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Top Policy Recommendations to Invest in Health Workers

by Public Health Update

A critical lesson from the COVID-19 pandemic is that we must invest in strengthening the health workforce to enable equitable pandemic prevention, preparedness, and response and deliver essential health services. The following are urgent actions that finance ministers, health ministers, other policymakers, and donors must undertake at all levels to prepare the workforce for the future and ensure universal health coverage.

  1. Allocate increased, dedicated funding for long-term health systems and health workforce strengthening. Donors should support low- and middle-income countries’ health system reforms to build and sustain their health workforce, including nurses, midwives, and community health workers (CHWs). National-level stakeholders, including ministries of health, ministries of finance, and the private sector should collaborate to expand fiscal space and align budgeting for the health workforce needed for universal health coverage.
  2. Train and employ new health workers and retain existing health workers to meet health needs. Provide fair and timely pay and career advancement opportunities. Ensure gender equitable preservice training, recruitment, and compensation. Provide supportive supervision, continuing in-service education, and supplies and commodities to enable health workers to deliver high-quality and responsive health services and improve population health outcomes. Define workforce standards with a gender lens and include responsibilities and tasks, educational guidelines, and minimum competency requirements.
  3. Ensure safe and decent work for all health workers, including women and community health workers. Provide health workers adequate protection, including personal protective equipment, and ensure adequate water, sanitation, and hygiene services. Address violence against health workers and foster policies and investments that improve their working conditions, including by preventing and addressing gender-based exploitation, abuse, and harassment. Ensure adequate infrastructure and access to health services for all health workers—including mental health care and vaccination—without financial hardship.
  4. Integrate community health workers into national health systems and pay them fairly. CHWs in particular are under-supported, even though they play a crucial role in pandemic response and providing quality care, and they could be tapped to do even more. Many CHWs are not paid or are underpaid, and most of them are women. Collect data on all health workers disaggregated by gender, age, type, location, and contract; track service delivery and health outcome information; and use data for better informed workforce planning. Services provided by community health workers, in particular, must be tracked separately to optimize resources and impact.
  5. Involve frontline health workers—including women, nurses, midwives, and community health workers—in health policymaking, including emergency response committees, budget planning, and donor consultations so that their needs and lived realities are considered. Ensure global health initiatives include frontline health workers in health policy planning bodies, such as in Global Fund Country Coordinating Mechanisms and ensure frontline health workers are included in key planning processes, such as the development of PEPFAR Country Operational Plans and proposals to the Pandemic Fund.

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