Despite all of the financial aids and
resources that many organizations like WHO, UNISEF, philanthropic
foundations have provided for developing countries to improve their
public health issues and achieve the health-related of Millennium Development Goals(MDGs) still most of
these countries are not on track of
MDGs. People in such countries still suffer from burden of infectious diseases,
health inequality and discrimination. Global Health system has well defined the
strategic plans by providing evidence-based preventive and therapeutic
intervention to reduce health problems in low income countries but less
attention is paid on how to deliver those interventions so they can be
effective. There are many factors that impede the success of interventions such
as complexity of the programs, lack of human resources, health system capacity,
lack of engagement of the local implementers, inadequate integration of
research and the most important one lack of management and leadership.
In
order to strengthen health care system in developing countries special
attention should be paid on the role of leadership and management in such
system. Global health should study how to define intervention
plans and simplify its programs for public health systems in developing
countries, and put in place programs to train leaders in health care systems to
use their resources properly. A leader in health care system should know how to
use the resources, scale up health workers, reach and engage communities; match
the best delivery strategy to the specific health problem. A health manager should know how to involve
civic society and the voluntary private sectors who can help on proper decision
making which are vital in progressing health equity. This function requires
strong leadership from government Ministries of Health and World Health. I
refer to one of the challenges that global health organization encounters in
health care systems especially in low income countries which has great impact
on the health indicators.
There are significant disparities in developing countries
in terms of distribution of health professional, and levels of care. One of the
most important reasons is lack of strategy plans of human resource management
for attraction and retention factors to keep health professionals in rural
areas which have caused many health professional to work in urban areas while
most of the population in such regions are living in rural areas. The impacts
of such misdistribution of professional health workers in primary health care can
cause resistance of infectious diseases, increasing risk of environmental
health issues, people are not receiving clinical preventive health services,
and as a result raising the rate of mortality especially among children. The
success of strategies within a health sectors depends on management skills, for
instance someone who realizes the personal characteristics like age, gender,
marital status, and other factors which could have an impact on an individual's
decision. Also, experience manager who knows how to work with international
partners, stakeholders, political parties and institutional organizations in
order to influence and shape general living conditions as well as national
policies, and socio-economic status in remote and rural areas. These general
living conditions are including staff accommodations, schools and qualified
teachers, safe drinking water, electricity, roads and transportation which
could influence staffs attraction and retention.
Ultimately, in order to improve
public health issues and achieve the
health-related Millennium Development Goals, WHO and its
partners should consider designing a framework containing a guidance and
support in leadership and management development , such as developing negotiating
skills, support systems, money management, staff distribution, monitoring
information, supplies, and create comparative environments in health care
management among developing countries to encourage them to enhance their
performance.
1)Staffing remote rural areas in middle- and low-income countries: A
literature review of attraction and retention
Uta
Lehmann1*, Marjolein Dieleman2 and Tim Martineau3
2)Working paper - World Health
Organization www.who.int/management/working_paper_10_en_opt.pdf 2007
3)Health
equity: challenges in low income countries
4)www.ncbi.nlm.nih.gov.
Afr Health Sci. 2009 October; 9(Suppl
2): S49–S51. 5)What are the barriers to scaling up health interventions in low and middle income countries? A qualitative study of academic leaders in implementation science.
Gavin Yamey
I think that leadership and health management is a necessary infrastructure on which to base sound health systems. However, the terms "leadership" and "management" imply that there are resources and personnel to lead. Many developing countries must rely heavily on economic development to raise the standards of living and underlying health infrastructure to facilitate adequate health. Truth be told, the economic development is beholden to many factors beyond its direct control. International trade agreements, the influence of powerful international corporations, natural resources, inter and intra-national hegemony, and human capital all influence the potential that health leaders and managers can hope to accomplish. This is not to suggest that such leadership is not important but, rather, to delve more deeply into the underlying influences behind the curtain of what countries can actually accomplish. Could this be considered to be a large-scale manifestation of what Paul Farmer calls structural violence? Factors such as globalization may create unfair political, trade, and technological differences that may create opportunities for more wealthy individuals/countries to benefit off of others in vulnerable positions. Perhaps in light of this context, it can be seen that health leaders and managers must engage in an up-hill battle in order to gain even the most marginal health benefits. Although many programs have seen great results, much more improvement is to be had. The fact that so much yet has to be accomplished illustrates the unfortunate fate of those health weighs in the precarious balance between aggressive public health measures and the context in which these measures struggle to gain ground.
ReplyDeleteI agree with your opinion since there is a massive global shortage of health workers especially in rural regions in developing countries. For example, Sub-Saharan countries need to increase triple of current members of workers. If they recruit new workers, in most case, they are not professionals. Thus, the role of readership among human resources is really important and the readership should be in line with goals of health care system. This is because the most important route to reach the health through the health workers. MDGs is They have to build effective workforce strategies based on achievable evidence, which enhances the performance of health systems even under difficult circumstances.
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