economic and social perspective, addressing financial issues of families and bolstering the country’s financial reserves. Our growing migrant population has become so significant that we now refer to them as the Overseas Filipino Workers.

To address the demand, we responded by:

• Creating the Philippines overseas employment administration, which was later expanded as the Department of Migrant Workers (Philippines as the first country to have this Department) in 2021, formalising and institutionalising the process of sending workers abroad, and protecting health workers’ rights;

• Developing enabling laws and policies, such as the passage of the Magna Carta of Health Workers and the Universal Health Care Act in 20,19 as well as developing the National Human Resources for Health Plan 2020-2040, outlining the framework for the management of the health labour market.

• And creating scholarship programmes for various cadres thereby generating demand; and developing a robust healthcare education system, producing highly skilled healthcare workers who are well-trained and fluent in English.

Today, the Philippines has 408 nursing higher-education institutions, 326 managed by the private sector, and 82 established in state and local universities and colleges. We also have 77 higher education institutions with doctor of medicine programmes, 51 of which are managed by the private sector and 26 by the publicly run universities and colleges.

Over the years, the Government also developed other health-related education programmes such as the Associate in Health Science Education programme, and retraining programmes, most prominent of which is the retraining of doctors as nurses; and, lastly, creating the National Health Workforce Support System to address local health workforce demands and manage local distribution issues.

These programmes are designed to actively deploy health professionals in underserved areas by the national government to support the efforts of the local governments.

The Philippines may have come a long way in managing migration of health workers, however, we continue to be burdened by the effects of these migration patterns. A balance has to be made to ensure that our respective health systems remain robust and competent, while at the same time, address the health workforce needs of the global community.

WAY FORWARD

Guided by the health sector’s medium health strategy for 2024-2028, the eight-point action agenda, the Philippines Department of Health is currently implementing the National Human Resources for Health Master Plan 2020-2030 as a framework to ensure that we achieve the balance we aim for.

The plan includes among its key results Health Education Strengthening and Regulations, with investments in sustainable production through health education strengthening and competency-based recruitment.

Human resources for health welfare, protection and career development are also included with a review now ongoing to ensure equitable workforce distribution, promoting decent work policies, and updating laws on compensation and working environments.

HRH Migration and Reintegration, together with improving data governance and information management, are also features of the plan.

The COVID-19 pandemic showed us the importance of the health workforce. The future of global health and our respective health systems depend on how we treat and invest in those who care for us. As policymakers and decision-makers, you have the power to shape this future.

To Jamaica, a new day dawns as our two nations forge a vital partnership to address the challenges of the global health workforce, and with it comes the promise of a new era of a South-South collaboration for health that I hope will translate into relevant actions and change the landscape of the health sector in the next decades to come.

It is an opportunity for us to turn shared challenges into collective action. Together, we can explore innovative and collaborative strategies to strengthen health workforce capacity, exchange knowledge and technical expertise on human capital development and systems strengthening, and promote decent work for health workers between our countries. This can serve as the foundation for our pursuit of universal healthcare and sustainable development.

Dr. Teodoro Herbosa is secretary of health, Republic of the Philippines. Send feedback to columns@gleanerjm.com