Abstract
Background:Health workers in both well-resourced and limited income settings face health threats from exposures encountered in their unique and complex work environment. Even before the 2014 Ebola outbreak, preventable harm was routinely felt by health workers, most visibly through the fatal collusion between the HIV/AIDS epidemic and tuberculosis (TB) infection in high endemic countries.Objective:The aim of this paper is to examine the analyses of the health sector workforce by development and public health agencies regarding its sustainability, threats from workers’ personal health risks and discussion of protections to address those risks.Methods:Development and public health agency reports assessing the sustainability of and threats to the health workforce both pre-and post the 2014 Ebola outbreak were examined with a focus on low and middle- income countries (LMICs).Findings:Reviews of the health sector workforce have largely focused on its role as a necessary component of sustainable development. Hence, staff competency, numbers and productivity have been emphasized with little notice of the conditions of work and the highly hazardous environment contributing to worker out-migration, illness and death.Conclusions:Going forward, the 2016 World Health Assembly campaign to advance human resources for health and other UN efforts on health employment may offer some opportunities to address needed health worker protections. However, to these largely competency-focused workforce development efforts must first be brought resources for and commitment to protecting the safety of these workers’ lives and livelihood. Doing less defeats investments in fragile health systems and is plainly unethical.
Highlights
In both well-resourced settings and in low- and middleincome (LMI) countries, the health workforce is threatened with harm from exposure to agents encountered in a unique and complex work setting
While the Ebola outbreak is the most recent example of preventable harm faced by the health workforce [1], serious threats to these workers’ lives and livelihoods predated that historic devastation, most visibly through the HIV/AIDS epidemic and the fatal collusion between HIV/AIDS and tuberculosis (TB) infection in high endemic HIV regions [2]
Unique Hazards and Challenges of the Health Sector The health sector is best identified with the risk of exposure to life-threatening infections such as TB, SARS, HIV, and hepatitis, which have been the primary focus of University of Maryland, School of Medicine, Division of Occupational and Environmental Medicine, Baltimore, MD, US mmcdiarm@som.umaryland.edu health worker (HW) safety programs, where they exist
Summary
Health workers in both well-resourced and limited income settings face health threats from exposures encountered in their unique and complex work environment. Methods: Development and public health agency reports assessing the sustainability of and threats to the health workforce both pre-and post the 2014 Ebola outbreak were examined with a focus on low and middle- income countries (LMICs). Conclusions: Going forward, the 2016 World Health Assembly campaign to advance human resources for health and other UN efforts on health employment may offer some opportunities to address needed health worker protections. To these largely competency-focused workforce development efforts must first be brought resources for and commitment to protecting the safety of these workerslives and livelihood. Doing less defeats investments in fragile health systems and is plainly unethical
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