Anne Mugisa, Raymond Baguma and Irene Nabusoba
5 March 2008
Kampala — A global health conference, which ended in Kampala yesterday, called for massive commitments by international organisations and countries to increase the number of doctors and nurses to resolve the health workers crisis.
The participants also want rich countries to pay a recruitment fee to the poor countries whose health workers they import.
These are some of the recommendations contained in the 'Kampala Declaration', adopted by the over 1,000 participants from 57 countries who were present at the Global Forum for Human Resources for Health.
Prof. Francis Omaswa, the executive director of the Global Health Workforce Alliance, told journalists that it would be "reasonable" for spending on the health workforce to increase to $27b by 2015.
In Africa, training the 1.5 million new health workers needed would cost $3.3b per year over the next eight years, he noted.
The International Monetary Fund came under attack over its Structural Adjustment Programmes, (SAPs) which forced governments to cut on public expenditure, including health.
The participants noted that the SAPs played a major role in creating conditions that led to health workers to move to richer countries.
But the immigration of health workers, generally referred to as brain-drain, is not the only obstacle to the effective delivery of services, the conference noted.
The fact that different health institutions are fighting each other for the available resources was identified as another problem.
The Ugandan delegation criticised the fact that donors preferred project support to budget support - funds given directly to government ministries.
This ended up distorting remuneration packages, said Dr. Sam Zaramba, the Director General of Health Services.
He noted that the argument in favour of project support, corruption within Government, did not hold water, as was evidenced by the Global Fund scandal, which was given to a project.
Better services for health workers in Uganda had not been realised because there was not enough money within the budget, he argued.
The Kampala declaration called on governments to provide incentives to motivate health workers to remain in their home countries. It also asked governments to develop a database to monitor the flow of health workers in order to manage migration.
The conference called on government leaders, professional and international agencies to develop national health plans that address the health workforce and increase the number of doctors and nurses through training.
The Global Health Workforce Alliance is to monitor the implementation of the declaration and reconvene the forum in two years' time in order to evaluate progress.
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