This Week's News

  This Week's News

 
3 month payday loans, car loan emi calculator, discover student loan, loan calc, loan calculator, loan interest calculator, loan payment calculator, savings and loans, simple loan calculator, student loans gov
  This Week's News
 


2016 /2017 heib loans to be reflected   - Weekly news clippings service featuring articles on the Global Health Workforce Alliance and selection of articles from around the world on the issue of the health workforce crisis


The Global Health Workforce Alliance ¦ News from WHO and partners ¦ Africa & Middle East ¦ Asia & Pacific ¦  North America ¦  Europe ¦  Latin America & Caribbean 


This compilation is for your information only and should not be redistributed

Global Health Workforce Alliance


Date    Headline
    Publication
07.10.10    Call for Proposals: Mid-level Health Providers (MLPs) systematic review and country case studies.
    The Alliance

News from WHO and partners

Date    Headline
    Publication
07.10.10    WHO simplifies treatment of mental and neurological disorders 
    WHO
07.10.10    Webcast:  Invitation to a Presentation on e-Health Experience in Spain  
    World Bank

Africa & Middle East

Date    Headline
    Publication
04.10.10    Emergency care faces crisis due to halt in courses 
    Weekend Post, SA
01.10.10    Swaziland leads in nursing wellbeing of health workers  
    Swazi Observer
01.10.10    SA's ambitious NHI scheme to gobble up billions  
    Southern Times
04.10.10    Kenya: Training Health Workers On HIV Prevention for Positives
    IRIN PlusNews
06.10.10    Health minister puts numbers to the nursing crisis 
    Times LIVE, SA
04.10.10    Zambian state doctors end strike 
    News24, SA
06.10.10    Shortage of doctors to treat mental issues 
    Gulf News

Asia & Pacific

Date    Headline
    Publication
01.10.10    369000 Health Workers Have No Benefits   
    Manila Bulletin
03.10.10    Two CET centres sign deal to train more healthcare workers 
    Channel News Asia
03.10.10    Gov’t urged to find migration balance 
    GMA News TV, Philippines
02.10.10    Weak public health system causes infectious diseases 
    New Nation, Bangladesh
04.10.10    Health workers protest 
    Calcutta Telegraph
06.10.10    Health ministry backs rural medical course 
    India EduNews
02.10.10    NHI, doctor shortages affect district hospitals 
    China Post
01.10.10    Nine Provinces ‘in Dire Medical State’ 
    Jakarta Globe
05.10.10    Health care professionals stop work for pay increase 
    ABC News, Australia

North America

Date    Headline
    Publication
29.09.10    Progress in Prevention of Mother-to-Child Transmission of HIV 
IPS Terra Viva
29.09.10    Maine gets $1.9M to boost health work force 
    Portland Press Herald
30.09.10    States See Staff Shortage For Health-Care Overhaul - Report
    Wall Street Journal
30.09.10    Study: Work force shortage looms in Nashville
    Nashville Business Journal
04.10.10    Baucus announces Montanan Kim Gillan as 1 of 15 on National Health Care Workforce Commission
    Clark Fork Chronicle
03.10.10    MTSU nursing students aiding African colleagues 
    The Tennessean
04.10.10    Community Health Workers: Bridging the Health Care Gap
    Huffington Post
10.10    Institute of Medicine Releases Future of Nursing Report 
    Institute of Medicine
06.10.10    Keeping foreign health workers focus of pilot 

    CBC News, Canada
Europe

Date    Headline
    Publication
02.10.10    Achieving the health MDGs: country ownership in four steps
The Lancet, UK

03.10.10    New mothers 'let down by NHS postnatal care,' report says 
    The Guardian, UK
03.10.10    Does Health Care Reform Do Anything for Midwifery?
    RH Reality Check, UK
04.10.10    All applicants for University nursing courses accepted
    Malta Independent
01.10.10    Nurses Welcome Boost For Clinical Placements In Regional Australia
    Medical News Today, UK
05.10.10    More must be done to address the cost of private healthcare and medical workers' training 
    Irish Independent
05.10.10    Health secretary defends NHS reforms as criticism grows 
    The Guardian, UK
02.10.10    Expansion of cancer care and control in countries of low and middle income: a call to action 
    The Lancet, UK
01.10.10    La Slovénie va simplifier la procédure pour agréer les médecins étrangers 
    AFP
04.10.10    Sanidad recurre a titulados extranjeros ante la falta de médicos de familia 
Información, Spain


Latin America & Caribbean

Date    Headline
    Publication
06.10.10    Saturan hospitales públicos por la fuga de especialistas 
    Norte Digital, Mexico

05.10.10    Más que hospitales, falta presupuesto: SS 
    Diario Ciudad Victoria, Mexico
05.10.10    Seguidilla de paros pone en jaque sistema de salud cruceño 
    El Mundo, Bolivia
01.10.10    Es alta la mortalidad en prematuros 
    La Nación, Argentina
03.10.10    Llegar antes de tiempo
    Diario La Prensa, Argentina
04.10.10    Se intensificará durante octubre la lucha contra el cáncer de mama
    Notisistema, Mexico
02.10.10    Más de 500 habitantes de Kankí padecen por la falta de médico 
    Tribuna Campeche, Mexico
02.10.10    La salud pública en crisis 
    La Prensa, Bolivia
Back to top


Global Health Workforce Alliance

Call for Proposals: Mid-level Health Providers (MLPs) systematic review and country case studies The Alliance
07/10/2010

Building on the Community of Practice discussion on MLPs moderated by the Alliance in May 2010, the Alliance is soliciting technical and financial proposals from reputable teams able and willing to undertake the assignment and tasks laid out in the Terms of Reference (TOR) available below.

The assignment will entail the generation of evidence and sharing experiences on effectiveness, cost and impact, as well as modalities to scale up production, deployment and management of MLPs to address Millennium Development Goals (MDGs) in countries facing an acute HRH crisis.

The deadline for submitting proposals is 28 October 2010.

Related links
: Download the concept note and Terms of Reference [pdf 68kb]

:: Alliance online discussion on Mid-Level Health Workers, May 2010


News from WHO and partners
1
WHO simplifies treatment of mental and neurological disorders
WHO
07/10/2010

7 OCTOBER 2010 | GENEVA -- Millions of people with common, but untreated, mental, neurological and substance use disorders can now benefit from new simplified diagnosis and treatment guidelines released today by WHO. The guidelines are designed to facilitate the management of depression, alcohol use disorders, epilepsy and other common mental disorders in the primary health-care setting.

The Intervention guide extends competence in diagnosis and management to non-mental health specialists including doctors, nurses and other health providers. These evidence-based guidelines are presented as flow charts to simplify the process of providing care in the primary health-care setting.

"In a key achievement, the Intervention guide transforms a world of expertise and clinical experience, contributed by hundreds of experts, into less than 100 pages of clinical wisdom and succinct practical advice," says Dr Margaret Chan, Director-General of the World Health Organization.

Almost 95 million people with depression do not receive any treatment or care
The WHO estimates that more than 75% of people with mental, neurological and substance use disorders -- including nearly 95 million people with depression and more than 25 million people with epilepsy -- living in developing countries do not receive any treatment or care. Placing the ability to diagnose and treat them into the primary health care system will significantly increase the number of people who can access care.

Expensive technologies are not required to improve mental health services
"Improvement in mental health services doesn't require sophisticated and expensive technologies. What is required is increasing the capacity of the primary health care system for delivery of an integrated package of care," says Dr Ala Alwan, Assistant Director-General for Noncommunicable Diseases and Mental Health at WHO.

An estimated one in four people globally will experience a mental health condition in their lifetime. People with mental, neurological and substance use disorders are often stigmatized and subject to neglect and abuse. The resources available are insufficient, inequitably distributed and inefficiently used. In the majority of countries, less than 2% of health funds are spent on mental health. As a result, a large majority of people with these disorders receive no care at all.

Implementing the guidelines
WHO in collaboration with partners will provide technical support to countries to implement the guidelines and has already initiated the programme for scaling up care in six countries; Ethiopia, Jordan, Nigeria, Panama, Sierra Leone and Solomon Islands.

How the programme will help people
"The programme will lead to nurses in Ethiopia recognizing people suffering with depression in their day to day work and providing psychosocial assistance. Similarly, doctors in Jordan and medical assistants in Nigeria will be able to treat children with epilepsy," says Dr Shekhar Saxena, Director of the Department of Mental Health and Substance Abuse at WHO. "Both these conditions are commonly encountered in primary care, but neither identified nor treated due to lack of knowledge and skills of the health care providers."

The Intervention guide will help scale up care for mental, neurological and substance use disorders - which is the aim of WHO mental health Gap Action Programme (mhGAP). Multiple partners including Member States, UN agencies, research institutes, universities, multilateral agencies, foundations, WHO Collaborating Centres and NGOs under the (mental health Gap Action Programme (mhGAP) Forum have agreed to assist WHO in advocating for improving mental health care and services in developing countries.

WHO through its mhGAP programme, calls on governments, donors and mental health stakeholders to rapidly increase funding and basic mental health services to close the huge treatment gap.


2
Webcast:  Invitation to a Presentation on e-Health Experience in Spain
World Bank
07/10/2010

e-Health Experience in Spain
When: October 7, 2010, 4:00 - 6:00 p.m.
Where: F Building L - 109

Speakers: Pablo Rivero, Director of the Quality Agency, Ministry of Health and Social Policy, Spain
Esther Gil-Zorzo, International Projects Manager, Ministry of Health and Social Policy, Spain

Webcast: See webcast information below

Pablo Rivero and Esther Gil-Zorzo from the Spanish Ministry of Health will be presenting in the World Bank on the ICT programs in Spain for innovation in e-Health initiatives. They will be sharing the challenges and practicalities in the implementation of e-Health policies and modernization programs.

Topics to be covered will include

The challenges of interoperability and information continuity in the Spanish health system
The experience of e-health implementation at various levels of the Spanish system -- primary care, hospitals, regional level.
Importance of change management in health systems and support for human resource development
Mobile services for improving efficiencies in primary attention and patient information"
Live Webcast:

mms://wbmswebcast1.worldbank.org/live (Windows Media)
http://streaming7.worldbank.org/vvflash/extlive (Flash Player)

Please send your questions and comments using Adobe Connect during the event. To connect through your computer, please click on the following link:

https://worldbankva.na4.acrobat.com/r21453813/

When the Adobe Acrobat Connect Pro Meeting screen appears,
(1) select the Enter as a Guest option,
(2) type your first and last name in the corresponding text box and
(3) click on the Enter Room button.

More information on live webcast can be found at http://www.worldbank.org/edevelopment/live
Recorded webcast will be available at: http://www.worldbank.org/edevelopment/live


Back to top


Africa & Middle East
1
Emergency care faces crisis due to halt in courses
Weekend Post, SA
04/10/2010

Shaun Gillham WEEKEND POST REPORTER gillhams@avusa.co.za

THOUSANDS of prospective emergency healthcare workers in the Eastern Cape and across the country face being barred entry into the profession, while scores of training institutions servicing the industry face closure by the end of the year following a Health Professions Council of South Africa (HPCSA) decision to halt all emergency care short courses.

The training requirements for emergency care workers, such as ambulance assistants and critical care assistants, are facing a massive overhaul following a recent Pretoria High Court ruling which effectively allows medical authorities to put a stop to short course training in this sector.
In an effort to improve training and qualifications the HPCSA is proposing that prospective emergency healthcare workers complete a two-year national certificate or a professional degree in emergency care in order to be employed in the industry.

Port Elizabeth-based training provider Justin Gatley, who has 20 years’ experience in the healthcare worker training industry, said his company had recently started its last training course and would no longer provide short-course training.
“Besides the impact on companies which provide training, what concerns me is that thousands of people from all walks of life will now be precluded from entering this industry.
“Many of the people in the industry and many of those who want to enter it are from poor backgrounds. They will now find it exceptionally difficult to get into the industry as they will simply not be able to afford it. This may have an impact on available skills in this field in the future,” he said.

Gatley said although training centres were aware of the HPCSA decision, there were still a lot of “conflicting messages” coming from the Department of Health. “We have to wait and see what happens,” he said.
Adrian Trollop of Dynamic Emergency Services in East London echoed Gatley’s concerns, saying that should the Department of Health legislate the new qualification requirements, there will be critical staff shortages in the near future.

“There is already a shortage of training people in the industry in both the government and private sectors. This decision, if implemented, will have massive and dire consequences for the emergency healthcare industry. As it is, technikons and universities do not supply enough emergency workers into this field,” he said, adding that a substantial number of training centres around the country will have to close as a result.

The HPCSA reiterated this week that it remained committed to the proposed review of emergency care training and education with the intention of halting the current short course Basic Ambulance Assistants, Ambulance Emergency Assistants and Critical Care Assistants training.
This comes in the wake of the Pretoria High Court ruling which
 effectively dismissed an application by the Emergency Care Training Association to review or set aside the HPCSA’s intended stoppage of short courses which had been submitted as draft regulations to the Minister of Health to be published for public comment.
“The HPCSA is enforcing its mandate to protect the public through the proposed review of emergency care training by ensuring that in future persons entering the profession are sufficiently trained to safely use the drugs and skills in their scope of practice for a specific emergency situation,” said acting HPCSA chief executive and registrar Marella O’Reilly.

O’Reilly said the HPCSA believed the current short course training duration and content were inadequate to meet the demands of the pre-hospital environment. “If you take into account that almost 80% of ambulance crews are made up of practitioners with three to four weeks’ basic training, attending and transporting sometimes critical patients, we have to ensure that the citizens of South Africa are in qualified and well-trained hands.

She said the aim was to give the industry professional status whereby either a two-year national certificate or a professional degree in emergency care will be required. However, current registered emergency service personnel who choose not to complete the new courses will remain on the register.


2
Swaziland leads in nursing wellbeing of health workers
Swazi Observer
01/10/2010

By Calsile Masilela

THE Swaziland Wellness Centre recently opened a TB wing courtesy of the ICN/LILY Fund and the ministry of health.

Present during the occasion was Uganda Wellness Centre Coordinator, Cliff Asher. Officiating at the opening was Health Under-secretary Muntu Mntungwa.

Asher was on a week long attachment to the Swaziland Wellness Centre, where he was learning and absorbing best practices of implementing the wellness centre model in his country. Minister of Health  Benedict Xaba had earlier done a full inspection tour of the centre before opening of the TB wing. 
A memorandum of understanding between wellness centre and ICN/LILY Fund that will kickstart a TB project next year has already been signed.  

Asher’s attachment was a continuation of a trend by the region’s countries. Each country has sent its wellness centre’s staff for essential study tours to Swaziland.

They do this as means to understand and be oriented on the proper functioning of the wellness centre. Swaziland is the first country in the region to have initiated a project of this magnitude and its noble strategy is currently being rolled out across the region. The regional awakening comes as a result of the fact that sub-Saharan Africa bears 75% of the world’s HIV and AIDS burden, yet enjoys only three percent of the global health workforce.

The Lesotho Nurses Association opened their centre in 2007 and Uganda was currently in the implementation phase as were Zambia and Malawi.
The World Health Organisation (WHO), Physicians for Human Rights and others have applauded the wellness centre model as an innovative and effective response to the shortage of health care workers in sub-Saharan Africa.   

The centre, a private clinic, was established in 2006 to provide health services to health care providers in the country. Former president of the Swaziland Nurses Association (SNA) Masitsela Mhlanga said that the wellness centre model was a result of a 2003-4 survey investigating the brain drain from the health care services.
Greener

“During this time there was an exodus of 80% of the health workers to what we assumed were greener pastures. We were shocked to learn that they were not migrating because of greener pastures, but felt uncared for and undervalued in the workplace. Statistics were indicating that ill health was the largest factor in the attrition of the health workers. Health care workers that were unwell had to queue alongside their patients for  treatment.

He said  this led to the health workers feeling that their authority was undermined and in turn feared stigmatisation. He said that the old arrangement meant that health workers who suffered needle stick injuries were simply left on their own, with no provision to ensure protection against HIV infection.
Haemorrhaging

“Something had to be done to stem out the hemorrhaging of invaluable human resources from the Swaziland health care system. If these key workers were not tended to, the health system was surely threatened with collapse and hence the birth of the wellness centre was so noble.”  The centre’s coordinator, Muzi Dlamini, added that in 2005, the SNA leadership in collaboration with the International Council of Nurses (ICN) developed the novel programme of establishing a dedicated facility to cater specifically for the health, professional and psycho-social needs of all health workers.

“A wellness centre, offering a holistic suite of services including; stress management, HIV and TB testing, counselling and treatment, general health checks and screenings, post exposure prophylaxis and a resource-knowledge centre for continuous professional development was born.”
Since its inception in 2006, the Swaziland Wellness Centre for health care workers has managed to attend to more than 6 000 health care workers.


3
SA's ambitious NHI scheme to gobble up billions 
Southern Times
01/10/2010

By Gabriel Manyati

Johannesburg - One of the most ambitious projects ever implemented by South Africa's ruling ANC since the advent of democracy in 1994, the National Health Insurance (NHI) scheme, will guzzle tens of billions for renovating dilapidated hospitals, training health personnel and importing thousands of doctors.

Hospital renovations alone will consume more money than was spent on the 2010 Fifa World Cup stadia construction and renovation, as SA seeks to improve health care through the NHI, which the government expects to start implementing in 2012.

According to health minister Aaron Motsoaledi, the ANC wants to start implementing NHI, which aims to provide South Africans with affordable universal health coverage, from 2012, and the programme is expected to cost R128 billion in its first year, increasing to R376 billion by 2025.

The government is planning to import thousands of doctors to implement the scheme, funded by taxpayers and which the ANC said would be staggered over three stages, starting in 2012 with a five-year phase focused on rural areas.

'Implementation will be phased in over 14 years and rolled out for start in 2012 in the seriously under-served areas where people have difficulty accessing health care,' the ANC's health sub-committee chairman, Zweli Mkhize, said at the ruling party's national general council in Durban on Tuesday.

'Membership to the NHI would be compulsory for the whole population, but the public can choose whether to continue with voluntary medical scheme cover,' Mkhize said, reading from proposals discussed at the ANC's national general council.

The proposal suggests that the NHI be funded from various sources, including a surcharge on taxable income payroll taxes for employees and employers, and an increase in value added tax which is earmarked for the NHI.

'We will put massive investment – it will be more than what the country spent during the soccer World Cup,' Motsoaledi told reporters at Inkosi Albert Luthuli Hospital in Durban.

Motsoaledi, doctors, engineers and Development Bank of SA (DBSA) representatives were attending a workshop aimed at preparing for the revamp of Durban's King Edward VIII Hospital.

The hospital was one of five that would receive a massive, billion-rand facelift, Motsoaledi said.

The other hospitals were Nelson Mandela Academic Hospital in the Eastern Cape, Dr George Mukhari and Chris Hani Baragwanath Hospitals in Gauteng and the Limpopo Academic Hospital.

'The revitalisation is [part] of the ten point programme which is needed in preparation of the National Health Insurance (NHI). I am here to start that process.'

He said they had decided to involve all health stakeholders in the revitalisation programme.

'This has never been done before. We are discussing how it can be done and we will be forming task teams.'

Motsoaledi said the actual cost of revamping hospitals would be known after the teams had started their work.

Dr Massoud Shaker, provincial health department head of infrastructure, said the project manager for King Edward would be appointed before the end of the year.

DBSA divisional executive Lucy Chenge said her bank would be a partner and 'possibly finance it'.

There was a shortage of about 80 000 health care workers in South Africa, and Mkhize said the government would aim to train extra health care workers and look externally for more specialists.

'The South African health system requires more doctors and nurses,' Mkhize said.

'But we will be dealing with that. We need to improve the quality of our facilities and the number of staff, technicians and so on.

The idea is to get good quality health care for everyone.'

He admitted, however, that the shortage of graduates with the skills in maths and science was a major challenge.


4
Kenya: Training Health Workers On HIV Prevention for Positives
IRIN PlusNews
04/10/2010

Bondo — Kenyan health workers have been missing the opportunity to prevent HIV-positive people from infecting others because they lack the skills and knowledge to counsel this population, say specialists.

"Health workers have certain misconceptions about people living with HIV... many don't have the training in how to provide messages to those already infected," said Ann Okoth, the district public health nurse in western Kenya's Bondo district. "So people who are positive come [to health centres] and the opportunity to give information to them is lost.

"Training and counselling for health workers dealing with HIV-positive people is very important in improving people's health-seeking behaviour and in turn for the success of prevention with positives programmes."

According to a 2008 report by the Centre for Reproductive Rights and the Federation of Women Lawyers of Kenya, negative healthcare experiences can discourage HIV-positive women from seeking medical care.

Among other violations, the report noted that women living with HIV were frequently turned away from public health facilities or secluded in an area of the hospital away from other patients; reprimanded for bearing children or being sexually active, and denied access to contraception, family planning and maternity services.

Training
National guidelines for promoting prevention among people living with HIV were released in May and the government is now partnering with JHPIEGO, an NGO affiliated to Johns Hopkins University, to train health workers across the country to deliver messages about prevention to their HIV-positive patients.

"For instance, when you test a mother who has come to the clinic for antenatal care, the priority would be to have her bring her partner for testing also and to help them in disclosure and to prevent mother-to-child transmission of HIV," explained Tom Marwa, HIV/AIDS technical officer for JHPIEGO.

So far 1,940 health workers - nurses, clinical officers, counsellors and nutritionists - have been trained in counselling as well as how to prevent unintended pregnancies, and how to screen for and treat sexually transmitted infections.

A 2004 study showed that in Kenya, disclosing HIV status to partners was associated with a four-fold increase in reported condom use, but according to JHPIEGO, before the training, 69 percent of HIV service providers in Kenya did not advise their HIV-positive clients to disclose their status, while 32 percent did not discuss HIV prevention with them. Afterwards, 80 percent of health facilities visited were offering prevention with positives messages.

Couples' counselling
Leonida Ojuok is one of the patients at the Bondo District Hospital who has benefited from the training. When she tested positive during a routine antenatal visit, she was terrified of telling her husband. Women are often divorced and thrown out of their marital homes after a positive HIV diagno sis.

"I told the nurse that I was not going to tell my husband because he would kill me... but she just told me to tell him to come for the next visit," she told IRIN/PlusNews. "When we came together, she talked to us and tested us.

"Then she told my husband - I was HIV-positive but my husband wasn't. I am happy the nurse convinced him to support me... even today we have come to the clinic together."

Identifying HIV-positive people
"The focus should not only be on those whose statuses are already known and on ART [life-prolonging antiretroviral therapy] programmes or some kind of support," Marwa said. "The 'healthy positives' are out there spreading the virus without knowing it."

I told the nurse that I was not going to tell my husband [my HIV-positive status] because he would kill me

According to the results of a 2010 systematic review of behavioural interventions targeting HIV-positive individuals in developing countries, they were useful not only in providing HIV prevention messages but in identifying HIV-positive individuals.

According to government statistics, an estimated 83 percent of HIV-infected people do not know their status.

The authors of the review noted that because many HIV-positive individuals had limited contact with health centres, it would be important to move interventions beyond clinic settings and into the community.
[ This report does not necessarily reflect the views of the United Nations ]


5
Health minister puts numbers to the nursing crisis
Times LIVE, SA
06/10/2010

By Brendan Boyle - PoliticsLIVE

South Africa's nursing schools and colleges are chronically understaffed and none has been inspected in the past five years to check the quality of their teaching.

South Africa’s 119 nursing colleges are running at 110 % of their capacity, but with less than half the optimal number of staff, health minister Aaron Motsoaledi has told parliament.

In written replies to questions put by Democratic Alliance health spokesman Mike Waters, Motsoaledi said the state’s nursing colleges and schools should have 4 479 staff, but actually have only 2 033, which is 45.5 % of the optimal level.

But while they have the capacity to train 19 575 nurses at any one time, the colleges actually have 21462 students enrolled.

Motsoaledi conceded that only 19 schools and colleges had been inspected since 1998 to make sure they meet the state’s requirements and the most recent inspections were in 2004.

“That figure really is disgusting. It makes my blood boil,” Waters told PoliticsLIVE. "The colleges need to be inspected regularly to make sure they are producing nurses to the appropriate level of qualification and that’s just not happening. Not one has been inspected in the past five years,” he said.

The staffing rate at training institutions fluctuates from 70% in KwaZulu-Natal's 25 schools and colleges to just 20% in the Western Cape’s nine training colleges.

While the Western Cape has just over half the educators it should, it has only one of the optimal number of 123 clinical preceptors, who are experienced nurses who should mentor students during their practical training.

Gauteng has more than three-quarters of the 372 educators it needs and more than half the ideal number of support staff, but not one of the nursing mentors that should monitor students in the wards.

Waters said the staffing crisis reflected the health department’s historical lack of an efficient human resources strategy and the low priority given to training nurses.

Motsoaledi’s figures do not cover the country’s private nursing colleges, which, Waters said, delivered more than half the nurses the country needs.


6
Zambian state doctors end strike
News24, SA
04/10/2010

Lusaka - State doctors in Zambia have returned to work a week after going on strike, but say the government has yet to resolve the problems facing the health sector.

"We would like to inform the general public that the work stoppage by the Resident Doctors Association of Zambia has been suspended in the interest of our patients," the union's acting president, Amon Ngongola, said at a news conference in the capital, Lusaka.

Ngongola said that despite resuming work, doctors are still unhappy and lack motivation. They are seeking the intervention of Zambian President Rupiah Banda.

"We advise the president to address this persistent problem with utmost urgency," Ngongola said.

The doctors went on strike on September 27 after talks with the government broke down.

Ngongola did not take questions on the union's specific demands, but strikes by doctors to secure better pay and working conditions are common.

Last year, medical doctors went on an indefinite strike, during which a woman gave birth on a pavement at the University Teaching Hospital in Lusaka.

A picture of the woman giving birth was given to the Post Newspaper, which did not publish it but sent it to Deputy President George Kunda and women's groups, causing uproar.

The news editor of the paper, Chansa Kabwela, was arrested for spreading pornography, but was later acquitted.


10
Shortage of doctors to treat mental issues
Gulf News
06/10/2010

Dubai: There are not enough qualified doctors to treat the growing number of people with mental health issues in the UAE, a senior psychologist said.

Psychologists should be the first line of defence against mental illness, not the psychiatrist and [anti-depression] drugs, as is the case in the emirates, said Dr Layla Abdul Wahab Asamarai, head of the psychology section at Rashid Hospital.

She was speaking at the Mental Health Day commemorations on Saturday, October 9 at Mirdiff City Centre.

"Peoples' lives have become more stressful. The first line of defence [against mental anxiety] should be the family. But that is not happening enough and they [those afflicted] come to us," said Dr Layla.

Some mental health experts say that taking drugs for depression usually has long-term adverse effect on the health of the patient. Anxiety and depression among people in the UAE seems to be growing due to work pressures and other issues.

Many people complain that they also work longer hours. The psychologist said the out-patient clinic in the newly-opened section has been busy now that people have an option.

Doctors said there are about 180 specialists working in the various hospitals around the country and that the number is not enough. Many school and university students who feel the pressures of study do not have easy access to psychologists.

According to the World Health Organisation depression will be the leading cause of disability and death worldwide by the year 2020. It said that one in five persons experiences some mental disorder in any given year.

Dr Layla said "the stigma [against mental illness] is still there but we are trying to change the face of mental health".

The Saturday commemorations at Mirdiff City Centre include a Harley Davidson bike parade, Police Band performance and martial arts and yoga performances. The event is organised by the Community Development Authority and the Dubai Health Authority.


Back to top


Asia & Pacific
1
369000 Health Workers Have No Benefits  
Manila Bulletin
01/10/2010

By BEN R. ROSARIO

MANILA, Philippines — Despite working to provide health services for millions of barangay folk, some 369,000 Barangay Health Workers in the country ironically get no health coverage and other medical benefits similar to what they extend to the public.

This was revealed on Wednesday by Rep. Alfredo “Albee” Benitez (NPC, Negros Occidental) as he batted for immediate congressional action on House Bill 2394 which will provide BHWs additional benefits that are commensurate to their crucial role int he delivery of health services in the country.
Benitez said HB 2394 or the Magna Carta for Barangay Health Workers which primarily provides for a reasonable set of benefits and incentives to BHWs to compensate for the work that they perform in making health services accessible especially to people in far-flung areas.
“BHWs are unsung heroes. Their additional functions and work amid the scarcity of public health workers must be appreciated by giving them additional benefits and incentives,” he noted.
The neophyte lawmaker explained that BHWs do not receive regular pay for work done but merely get allowances.

They have no health coverage and other benefits that are being received by public health workers.
“It is a shame that BHWs do not even have health insurance. They are in the forefront of health services delivery but when they get sick or hospitalized, they cannot even count on their government to subsidize their hospital bills and to grant them free medicines” Benitez lamented.
HB 2394 mandates the provision of health benefits to BHWs such as compulsory PhilHealth coverage and their dependents. Premium  contributions shall be borne by their local government units.
For those who belong in the 4th, 5th and 6th class municipalities, the national government shall subsidize 50 percent of the contributions


2
Two CET centres sign deal to train more healthcare workers
Channel News Asia
03/10/2010

SINGAPORE: Early school leavers and those without any formal education can look forward to jobs in the healthcare sector.

Two training providers - HMI Institute of Health Sciences (HMI-IHS) and SSA Consulting Group (SSA) - have signed a deal to train about 100 people each year to ease the shortage in skilled healthcare workers.

Both are Workforce Development Agency (WDA)-appointed Continuing Education and Training (CET) centres which provide industry-recognised skills and certification.

Mr Suhaimi Salleh, CEO of SSA, said the training will bridge the learning gaps for lower- or even zero-skilled workers to step into the healthcare industry with confidence.

Those who qualify can expect jobs as healthcare assistants, operating theatre assistants, community healthcare assistants or therapy assistants, for example.

Associate Professor Muhammad Faishal Ibrahim, MP for Marine Parade GRC (Kaki Bukit), was at the signing ceremony at the Kaki Bukit Community Centre on Sunday.

After witnessing the signing of the deal, he also opened the "HealthCARE@Kaki Bukit" carnival at the community centre.

"HealthCARE" stands for Health Community Awareness outReach Event. It is expected to be a quarterly event for the community.

The "HealthCARE@Kaki Bukit" carnival was supported by the Kaki Bukit CC Committee, PA MESRA, Asian Women's Welfare Association Family Service Centre and Al-Ansar Mosque. More than 400 people attended the carnival.


3
Gov’t urged to find migration balance
GMA News TV, Philippines
03/10/2010

The Philippines should determine the “optimum level" of migration for different professions to prevent either a shortage or surplus in the country’s human resources.

Such an exercise will benefit both the country and its labor force by ensuring that the economy is well supported and at the same time providing the workers ample opportunity to recover their investments in education, Winfred M. Villamil, dean of the De La Salle University School of Economics, told BusinessWorld in an interview.

Migration for better work abroad is not bad in itself, Mr. Villamil said.

“People who would otherwise not invest in a college degree or in learning a new skill will be encouraged because of the prospect of working abroad and earning more. A certain optimum amount of migration will therefore raise the welfare not only of the migrants but also of the people left behind," Mr. Villamil said.

But the migration rate must be monitored as an imbalance will have a negative impact, he said.

Mr. Villamil said signs that migration in a particular profession has breached the optimum point is when shortages occur and when average productivity of workers in the profession is declining. Another sign is when there is a surplus of workers in the profession.

Such an imbalance can be observed in the nursing profession, Mr. Villamil said.

“When nursing became in demand abroad and a lot of people were being hired as nurses abroad, you saw all these nursing schools sprout and you see all these people enrolling in nursing schools," he said, noting that this sudden outflow of nurses temporarily caused a shortage of nurses locally.

“Today, I think we are now experiencing a surplus [of nurses]," he said.

Similarly, the number of Philippine workers in the maritime industry might also be breaching the optimum mark, as the demand abroad is now for more skilled workers.

“In terms of crews for ships, I think the demand is starting to decline.

We are also facing competition from other countries. I think the trend now is more toward the higher skilled level, for people who are going to be officers in ships," he said.

Mr. Villamil said once the national government determines the optimum level of migration in different sectors, it can encourage people to develop skills in professions where labor supply has not reached the optimum mark, so they can enhance their employment opportunities abroad.

“The government should also think about ways to control migration so that the flow is optimal, but without infringing on the right of people to go where they want to go," he said.

But Rene E. Ofreneo, professor at the University of the Philippines’ School of Labor and Industrial Relations, is cautious of the promotion of migration, saying this produces a “vicious cycle" that will end in the depletion of the country’s human resources.

“Our dependence on migration drains us of many high-end workers, such as engineers. This will slowly but surely affect the local industry and could even lead to the failure of local industries and even mission-critical services, such as health care," Mr. Ofreneo said in a telephone interview.

He urged the government to focus on developing the local job market. -- Nathaniel R. Melican, BusinessWorld


4
Weak public health system causes infectious diseases
New Nation, Bangladesh
02/10/2010

BSS, Dhaka

The absence of a robust public health system over the years has resulted in emergence of infectious diseases in Bangladesh and the current onslaught of endemic anthrax is a reflection of it, says the regional chief of the World Health Organization (WHO).

"A weak public health system in Bangladesh leads to spread of many infectious diseases in short intervals in this densely populated country," WHO's regional director for South-East Asia Regional Office (SEARO), Dr Samlee Plianbangchang, told BSS in an exclusive interview here.

Despite an epidemiological transition towards non-communicable diseases, Samlee said, infectious diseases appeared to remain as the main heath challenge for years in Bangladesh because of poor investment in public health neglecting the approach of prevention of disease than cure.

He said the long neglected health related factors such as malnutrition has led poor younger generations to become more susceptible to infections-the present leading cause of neonatal and infant mortality in Bangladesh. This country, he said, now should invest more on food security, nutrition, education, women and community empowerment to prevent infectious diseases and improve human health.

Samlee arrived here to launch a three-day regional conference on primary healthcare in emergency situations that ended on Thursday.

"As health is a multidisciplinary field, all concerned ministries and sectors such as water, sanitation, education and nutrition must act together to improve health of people as it is not the task of Health Ministry alone," said WHO regional chief on the eve of the conference.

Bangladesh has experienced several outbreaks of Japanese encephalitis, bird flu, swine flu and anthrax after 2007 in quick succession. Although the country contained the infectious diseases but it had to count a major health and economic loss during the last three years.

He said the coordination and collaboration among inter- agencies, including health and family planning, were crucial to extract best health outcomes in Bangladesh removing the long prevailing health sector dichotomy-health in one side and family planning on the other.

As this dichotomy is hurting health management and structures, WHO regional Chief advocated for coordination and collaboration among inter-agencies, including health and family planning for extracting best health outcomes in Bangladesh.

Samlee appreciated the present government's programme to reactivate 13,000 community clinics across the country. He, however, said the discontinuation of policies of running community clinics by previous governments left adverse affect on health, especially for rural poor. The community clinics must continue to strengthen Bangladesh's Primary Heath Care (PHC) in line with Alma-Ata declaration of 1978.

He referred to Bangladesh's shortage of health workforce for qualified doctors, nurses and midwives and said sometime the 'shifting of tasks' yield good results to promote health. In rural areas, he said, well-trained nurses or midwives can provide PHC as good as the general practitioners.

"If you don't have enough doctors, you may train quacks and see how they perform in communities," he said as Bangladesh is in shortage of an estimated 60,000 medical graduates, 483,000 health technologists and 120,000 nurses, and chances are very slim to fill the gap in near future. The development of health volunteers can, however, help offset existing shortage of health workforce at community levels, he said.

Bangladesh should focus more on 18 targets of eight millennium development goals set by the United Nations for 2015, Samlee said adding higher investment in primary healthcare can help Bangladesh attain heath related MDGs on time.

He appreciated Bangladesh's achievement of UN Award for MDG-4 ahead of schedule and urged the government to continue higher investment on girls' education for further acceleration of socio-economic growth, and thus reduce child and maternal mortality.

Asked about WHO's future supports, especially under emergency situations-earthquake and climate induced cyclone and flood situations-Samlee said his organization was devising a new strategy to enhance technical assistance for capacity building of volunteers and community empowerment.

He urged the government to involve more volunteers, improve disaster warning system and simulate disaster preparedness in short intervals to keep people ready to face emergency situations.


5
Health workers protest
Calcutta Telegraph
04/10/2010

A STAFF REPORTER

Guwahati, Oct. 4: About 6,000 workers of Accredited Social Health Activist (Asha) and Anganwadi members gathered in the city today to protest against the non-fulfilment of their demands.

The members, in the meeting held at Sahitya Sabha Bhavan near Dighaliphkhuri, decided to submit a memorandum to the government of Assam.

“We have been demanding fulfilment of various demands of our organisations for a long time. However, all our demands seem to have fallen on deaf ears and the state government has done nothing,” said Asha’s general secretary Biju Moupia.

“Our main demand is to increase the existing daily wages to Rs 200 according to the Supreme Court’s latest direction on minimum wages,” she said.

The government had also failed to regularise their jobs despite several assurances, she said.

Moupia said Asha and Anganwadi workers of Assam have been providing the best services in the country. It is the Asha workers who have been actively providing best of the healthcare services to the remote places of the state, she said adding that the government was yet to cover the workers under any life insurance schemes.

Asha is one of the key components of the National Rural Health Mission, which provides every village in the country with a trained female health activist. The workers are selected from the villages and are accountable to it. They are trained to work as an interface between the community and the public health system.

“We have also demanded the government of Assam to ensure that Asha and Anganwadi workers are given similar status like the employees in other government services,” she said.

The organisation would not stop their agitation programmes unless the government fulfilled their demands.


6
Health ministry backs rural medical course
India EduNews
06/10/2010

New Delhi: While widespread protests have stalled a proposal to start a three-year rural medical course, the union health ministry maintains it would be the most effective solution to tackle the lack of trained medical professionals in villages.

"We lack trained medical professionals in rural areas and this will help in meeting the demand-supply gap," Health Secretary Sujatha Rao told the sources.

"Doctors don't want to go to rural areas, so if we train people from local areas and give them a diploma, we will be able to meet the gap in providing healthcare," Rao said.

The Bachelor in Rural Medicine and Surgery (BRMS) course proposed by the health ministry will be a three-year short-duration course that will give students a diploma, enabling them to practice in rural areas only.

The health secretary said that since the course will take mostly local students, they will serve in their villages, thereby solving the problem of shortage of trained professionals.

"The lack of doctors strengthens the nexus of quacks. Earlier, they were only into treating people, now a nexus is developing between the doctors of nearby towns and village quacks," Rao said.

"These quacks play brokers in taking village patients to the doctors, take commission and the poor villagers are charged more. We need to change such a situation," she said.

Lack of trained medical professionals has been repeatedly highlighted as one of the biggest challenges for India by leaders at all levels, including Prime Minister Manmohan Singh and Health Minister Ghulam Nabi Azad.

The health ministry is also contemplating making it mandatory for graduates who have received subsidized education to serve in rural areas for some time.

The secretary, however, added that the new course would serve the immediate needs of villages.

"This is what China did to meet the need for rural doctors. We too need to address the gap in service," the secretary added.

She added that consultations are on with all stakeholders and various state governments to take the proposal forward. The secretary, however, did not give a time line for starting the course. IANS


7
NHI, doctor shortages affect district hospitals
China Post
02/10/2010

The National Health Insurance (NHI) program, which has been in effect for 15 years, has placed the operation of district hospitals in peril, reported Control Yuan member Huang Huang-hsiung yesterday, adding that the number of district hospitals nationwide has dropped from 568 to 385.

According to Huang, the rise of national health insurance payments and a lack of doctors have made it increasingly difficult for district hospitals to maintain operations. The Control Yuan member urged the government to create policies that would protect and ensure the survival of regional hospitals.

In a press conference yesterday morning, Huang said district hospitals not only shoulder the responsibility in the frontline of patient emergencies and primary health care, they are also the first places that victims of natural disasters flock to seek immediate aid. Following the devastation brought on by the 921 Earthquake and Typhoon Morakot, district hospitals served as the emergency operation centers for many patients, Huang added.

With the advent of the NHI program, many patients prefer the services of medical centers, causing a huge void at district hospitals, Huang explained. After 15 years of the insurance program, the Control Yuan member described medical centers as burgeoning, regional hospitals seeing an increase in operations, while district hospitals suffered the greatest decline.

In 1995, there were 568 district hospitals accounting for 90.3 percent of all medical facilities, 13 medical centers (2.07 percent) and 48 regional hospitals (7.63 percent). By 2009, district hospitals declined to 79.22 percent, while medical centers and regional hospitals rose to 4.73 percent and 16.05 percent, respectively.

In terms of the hospital expenses reported and its correlation to the medical services offered, a 2009 survey found that medical centers accounted for 41.2 percent, regional hospitals took up 37.7 percent while district hospitals, only 18.7 percent with other facilities accounting for the remaining 2.4 percent.

Huang said the physician salaries at district hospitals were not necessarily lower, yet because of the fact that the facilities were located in more rural areas combined with the amount of money paid for by the NHI, manpower has been hard to find, resulting in its decline. Huang urged for the government to come up with the appropriate policies and provide the necessary funds to keep the hospitals operating.


8
Nine Provinces ‘in Dire Medical State’
Jakarta Globe
01/10/2010

Nine provinces have huge health problems because of a lack of medical practitioners and prevention efforts, the government says.

Health Minister Endang Rahayu Sedyaningsih said on Friday that the main diseases affecting these areas were largely preventable, such as HIV/AIDS, tuberculosis and malaria.

“These three also account for the highest number of illnesses in the country,” she said.

The inability to tackle them was largely because of a lack of qualified doctors and nurses, even in regions where the government had set up health centers to cater to remote communities.

“For this reason, we’re offering full scholarships for doctors from these provinces who want to specialize and return to their provinces,” Endang said.

The nine are Aceh, West Nusa Tenggara, East Nusa Tenggara, West Papua, Papua, Central Sulawesi, Southeast Sulawesi, Maluku and Gorontalo — the latter eight all in the country’s less-developed eastern half.

Another challenge, Endang said, was to boost preventive measures in the provinces.

“In places such as Papua and West Papua, the lack of access to health centers remains the biggest barrier, even though we have mobile clinics,” the minister said. “But these clinics can’t teach the locals to adopt healthy practices once they leave.”

Endang cited the example of diarrhea, a common ailment in regions lacking clean water.

“A mobile clinic can provide clean water to a village for a week, as well as medicine to treat diarrhea patients, but it can’t help the residents build a water reservoir,” she said.

“While technically the construction of a water reservoir is the responsibility of the public works office, as health officials we need to be more proactive in helping the people.”

These challenges threatened to set back Indonesia’s progress toward meeting the UN Millennium Development Goals on eradicating poverty and raising health standards, she said.

Endang also called for more meetings between regional officials and medical practitioners to streamline and optimize health programs at the local level.

She said West Nusa Tenggara had made progress by encouraging healthy living among its residents, including by rolling out campaigns to promote better nutrition for children and expectant mothers.

In 2007, 13 percent of children under the age of 5 were deemed moderately malnourished, while 5.4 percent were chronically malnourished. This year, the number of moderately malnourished children is the same, but fewer are chronically underfed.


10
Health care professionals stop work for pay increase
ABC News, Australia
05/10/2010

By James Kelly

Hundreds of health workers went on strike in regional Queensland today demanding a better pay deal from the State Government.

The Queensland Public Sector Union (QPSU) says as many as 800 health professionals, including radiographers, psychologists and social workers, walked off the job in Cairns, Townsville and Toowoomba in support of their pay demands.

The Government has offered them an annual pay rise of 2.5 per cent over three years, but QPSU spokesman Heath Mitchell says that is nowhere near enough.

"2.5 per cent is a fettered bone, tossed out to the people with an added measure of a kick in the guts for your wages and conditions," he said.

However, Queensland Health (QH) says the professionals are the highest paid in Australia and the industrial action has had little impact on patient care.

A similar stop work rally is planned for Brisbane on Thursday


Back to top


North America
1
Progress in Prevention of Mother-to-Child Transmission of HIV
IPS Terra Viva
29/09/2010

By Susan Anyangu-Amu

NAIROBI, Sep 28, 2010 (IPS) - The number of pregnant women being tested for HIV and accessing treatment in Sub-Saharan Africa has shown significant progress – indicating that virtual elimination of mother-to-child transmission of the virus by 2015 is possible.

According to a new report Towards Universal Access, the proportion of pregnant women in Sub-Saharan Africa who received an HIV test increased from 43 percent in 2008 to 51 percent in 2009. The report by the World Health Organisation (WHO), the United Nations Children’s Fund (UNICEF) and the Joint United Nations Programme on HIV/AIDS assessed HIV/AIDS progress in 144 low- and middle-income countries.

It found an estimated 24 percent of the approximately 125 million pregnant women in these countries received an HIV test in 2009, an increase from 21 percent in 2008 and eight percent in 2005. Fifty-four percent of HIV-positive pregnant women in Sub-Saharan Africa received antiretroviral drugs to prevent transmission to their children in 2009, up from 45 percent in 2008.

Speaking to IPS during the launch of the report in Nairobi on Sep.28, UNICEF regional director Elhadj As Sy said the progress made in the prevention of mother-to-child transmission is testimony of the fact that virtual elimination by 2015 is achievable.

"What we need is strong political leadership, funding, good programs and activism. If we build on the progress and with renewed commitment we are well on our way to achieving virtual elimination by 2015," Sy said. However, despite the progress there are still challenges with disparities between regions and within countries.
Four countries in the region report providing HIV testing and counselling to over 80 percent of pregnant women. They are South Africa, Zambia, Namibia and Botswana. These countries have already reached the target set at the United Nations General Assembly Special Session (UNGASS). This is the target of providing 80 percent of pregnant women in need of treatment with antiretroviral drugs to reduce transmission to their children.

Despite the marked progress, countries in Eastern and Southern Africa fared better than their counterparts in West and Central Africa. In Eastern and Southern Africa, 50 percent of pregnant women received HIV testing and counselling, an increase from 43 percent in 2008. In Western and Central Africa, coverage increased from 16 percent to 21 percent between 2008 and 2009.

"While the figures in Western and Central Africa are low, this does not mirror failure on their part. The burden of HIV/AIDS has leaned heavily on Eastern and Southern Africa and this is where most interventions have been directed. Western and Central Africa are just beginning to pick up the problem and their burden of the epidemic is lower," said Dr. David Okello. Okello is director, HIV/AIDS, Tuberculosis and Malaria Cluster at the WHO regional office for Africa.

Seven countries including Nigeria, Angola, Democratic Republic of Congo (DRC) and Ethiopia provided HIV tests to less than one third of pregnant women. "Knowing and accessing treatment is very crucial. Greater investments are needed to increase HIV testing and counselling among pregnant women in order to effectively prevent mother-to-child transmission of HIV," Okello said.

Nigeria, DRC, Ethiopia and Uganda are still far from attaining the UNGASS target. These four countries contributed to 50 percent of the global gap in reaching the UNGASS target. The global gap is the difference between the current number of pregnant women in need who have access to ARVs and the estimated number who must be reached to achieve the UNGASS goal. Nigeria alone accounts for almost one third, 32 percent of the gap.

The number of children receiving antiretroviral therapy in Sub-Saharan Africa rose from 224,100 to 296,000. However, the total coverage among children in the region is still low at 26 percent compared to adults at 37 percent. "Too many children are still dying in this time and era when we can test and treat. We need to do more to reach the 10 million who still need treatment," Sy said.

Among infants and children exposed to HIV, access to early testing, care and treatment is still a challenge. More than 90 percent of children living with HIV are infected through mother to child transmission during pregnancy, around the time of birth or through breastfeeding. The challenges facing Sub-Saharan Africa include weak integration of services, persistent drug stock-outs and little follow up of patients started on treatment.

"To address these challenges, countries need to strengthen health systems, improve integration of services and bring facilities closer to the people," Okello said.

Integration of services means having related areas close together such as child and maternal health, tuberculosis and reproductive health services. "We need to develop strategies to reach out to every woman and child especially those in marginalised areas, the poor and those living in rural areas. We need to counter stigma and discrimination and the risk of violence against women particularly," Sy said.

Countries need to develop mechanisms to engage communities as partners and establish links between health facilities and the local people. Address challenges that keep people away from health facilities such as financial barriers and user fees. Strong follow-up systems are needed to monitor and ensure identified needs are actually being met. Many infants and pregnant women who test HIV-positive are lost to follow up.

However, Sub-Saharan Africa which greatly relies on donors for its HIV interventions, faces tough times in the future, with the announcement that funding is steadily declining. "Funding for HIV has flat-lined for the first time in 15 years. In 2009 we had 8.7 billion dollars, now we have 7.7 billion (dollars), the funding gap has increased to about 10 million dollars," Okello said.

African governments are being urged to increase national budget allocation to healthcare. "Countries must live up to the Abuja declaration of 15 percent of national budget going towards health. With good governance structures and accountability, these monies can be put to good use. The advantages of increased investment in healthcare are immense," he said.

The platform at the Global Fund replenishment conference in New York in October will be used to appeal to governments to reduce the funding gap.


2
Maine gets $1.9M to boost health work force
Portland Press Herald
29/09/2010

By John Richardson jrichardson@mainetoday.com, Staff Writer

Maine has been awarded nearly $1.9 million in federal aid to help reduce a shortage of primary health care workers.

The U.S. Health and Human Services Department has announced a total of $320 million in grants under the Affordable Care Act to strengthen the country’s health care work force through a variety of programs, including by training low-income workers for health careers.

Maine and other states are in need of more primary care physicians, physician assistants, nurses and other professionals to meet the demands of an aging population and expanded access to health insurance due to federal reforms passed early this year.

Maine is receiving a portion of the funding to help states as they plan and implement their own strategies to address the work force shortages.

“Investing in our primary care work force will strengthen the role that wellness and prevention play in our health care system,” HHS Secretary Kathleen Sebelius said in the department’s announcement. “With these grants, Americans from all backgrounds will have new opportunities to enter the health care work force


3
States See Staff Shortage For Health-Care Overhaul - Report
Wall Street Journal
30/09/2010

By Ruth Mantell

 There may not be enough state staffers to implement President Barack Obama's health-care overhaul on time, and contractors may need to be hired for some "key" responsibilities, according to a report released Thursday by the Kaiser Family Foundation.

While there is expertise among state staff members, designing insurance exchanges and handling increased Medicaid enrollment will be challenges, with many major health-care overhaul provisions going into effect in 2014.

"States are concerned that there is not adequate staff capacity to carry out the volume of work within the fixed time frames under [health-overhaul law]," according to the report. "Many states have not completed a comprehensive work-force needs assessment, but all are concerned about their aging work force, limitations of state hiring processes and salary schedules, as well as the effects of the recession on the state work force, particularly with the amount of work required to implement health reform."

The report examined five states that analysts thought represented a range of geographic and political experiences: Connecticut, Michigan, Massachusetts, North Carolina and Washington.

The establishment of exchanges is the "biggest work-force challenge" of the health-care overhaul, according to a senior official cited in the report. To work on technology systems and health exchanges, states expect to hire consultants, and there may be increased competition for these workers, according to the report.

"Because all states are working on the same timelines to develop similar programs, contractors with special expertise--particularly for design of health-insurance exchanges and complex information-management systems--could be in short supply," according to the report.

Expanding Medicaid also presents a challenge as in most states administrative capacity is "already very lean," and new requirements will "stretch that capacity," according to the report.

"Building the infrastructure needed to administer vastly expanded Medicaid programs will stretch both staff capacity and expertise, particularly in creating more sophisticated information systems to expedite eligibility determinations and enrollments," according to the report. "Generally, additional staff will most likely be required to meet new program responsibilities as well as larger caseloads."

Separate analysis from Kaiser found that Medicaid enrollment rose by 3.7 million people between December 2008 and December 2009, as the weak economy took its toll.

An aging work force also presents a challenge to implement the health-care overhaul, according to the report. The greatest recruitment challenges are for higher-level positions, as well as spots requiring specialization or licenses, such as those for technology professionals, nurses and doctors, according to the report.

"Overall, a looming talent challenge is emerging as one-third of the state government work force is eligible to retire in the next five years," according to the report. "Human-resource managers say they are having difficulty finding qualified candidates for positions that require substantial expertise and experience given the competitive job market for these positions."

The report added that the recession has "exacerbated pressure on state work force capacity."

"With ongoing publicity about state budget challenges, state employment no longer enjoys a reputation for job security," according to the report. "State officials fear that ongoing publicity about state budget challenges may make state employment a less attractive option even if funding for new or frozen positions becomes available."
-By Ruth Mantell, 415-439-6400; AskNewswires@dowjones.com


4
Study: Work force shortage looms in Nashville
Nashville Business Journal
30/09/2010

by Dan Hieb Staff Writer

Nashville will experience a worker shortage starting in the middle of this decade, according to a report released today by the Nashville Area Chamber of Commerce.

The shortage will be caused by retiring baby boomers, a smaller crop of workers to replace them, and continued job growth, according to the “Leveraging the Labor Force for Economic Growth” study, which projects that unemployment will return to pre-recession levels in 2015 or 2016.

By 2019, the study projects there will be 23,688 more jobs than there will be workers to fill them.

Professional and business services, health care and financial activities are expected to experience the most growth, with manufacturing continuing to decline.

The study urges schools and policymakers to guide more people to careers in health care, information technology and engineering.

The full study can be read here.

Some highlights:
151,000 new jobs: That’s how many new jobs the study projects by 2019.

Retirement-driven worker shortfall: More than 67,500 workers will reach retirement age this decade, and only 24,400 people will enter their early working years — leaving a gap of 23,688 workers by 2019.

Increasing entrepreneurship: The percentage who are self-employed increased from 18.3 percent in 1998 to 22.7 percent in 2008.

Education and money: Nearly 28 percent of adults have a bachelor’s degree or higher, better than the overall figures for the U.S. (26.7 percent) or Tennessee (21.6 percent). People with advanced degrees earned an average of $85,865, those with a four-year degree averaged $60,185 and those with a technical degree averaged $41,140. Williamson County is the most educated in the region, with 48.1 percent of adults having at least a four-year degree. Dickson County is least (12.5 percent).

Continued hiring during the recession: 85 percent of the businesses surveyed said they hired workers in the past year, with 28 percent hiring more than 25 positions, 57 percent currently hiring, and 23 percent hiring for more than five positions.


5
Baucus announces Montanan Kim Gillan as 1 of 15 on National Health Care Workforce Commission
Clark Fork Chronicle
04/10/2010

by Jennifer Donohue

Montana’s senior U.S. Senator Max Baucus announced today that State Senator Kim Gillan has been appointed to be one of 15 experts and heath care professionals nationwide to serve on the National Health Care Workforce Commission. Baucus helped create the independent group of experts to find ways to strengthen and improve America’s health care workforce, and Baucus pushed hard to get Gillan on the panel to ensure Montana had a strong advocate for rural needs on the commission.

“This commission will do important work to help us prepare our health care workforce to meet the needs of the 21st century. And I fought hard to make sure Montana has a voice on the commission to meet the specific needs of our rural state,” Baucus said. “I’m so proud to announce that Montana State Senator Kim Gillan will be that voice for Montana. I know Kim will fight for the rural needs of our state and she will bring common sense and practical experience to the discussion.”

“I am honored to be appointed to the commission and eager to get to work advocating for rural health care workers and patients. I will use my first-hand experience working with rural health care professionals in Montana to focus the commission on ways to address the specific needs of states like Montana,” Gillan said. “I thank Senator Baucus for recognizing the importance of addressing the specific needs of rural and frontier hospitals and for stepping up to provide the tools rural facilities need to develop a strong workforce to serve Montana patients.”

Baucus helped create the National Health Care Workforce Commission in the Affordable Care Act to provide independent insight for lawmakers on ways to help our health care workforce meet the needs of patients. For example, the commission will focus on ways to address the shortage of health care workers across the country, including in rural states like Montana. And the commission will explore the best ways to train the next generation of doctors and nurses to provide the best care for America’s patients.

As part of the Affordable Care Act, Baucus helped to double funding authorization for the National Health Service Corp which provides scholarships and student-loan repayments for doctors who practice in rural areas.

“Kim’s smart, she’s driven, she works hard, and she’ll bring a unique perspective to this panel,” said Tester, who joined Baucus in recommending Gillan’s appointment to the commission. “Folks like Kim will lead us forward in the right direction as we work together to continue improving access to quality, affordable health care—especially in Montana and across rural America.”

Gillan is the Workforce Development and Training Coordinator at Montana State University’s Billings College of Professional Studies and Lifelong Learning, where she coordinates short-term workforce training targeted at rural health care facilities and manages an innovative training effort to improve the job readiness and skills for underserved populations. Gillan is a second-term Montana State Senator and also serves on Montana's State Workforce Investment Board and the Montana Economic Development Advisory Board.


6
MTSU nursing students aiding African colleagues
The Tennessean
03/10/2010

Students in MTSU's School of Nursing are teaming up to help their embattled colleagues half a world away — in Botswana, where nurses are often the only health care practitioners citizens ever see.

The university's Student Nurses' Association plans a "Bake for Botswana" event on Tuesday to raise funds to support a national campaign, "I Am Proud to Be a Nurse," aimed at improving the image and increasing the number of Botswanan nurses and midwives and ultimately improving health care options for the South African nation.

The "I Am Proud to Be a Nurse" campaign, held in conjunction with the 2010 International Year of the Nurse, intends to purchase buttons for each of Botswana's 7,500 nurses as a show of support for their efforts. The buttons, which also can be purchased by and for U.S. nurses, are $5 each.

The bake sale will be held on the second floor of the Keathley University Center and on the KUC knoll from 10 a.m. to 2 p.m.; all bake-sale and button proceeds go to the Botswanan button effort.
"Many nurses work in difficult circumstances in Botswana, exposed to shortages of equipment, medicines and poor practice environments. Retaining nurses in the profession has become an even bigger challenge due to compromised working conditions, high workloads and the expanded scope of practice," said Dr. Debra Rose Wilson, MTSU nursing professor.

Wilson met with leaders of Botswana's nursing community this summer, including the Nurses Association of Botswana and the country's Ministry of Health, to discuss a plan of action for the nursing shortage there.
"In the United States and Canada, there are between 10 and 15 nurses per 1,000 people, depending on the state or province," Wilson noted. "The ratio of nurses is about 3.8 per 1,000 in Botswana. Opportunities for education, both a bachelor's degree and a three-year diploma in nursing, are available, but recruitment is challenged because of the limited number of local options available to high-school graduates."

Wilson observed that the image of nursing in Botswana has become somewhat tainted because of complaints of substandard care, workplace violence and other issues that most nurses in North America never face.
"The nursing leaders in Botswana recognize that the image of nursing is influenced by nurses' professional conduct, appearance, commitment, confidentiality, knowledge and skills base and, most of all, a caring approach to patient care," Wilson explained.

"In North America, the high standards of education, tightly regulated practice, recognition of nursing as an esteemed profession and the greater availability of resources contribute to effective and honorable nursing practice. In Botswana, however, the compromised circumstances in which nurses often work have affected the image of nursing negatively."
For more information, contact Wilson at 615-898-5841 or drwilson@mtsu.edu


7
Community Health Workers: Bridging the Health Care Gap
Huffington Post
04/10/2010

James R. Knickman, President and Chief Executive Officer of the New York State Health Foundation

While the current debate on health reform has focused on whether it is too much big government, too expensive, or too intrusive, a key challenge is how we will find the medically trained people to take care of our everyday health care needs. Finding people who focus on primary care--especially for the chronically ill--predates the passage of health reform, but will become crucial as 32 million people become newly insured.

On Tuesday, October 5, 2010, an important Institute of Medicine report examining the challenges of developing a health workforce to care for an aging society with more insured Americans will grab headlines.

While the report focuses much of its attention on impending nursing shortages, I hope the national discussion--and the New York State discussion--can focus on the broader issue of developing primary care teams to better manage health needs. The days are ending when a physician, or even a physician and a nurse, do all of the work to manage the care of people with complex chronic conditions.

In our discussions about primary care, we should include a part of our health workforce that plays an important role in improving outcomes and efficiency in managing people with chronic health problems: community health workers.

The Federal health reform law recognizes community health workers as important members of a redesigned health care system that includes more attention to team-based care and community-based services to prevent and manage chronic conditions, like diabetes and asthma. These workers provide a range of services, educating their clients about health issues, like smoking or nutrition, and helping them navigate complex health care and social services systems.

Community health workers have been particularly effective in facilitating enrollment in public health insurance programs and in connecting uninsured clients to the care they need, when they need it. Both of these competencies will be in high demand as an estimated 1.2 million New Yorkers gain health insurance coverage under Federal health reform, but hundreds of thousands remain uninsured.

At a meeting I attended last week, someone asked, "Why community health workers, specifically? What makes them different?" One of my colleagues explained that anyone can read about what it means to go to bed hungry, but a community health worker in a low-income neighborhood has herself or himself gone to bed hungry.

Community health workers are effective because they are members of the communities they serve; they and their clients have a shared experience, language, and understanding that allows for real trust to flourish.

Among the several obstacles to formally integrating community health workers into health care teams, the most daunting is a lack of a mechanism in New York State to reimburse for the services community health workers provide. Other states, like Minnesota, have secured Medicaid reimbursement; New York would be wise to follow suit. Developing a standard scope of practice for the profession and instituting uniform core competencies for training and certification are important first steps to take.

Federal health reform gives us an unprecedented opportunity to reshape the health care system in New York State and to reimagine what a high-quality team of health care providers looks like. Educational institutions, policymakers, health insurers, community health workers, and other health care providers all have a stake in achieving that vision and ensuring that community health workers are an integral part of our shared goal to improve patient care and reduce health care costs.


8
Institute of Medicine Releases Future of Nursing Report
Institute of Medicine
/04/2010

Landmark Report Outlines Blueprint for Nurses’ Role in the Future of Health Care
The Institute of Medicine has released a landmark report on nursing, Future of Nursing: Leading Change, Advancing Health. Secretary Donna E. Shalala led the committee that developed the report, which outlines a path for transforming our nation’s health care system in a way that puts patients and people first.

The complete report is available for free on the IOM Web site.

Content:
Summary (1-14)
Overview of the Report (15-18)
1 Key Messages of the Report (19-42)
2 Study Context (43-68)
3 Transforming Practice (69-138)
4 Transforming Education (139-184)
5 Transforming Leadership (185-212)
6 Meeting the Need for Better Data on the Health Care Workforce (213-226)
7 Recommendations and Research Priorities (227-242)

A Methods and Information Sources (243-260)
B Committee Biographical Sketches (261-266)
C Highlights from the Forums on the Future of Nursing (267-272)
D NCSBN Consensus Model (273-316)
E Undergraduate Nursing Education (317-322)
F Health Care System Reform and the Nursing Workforce: Matching Nursing Practice and Skills to Future Needs, Not Past Demands (323-346)
G Transformational Models of Nursing Across Different Care Settings (347-384)
H Federal Options for Maximizing the Value of Advanced Practice Nurses in Providing Quality, Cost-Effective Health Care (385-414)
I The Future of Nursing Education (415-492)
J International Models of Nursing (493-560)

The report outlines eight bold recommendations calling for significant improvements at the national, state and local levels through on the topics of nursing education, scope of practice, leadership and evidence. The IOM anticipates this report will have a significant effect on how our health care system is remodeled to meet the changing needs of patients and how nurses are educated and trained to deliver high-quality care.

In a statement and video address, Risa Lavizzo-Mourey, CEO of RWJF, says this report marks a significant milestone for improving the health of our nation. She calls for leaders in every sector of health care, business, education, government and philanthropy to work together to put these recommendations into action.

Please join us as we work to make these recommendations a reality. Sign up to get involved or stay connected as we take steps to improve the health and health care of all Americans.

More information on the Initiative on the Future of Nursing and the Future of Nursing: Leading Change, Advancing Health report is available at:
•         http://thefutureofnursing.org/
•         http://twitter.com/futureofnursing  (#futureRN)
………….http://www.facebook.com/futureofnursing


9
Keeping foreign health workers focus of pilot
CBC News, Canada
06/10/2010

A new pilot project for Atlantic Canada is aimed at getting and keeping foreign health-care workers by integrating them into the community.

The project is running in three locations and is being funded by the health departments in all four Atlantic provinces. The premise is simple: the happier someone is in their new community, the more likely they are to stay.

Tomoko Craig, who is working on the project in Summerside, P.E.I., said that means focusing on the needs of the entire family.

"The spouse might be isolated in the home or have to find new employment in the new community, so we would support that issue," Craig told CBC News Tuesday.

Along with helping spouses find employment, she finds activities for their children, volunteer opportunities and language training if needed. All things that help newcomers make personal connections.

Dr. Shabbir Amanoulah, head of psychiatry at the Hillsborough Hospital in Charlottetown, is originally from India and arrived on the Island with his wife and two children four years ago. He said he's happy here now, but it took a while.

"I think a lot of people come and go and I guess a lot of Islanders think you're going to go anyway, so why should I get to like you or know you," said Amanoulah.

"But once they do know you and like you, you feel very comfortable, but it takes time to get there."

He thinks the pilot project will help immigrants in Summerside make those connections more quickly.

The project runs until March. If successful, it could be extended and rolled out in other parts of the region.


Back to top


Europe
1
Achieving the health MDGs: country ownership in four steps
The Lancet, UK
02/10/2010

Tedros Adhanom Ghebreyesus ab

This week (Sept 20—22), world leaders gathered in New York, NY, USA, to give a final push to accelerate progress towards the Millennium Development Goals (MDGs) to which they committed in 2000. Although some progress has been made, a new approach is sorely needed if countries are to achieve MDG targets by 2015.
There has been much debate in the global health community on how best to accelerate positive health outcomes. The notion of country ownership has surfaced in many of these conversations. Country ownership is the surest way for developing countries to chart their own course of development and overcome the challenges they face in building effective and productive states. But what exactly do we mean by country ownership? Drawing on our experiences in Ethiopia, I can point to four key steps for making country ownership a reality.

The first step is planning. Countries must start with a clear development vision, but they also need to elaborate a detailed roadmap for realising it. In Ethiopia, our vision is to become a middle-income country over the next 10—15 years, and our government has clearly articulated strategies for how to get there. For country ownership to be realised, development partners must allow countries the space to identify their own needs and priorities, and develop their own plans as they see fit. But countries should also be open to ideas and seek to tailor proven practices to their particular circumstances. Once a well-considered national plan is in place, however, partners need to support that plan if country ownership is to thrive. We remained open to ideas throughout the planning process. We invited partners' contributions and benchmarked best practices from other countries. This is the most decisive step towards real ownership.

The second step is resourcing the plan. Here too, countries must take the lead. And because resources are limited, careful prioritisation is crucial. In crafting our health plan, we defined two alternative versions. If resource constraints mean that we cannot implement our broader and more ambitious plan, we go with our contingency plan, which focuses on the most pressing priorities. Even more important is the way in which resources are channelled. Flexible and predictable funding fosters accountability and ownership by allowing countries greater leverage in responsibly managing resources. Direct budget support is the ideal mechanism, in view of the enhanced flexibility and control it affords countries. In cases where our partners' chosen mechanism is not budgetary support, we have negotiated ways in which the funding can be used to benefit the whole health system. We have even used vertically raised funds—ie, those earmarked for disease-specific services—to strengthen our health system. For example, about 25—30% of HIV/AIDS grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria and 15% of resources from the US President's Emergency Plan for AIDS Relief have been used to build system capacities in many areas, including an information system for health management, a supply-chain management system, and major improvements in human resources.

The third step is implementation, in which countries must also be fully engaged. Some have argued that countries lack the capacity to implement. If so, the most efficient and sustainable solution is for partners to strengthen existing capacities within the country rather than replacing them with parallel structures. If existing national systems and procedures are inadequate, partners should work with countries to fix them.
The fourth step is monitoring and evaluation. Partners should also help countries to build their capacities to track performance. Mutual accountability between countries and partners requires a solid results-based framework, premised on clear outcome targets that must be defined and agreed at the outset.

Ownership reinforces commitment. And commitment, in turn, yields results and assures long-term sustainability. In Ethiopia, we could not have achieved such encouraging progress in our health sector without this type of genuine ownership and the space to pursue an approach to service delivery on the basis of health-system strengthening.

These practical steps towards country ownership are neither new nor particularly difficult to understand. Countries simply must own all these stages for the effect of development aid to be maximised. What seems to be missing is partners' full commitment to country ownership. Partners have a wide range of interests that hinder them from fully embracing country-led processes. But a decisive shift has to happen now if the MDG targets are to be reached. We urge all development partners to move forward in a new spirit of candour and partnership to make country ownership a reality. That way, achieving the MDGs will become reality too.
I am the Minister of Health for Ethiopia and Chair of the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

a Ministry of Health, Addis Ababa, Ethiopia
b Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland


2
New mothers 'let down by NHS postnatal care,' report says
The Guardian, UK
03/10/2010

Haroon Siddique

Women giving birth are being left unprepared and unsupported by the NHS, the UK's largest parenting charity claimed today, citing a survey it says "paints a shocking picture" of postnatal care.

The survey of 1,260 first-time mothers by the National Childbirth Trust found that 57% said they did not get the emotional support they needed in the 24 hours after a hospital birth, and only 45% said they received a satisfactory level of information and advice.

The Royal College of Midwives said that the concern in the trust's report over a shortage of midwives illustrated the need for greater government investment. The trust concluded that urgent improvement in postnatal care was needed, and every mother to be should have a professional responsible for ensuring she has the right care at the right time, and a personalised postnatal care plan.

Guidance from the National Institute for Health and Clinical Excellence recommends that all women should have such a plan, but the survey found 96% were not given one.

Anne Fox, the trust's head of campaigns and public policy, said: "It's clear postnatal care urgently needs improvement. Our report paints a dreadful, shocking picture of care in the UK. Evidence shows that supporting women and babies at this vital time can have a major impact on future health and learning."

The charity found that women who had operative births (forceps, ventouse or caesarean) had the greatest gaps in care – a situation it described as "concerning, since their needs are the greatest". Three in 10 women who had a caesarean found midwives were kind and understanding only some of the time or never, while 43% said their emotional needs were not met from 24 hours to a month after the birth.

Just over half (52%) of the women surveyed felt they did not get consistent advice about feeding.

Positive findings included that 79% of mothers were encouraged to have skin-to-skin contact in the first hour after birth, which can help with feeding and bonding, and most women who gave birth at home or in a birthing centre felt they received satisfactory emotional support in the first 24 hours after birth. But two in five thought there were only sometimes or never enough midwives to help them in hospital, as opposed to always or mostly enough.

Most women (71%) wanted to see the same midwife throughout their care, but 51% ended up seeing three or more different midwives after discharge from a maternity unit or birth at home.

Louise Silverton, deputy general secretary of the midwiuves college, said: "This document sends a compelling and timely message to the people controlling the purse strings about the need to continue investing in maternity services," she said.

"[It] adds weight to our call for more resources and for the current government to honour their pre-election pledges to increase the number of midwives."

The report was designed to replicate aspects of an NCT postnatal care survey carried out in 1999-2000. It found that, over the past 10 years, there had been "very limited improvements in postnatal care and possibly an overall decline in the extent to which woman-centred quality standards are being met".

The online survey was completed between October 2009 and January 2010 by a self-selecting group who had given birth in the previous 12 months.

The Department of Health said: "The government is working with the Royal College of Midwives, the NHS and other partners to design new provider networks to improve the quality of maternity care and extend the choices available to every pregnant woman.

"We are also committed to recruiting an extra 4,200 health visitors who will be able to give professional support to women after birth, and are currently exploring with the profession how best to achieve this."


3
Does Health Care Reform Do Anything for Midwifery?
RH Reality Check, UK
03/10/2010

By Eileen Ehudin Beard, American College of Nurse-Midwives

Most midwives would agree that The Patient Protection and Affordable Care Act has several concrete benefits for the midwifery profession. The act establishes reimbursement for certified nurse-midwives (CNMs) at 100 percent of the Medicare Part B fee schedule, which means that as of January 1, CNMs will be reimbursed at the same rate as physicians. The law also recognizes freestanding birth centers under Medicaid, which allows birth centers to receive reimbursement for their facility fees.

But since these parts of the legislation have not yet gone into effect and do not affect all midwives, does health reform really mean anything for the thousands of US midwives and their patients?

The answer is yes! To the prospective midwifery student, I can now say that more money will be available for graduate nursing education and that there will be more help with loan repayment for midwives who practice in maternity care shortage areas. When I am asked how reform legislation has affected midwifery practice thus far, I can say it has brought the evidence forward as we move towards some major changes and improvement in care for women and infants.

There is a new focus on evidence-based practice, which I believe is the direct result of health care reform legislation. A dialogue is taking place among the stakeholders in this country about how we can do better for mothers and newborns. This year, Childbirth Connection published two reports in addition to hosting a symposium called Transforming Maternity Care: A High Value Proposition. One of the reports, the Blueprint for Action, reinforces the importance of evidenced-based maternity practices. The American College of Nurse-Midwives is about to release a PowerPoint presentation entitled Evidence-Based Practice: Midwifery Pearls, to help midwives spread the facts about evidence-based practice. Evidence-based practice in maternity care is definitely in the limelight. Also, the National Institutes of Health (NIH), discussed vaginal birth after cesarean (VBAC) at a Consensus Development Conference.

But there is still more work to be done. Passage of the “Maximizing Optimal Maternity Services for the 21st Century Act (MOMS 21)” is the next step to help move this nation forward as we create a focus on maternity services. If the bill passes, there will be expanded federal research on best maternity practices and support for the education of a more culturally diverse interdisciplinary maternity care workforce. There will also be a national consumer education campaign to inform women about evidence-based maternity care practices.

For midwives, this legislation has brought renewed hope to a system of care that spends more than double per capita on childbirth than other industrialized countries, yet ranks far behind almost all developed countries in perinatal outcomes. For years midwives have been the champions of reducing risks in childbirth and eliminating disparities in communities of color. We have fought hard over the past several years to have federal legislation address concerns of midwives and the women we serve. A major barrier for women who want a midwife has been inadequate reimbursement for services. We know that midwives provide health care services to women of all ages and play a significant role in access to quality, affordable primary care, gynecology, family planning, and maternity services. Passage of MOMS 21 will enhance the viability of midwives as well as increase the incentive for hospital and physician practices to employ them.

The times, they are a' changing, and we have renewed hope that the four million women who give birth in this country will have many safe, affordable maternity care options— and that the care they receive will be based on the evidence of best practices.


4
All applicants for University nursing courses accepted
Malta Independent
04/10/2010

All the applicants with the required qualifications for joining the two nursing courses at the University of Malta have been accepted, bringing to nothing claims made by the Malta Union of Midwives and Nurses that about 100 students were to be deprived of such an opportunity.

In fact, the university has accepted 170 students, which is five more than was originally intended. Sources said that the extra five students would make little difference to the administration of the course, and therefore the university decided to accept all the applicants who had the necessary qualifications.

Originally, 165 applicants were to be accepted on the two nursing courses: BSc (Hons) Nursing and the Preparatory Course for the Diploma in Nursing.

The MUMN had claimed that some 100 applicants for the nursing courses were to be turned down by the university in spite of them having the necessary qualifications at a time when there was a shortage of nurses. This was one of the main reasons that pushed the union into taking drastic industrial action in hospitals and health centres in September.

Industrial action directives included nurses being told not to collect medicine from the hospital pharmacy and not to take blood samples in health centres. There was also industrial action at the Renal Unit at Mater Dei Hospital and Nurses were also told not to administer CPR in the event of a power failure at night at Mount Carmel Hospital.

The union was accused of putting patients’ lives at risk by the Health Ministry, which did not agree to negotiate with the MUMN until the directives had been withdrawn. The union withdrew the directives on 20 September and the two sides are now holding regular discussions.

But the claim made by the union that many students would not be accepted on nursing courses has now been shot down, as the university has accepted all applicants with the necessary qualifications. “No student who had the requisites to join the nursing course was turned down,” the sources said.


5
Nurses Welcome Boost For Clinical Placements In Regional Australia
Medical News Today, UK
01/10/2010

The Australian Nursing Federation welcomes the federal government announcement of funding for regional hospitals.

ANF federal secretary Lee Thomas said nurses and midwives were pleased the funding would support clinical training capacity in regional hospitals.

"We know that regional Australia continues to experience limited access to health services, including an inability or difficulty in recruiting nurses," she said. "If you provide clinical placement opportunities for nurses in regional hospitals then experience tells us that they are more likely to return to that community once they are registered.

"Local student nurses - particularly where there is a regional university - will also have the opportunity to do their clinical placement in their home town rather than travelling to metro areas where there is a shortage of available openings."

Ms Thomas said this was also about ensuring patients didn't have to travel long distances to get care.

"Forcing people to travel great distances will often result in them delaying treatment and only seeking help once their condition has deteriorated," she said.

Local access to nurses and local clinical training of nurses in regional communities will increase access to services, ultimately improving health outcomes, she said.

The ANF would also like to see more funding for graduate placements in regional and remote hospitals to encourage graduates to relocate or return to work in their communities, Ms Thomas said.

Source:
Australian Nursing Federation


6
More must be done to address the cost of private healthcare and medical workers' training
Irish Independent
02/10/2010

By John Shirley

I recently had occasion to go to a specialist for an ultrasound scan on my abdomen. The episode got me thinking about the cost of health in this country. I did not think about the treatment fee but got a shock when the hospital receptionist asked me for €255 even before I got near the scanning consultant.

When I did meet the good doctor, the conversation went like this.

Me: "Is that the same scanner that is used to confirm pregnancy in my sheep and cows, and for which I pay about €3.50 a cow and less than a euro a head for sheep?"

Doctor: "Ah, you farmers are always haggling. Sure, farmers are rolling in money -- and look at the grand way of life you have."

Me: "I hope that your knowledge of medicine is better than your knowledge of farming."

Doctor, as he moved the probe around: "You're full of wind, it's hard for the scanner to focus on anything."

Me: "You are not the first person to make that observation!"

Happily, apart from the excess wind, the doctor found nothing untoward.

But I began to do sums. Four scan patients an hour at €255 a time equals €1,020 an hour. Thirty hours a week and you nearly have the annual average industrial wage in that one week.

I asked Dr Dan Ryan, of www.cows365.com, to find out about ultrasound scanners for humans versus farm livestock. He had worked on scanning humans while in the US and he confirmed that it was essentially the same scanner that was used on both. Again, the same scanning principle is applied for units measuring fat and muscle depth, for instance in the Tully Beef Performance Test Centre.

I related my scanning experience to others and they came back with their own stories of private consultants. Post-cancer check-up visits, which took less than five minutes in the actual company of the consultant, cost €180 a visit. Post-hip-replacement check-ups were at €90 a visit. Private medicine in this country does not come cheap.

Neither does the Public Health Service. In spite of the €15bn budget allocation for health, dissatisfaction is widespread and we are nowhere near getting the universal healthcare that is enjoyed by the French or the British. Surely Ireland too should have a health system where a patient is treated on the basis of need rather than ability to pay.

I remember once being in the company of a group of doctors and consultants and being fascinated with the chat around the table. It was all about who was sending clients to whom from down the country. The talk was more about money than medicine. Minister for Health Mary Harney was seen as enemy number one as she tried to get consultants to sign up exclusively for Public Health Service contracts, even though she was offering an annual salary in the region of €200,000.

Another interesting insight into the politics and realities of the health service comes from a friend who worked for the HSE and then joined a private clinic. With the HSE, the waiting list was long and, by the time some patients were treated, their condition was either chronic or self-cured. An effort was made to speed up patient throughput to shorten the waiting time but my friend was subsequently instructed to slow down and stick to the quota of patients. Then this medic joined a private clinic. Here, patients were being encouraged to continue for more treatments that were medically justified. So, neither system is perfect.

Whether it's drugs, a visit to your GP or a consultant visit, the cost of health in this country is extraordinarily high. Rates are more than twice those in Spain. Health insurance costs are soaring way ahead of inflation. And, because the VHI works on a rate of cost plus a percentage, it has no real incentive to keep costs down.

For almost a decade, Ms Harney has been trying to tackle the power of the medics. The Irish Medical Council now has a majority of non-medics on its 25-member board.

Lack of competition seems to be the issue on the ground. We are not training enough doctors and there are insufficient consultants in the system. A period of hospital internship is a key part of training to become a consultant. I'm told that many of the hospital interns are from abroad and are working in Ireland on a time-limited visa. Staying on in Ireland to set up in consultancy is not an option, even if they wished to jump on our gravy train.

Tension between the medical profession and Government is nothing new. On the IMO website I spotted these lines: In 1957, relations between the Irish Medical Association and the Department of Health were at an appallingly low level. Doctors of all grades were "lambasted" as ultraconservative, incompetent money grabbers. It was said that the IMA was not a trade union or excepted body and it had no authority to negotiate terms or conditions of service. To add to the disharmony, William Doolin, editor of the Journal of the Irish Medical Association, wrote in July 1960: "For nearly 2,000 years, divinity, law and medicine have been bracketed as the three learned professions, and how any man with even a glimmer of history in his mental make-up could advocate a descent from that high position is incomprehensible."
- John Shirley


7
Health secretary defends NHS reforms as criticism grows
The Guardian, UK
05/10/2010

Hélène Mulholland, political reporter

The health secretary, Andrew Lansley, today defended the government's controversial reforms to the NHS in the face of mounting pressure from professional bodies and health unions.

Lansley underlined the Conservative commitment to the NHS, saying the party wanted to turn it into one of the world's "great health systems", "true to its values, but fit for the future".

He outlined plans to turn healthcare provision into the "largest social enterprise in the world", but health professionals warned that signalled further fragmentation of the NHS and could strip it of expertise and healthcare of its public service ethos.

Lansley – whose party reassured health workers in the run-up to the general election that there would be no further sweeping, "top-down" reforms of the NHS – also reiterated what he said were the merits of handing control for commissioning budgets to GPs and scrapping primary care trusts.

He reminded delegates at the Conservative conference in Birmingham that the government had promised to increase NHS funding year on year despite the budget deficit.

"We will not make the sick pay for Labour's debt crisis," he said, but warned that the financial deficit meant ministers could not "sit back" and put more taxpayers' money into an unreformed system.

He said ministers would not "delay or dither" in taking action to ensure the NHS delivered the quality of care expected in return for the amount of money committed to it.

And he defended the decision to give GPs control over budgets "because family doctors see patients every day, they know where services are failing and they will fight for best care possible for their patients".

Under the plans, groups of GPs will control 80% of all NHS health spending and commission services for patients from 2013. PCTs, the NHS trusts that currently manage the funds, will be abolished.

Patients would have the choice of doctor and treatment from a range of providers that met NHS standards and cost the same or less.

"That means any social enterprise, charitable organisation, public or independent provider – has the right to choose where to be treated at any provider, in what will become the largest social enterprise in the world," Lansley said.

Doctors have questioned the speed and cost of Lansley's plans and warned of a possible "erosion of the crucial relationship" between doctors and patients.

The Royal College of GPs (RCGP) raised "grave" concerns about the use of private companies to run NHS services and the loss of expertise in existing NHS trusts.

It said: "Many GPs are concerned that a system of GP commissioning will lead to the erosion of the crucial relationship between GPs and their patients."

Responding to public consultation on the government's Liberating the NHS white paper, it warned that any threat to the trust between doctor and patient "will have widespread repercussions in the effective uptake of services and clinical interventions, and ultimately on perceptions of the NHS as a whole".

The RCGP said it supported the government's aim of cutting bureaucracy and improving efficiency, but its members questioned the costs of the new plans and said they could result in a more expensive system.

"Members are sceptical that the reforms outlined in Liberating the NHS will save money, in either the short or the long term," its response said.

"There are enormous costs associated with reorganisation – in this case the redundancy costs of whole tiers of NHS management, as well as the likely expansion of general practice staff and facilities."

Most RCGP members had also expressed "grave concerns about the level of engagement of the for-profit sector in the restructured NHS". The document said private companies may bring experience but could undermine "the essential ethos of the NHS".

The British Medical Association said it was not against the whole plan, but voiced concern that the changes could affect the service's "stability and future".

The Unison union warned of possible instability, saying this could have an impact on patients.

Lansley did not acknowledge the RCGP response in his conference speech, which highlighted the government's commitment to improve patient care through reforms.

He told delegates he had cut NHS management costs by almost a half – with "every penny saved" to be reinvested into services – and set out the case for securing better value for money.

He also announced a £70m cash boost to enable the NHS to support around 35,000 people going back into their homes after spells in hospital. From April, the NHS will have new responsibilities for people's care needs for 30 days after they leave hospital.

"This new funding will mean people will benefit right now, and around 35,000 will start to get the help and support they need, to allow them to be once again independent in their own homes," Lansley said.

The measure is expected to save money for health and social care by preventing costly hospital readmissions.

"Too many patients don't get the seamless effective service they should when they leave hospital," Lansley said. "They leave an environment in which they have been cared for around the clock to go home, sometimes alone, with no help.

"Too often, they end up back in hospital because they haven't had help readjusting to life at home. In fact, we've seen a 50% increase in the number of emergency readmissions in the 10 years from 1998. We need to do more to prevent this from happening."


8
Expansion of cancer care and control in countries of low and middle income: a call to action
The Lancet, UK
02/10/2010

Volume 376, Issue 9747, Pages 1186 – 1193

Prof Paul Farmer MD a, Julio Frenk MD b, Dr Felicia M Knaul PhD c, Lawrence N Shulman MD d, George Alleyne MD e, Lance Armstrong f, Prof Rifat Atun FFPHM g, Douglas Blayney MD h, Lincoln Chen MD i, Prof Richard Feachem PhD j, Mary Gospodarowicz MD k, Julie Gralow MD l, Sanjay Gupta MD m, Ana Langer MD b, Julian Lob-Levyt MD n, Claire Neal MPH f, Anthony Mbewu MD o, HRH Dina Mired BSc p, Prof Peter Piot MD q, K Srinath Reddy MD r, Prof Jeffrey D Sachs PhD s, Mahmoud Sarhan MD t, John R Seffrin PhD u

Summary
Substantial inequalities exist in cancer survival rates across countries. In addition to prevention of new cancers by reduction of risk factors, strategies are needed to close the gap between developed and developing countries in cancer survival and the effects of the disease on human suffering. We challenge the public health community's assumption that cancers will remain untreated in poor countries, and note the analogy to similarly unfounded arguments from more than a decade ago against provision of HIV treatment. In resource-constrained countries without specialised services, experience has shown that much can be done to prevent and treat cancer by deployment of primary and secondary caregivers, use of off-patent drugs, and application of regional and global mechanisms for financing and procurement. Furthermore, several middle-income countries have included cancer treatment in national health insurance coverage with a focus on people living in poverty. These strategies can reduce costs, increase access to health services, and strengthen health systems to meet the challenge of cancer and other diseases. In 2009, we formed the Global Task Force on Expanded Access to Cancer Care and Control in Developing Countries, which is composed of leaders from the global health and cancer care communities, and is dedicated to proposal, implementation, and evaluation of strategies to advance this agenda.

a Harvard Medical School, Boston, MA, USA
b Harvard School of Public Health, Boston, MA, USA
c Harvard Global Equity Initiative, Boston, MA, USA
d Dana-Farber Cancer Institute, Boston, MA, USA
e Pan American Health Organization, Washington, DC, USA
f Lance Armstrong Foundation, Austin, TX, USA
g Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
h American Society of Clinical Oncology, Alexandria, VA, USA
i China Medical Board, Cambridge, MA, USA
j Global Health Group, University of California, San Francisco and Berkeley, CA, USA
k Princess Margaret Hospital, Toronto, ON, Canada
l Seattle Cancer Care Alliance, Seattle, WA, USA
m CNN, Atlanta, GA, USA
n Global Alliance for Vaccine and Immunization, Geneva, Switzerland
o Global Forum for Health Research, Geneva, Switzerland
p King Hussein Cancer Foundation, Amman, Jordan
q Institute for Global Health, Imperial College London, London, UK
r Public Health Foundation of India, New Delhi, India
s Earth Institute, Columbia University, New York, NY, USA
t King Hussein Cancer Center, Amman, Jordan
u American Cancer Society, Atlanta, GA, USA
 Correspondence to: Dr Felicia M Knaul, Harvard Global Equity Initiative, 651 Huntington Avenue, FXB Building 632, Boston, MA 02115,

Full-text: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61152-X/fulltext


9
La Slovénie va simplifier la procédure pour agréer les médecins étrangers
AFP
01/10/2010

LJUBLJANA - La Slovénie a décidé de simplifier la procédure pour autoriser les médecins étrangers à exercer dans le pays pour lutter contre le manque chronique de personnel médical, ont rapporté les médias slovènes vendredi.

Le ministère de la Santé estime qu'au vu du nombre actuel d'étudiants en médecine, la Slovénie ne pourra pas faire face à ses besoins médicaux avant 2015, selon la chaîne d'informations 24ur.

"Le ministère de la Santé veut débureaucratiser la procédure (d'obtention du droit d'exercer en Slovénie) pour les médecins étrangers", a déclaré le ministre de la Santé Dorjan Marusic cette semaine, a rapporté la chaîne.

Environ 250 médecins étrangers, dont 50 spécialistes dans différents domaines, font l'objet d'une procédure de certification nécessaire à l'obtention d'une licence d'exercice en Slovénie, a-t-il précisé.

La plupart de ces médecins viennent des anciennes républiques yougoslaves, telles que la Serbie, la Macédoine ou la Croatie. Ils doivent payer plus de 3.000 euros et la procédure de certification, qui comprend entre quatre et onze examens, peut durer jusqu'à deux ans, a expliqué le ministre.

M. Marusic a indiqué en outre que le gouvernement envisageait la création de "licences temporaires" qui leur permettraient d'exercer immédiatement en Slovénie, en attendant que la procédure de certification arrive à terme.

La Slovénie, qui compte 2 millions d'habitants et a rejoint l'Union européenne en 2004, connaît une pénurie de médecins d'environ 500 professionnels selon le gouvernement, de 2.000 selon le Conseil de l'ordre des médecins.
©AFP


10
Sanidad recurre a titulados extranjeros ante la falta de médicos de familia
Información, Spain
04/10/2010

ANA AITANA FERNÁNDEZ

El descenso de médicos de la Comunidad Valenciana que eligen la Medicina Familiar y Comunitaria obliga a la Conselleria de Sanidad a recurrir cada vez más a la contratación de facultativos extranjeros en los centros de salud y hospitales de la provincia. 
El interés por otras especialidades más atractivas dejó en la última convocatoria -del pasado enero- más de cincuenta plazas de esta especialidad sin cubrir, según explica el decano de la Facultad de Medicina de la Universidad Miguel Hernández de Elche y vicepresidente de la Confederación Nacional de Decanos de Facultades de Medicina, Juan Caturla.

Aunque la necesidad de nuevos facultativos afecta a todas las especialidades médicas, la Medicina Familiar es una de las que más carencias de personal presenta, junto con Pediatría, por el menor número de estudiantes que la eligen. Así lo estableció el año pasado el Ministerio de Sanidad en su estudio de Oferta y Demanda de Especialistas 2008-2025, en el que además se ahondó en los problemas que estaban creando los "numerus clausus", es decir, el cupo de plazas para estudiar la Licenciatura de Medicina. Esta necesidad ya se apuntó en el informe de la Agencia Valenciana d'Avaluació i Prospectiva (AVAP), en el que se instaba a ampliar en 300 las plazas para estos estudios en la Comunidad.

Ante el número de vacantes en Medicina Familiar de la última elección de plazas MIR, las universidades apuestan por hacer más atractiva la Medicina Familiar. "No se trata de un problema de centros, sino de la elección de especialidad que es deficitaria desde hace más de cinco años en determinadas plazas, como la de Medicina Familiar y Comunitaria", explica Caturla. Y añade: "Prefieren optar a otra especialidad, por lo que queda un número muy importante de vacantes porque no quieren ser médicos de cabecera". No obstante, aclara, el problema de la falta de facultativos en Medicina Familiar "no ocurre únicamente en España, sino que es internacional, sucede lo mismo en Canadá así como en otros países de Europa".

El poco atractivo que parece tener esta especialidad se une al aumento anual en la diferencia entre los nuevos licenciados y las plazas MIR que convoca Conselleria, según datos de AVAP. Mientras que el total de plazas MIR ofertadas en la Comunidad Valenciana era de 610 en 2007, la cifra de nuevos titulados en Medicina no superaba los 360 en ese mismo periodo. En 2002 la diferencia entre la oferta y los titulados era de 187 y cinco años más tarde ya alcanzaba las 252, lo que significa un incremento de 87 plazas MIR vacantes respecto al total de licenciados.

Esta progresión ha provocado que el número de colegiados extranjeros pase en seis años de los 77 a los 249. Actualmente, en la Comunidad trabajan entre 300 y 350 facultativos foráneos y el 90% se centra en Medicina Familiar, según datos de la Conselleria de Sanidad. Licenciados a los que para ejercer como médicos se les exige la homologación de su título. Esta convalidación la realiza un comité de técnicos que selecciona el Ministerio de Educación y al que la Confederación Nacional de Decanos de Facultades de Medicina ha solicitado incluir una parte procedente del ámbito universitario. "Se ha insistido en que en las homologaciones exista, además del personal técnico, personas del ámbito universitario y siempre se han negado en banda", declara el vicepresidente de la entidad. De hecho, el desequilibrio entre la cualificación de los nacionales y los extranjeros es otro de los puntos a debate entre los profesionales de la salud, ya que si para acceder a la carrera de Medicina en España es necesario una nota superior a 8, "es incongruente que entre gente de fuera de la que no se conoce su nivel". "Si aplicáramos el mismo filtro de calidad veríamos qué pasaba", apunta un profesional.

Menos plazas en la Comunidad Valenciana
La Comunidad Valenciana redujo en diez las plazas -de las 182 de 2009 a 172- reservadas para Medicina Familiar y Comunitaria, una de las especialidades más deficitarias, según un estudio realizado por la Universidad de las Palmas sobre la necesidad de médicos especialistas en el Sistema Nacional de Salud (SNS). Mientras, a nivel nacional esta especialidad -entre las más importantes del SNS al superar las 200 plazas convocadas- ha visto un leve incremento en su oferta, como indican los datos del informe, al pasar de las 1.892 plazas del pasado año a las más de 1.900 de 2010. El descenso de oferta en la Comunidad choca con la escasez de profesionales que existe en España, señala el estudio, así como con la necesidad de especialisstas y el aumento de la oferta, objetivo del Ministerio de Sanidad en 2008.


Back to top


Latin America & Caribbean
1
Saturan hospitales públicos por la fuga de especialistas
Norte Digital, Mexico
06/10/2010

SALVADOR CASTRO

La carencia de médicos especialistas se agravó en los últimos meses porque éstos intensificaron su emigración a otras partes del país o a Estados Unidos provocando que las instituciones públicas de salud se encuentren saturadas por la demanda de atención.
Leticia Chavarría, del Comité Médico Ciudadano, coincidió con el secretario de Salud del Gobierno federal, José Ángel Córdova Villalobos quien lamentó que la violencia que se vive en Ciudad Juárez provoque que organizaciones médicas o profesionistas de la salud prefieran dejar esta ciudad.

Expresó que una de las preocupaciones es que a mediano plazo no haya especialistas y tengan los pacientes que ser trasladados a otros sitios para ser operados e incluso que no haya suficientes médicos para que trabajen en el nuevo hospital de especialidades que se planea abrir en Ciudad Juárez.

Chavarría informó que los representantes de los colegios de médicos ofrecerán mañana jueves una conferencia de prensa en la que darán a conocer las acciones que tomarán ante el clima de inseguridad que tiene devastada a la ciudad.

Dijo que de seguir la situación así, llegará un momento en que las personas no tengan al alcance de manera inmediata en sus colonias o fraccionamientos el servicio médico porque cada vez son cerrados más consultorios y los doctores que tienen posibilidades se instalan por cuestiones de seguridad en los grandes hospitales.

Señaló que son muchos los médicos especialistas que abandonaron la ciudad u otros más planean irse debido a que la inseguridad no sólo los afecta a ellos en el desarrollo de su profesión sino que también a sus familias.

Mencionó que por la crisis económica y el desempleo cada vez menos personas se atienden con médicos particulares y se atienden en instituciones como el ISSSTE, IMSS y se dan de alta en el Seguro Popular, pero en estos lugares no se dan abasto para atender la alta demanda de servicio, por lo cual pueden transcurrir meses para la obtención de una cita con un especialista o cuando se presenta una emergencia al haber personas lesionadas por la cuestión de inseguridad se difieren por meses las operaciones que ya estaban programadas.

La doctora señaló que en la actualidad no se tiene una cifra exacta de cuántos médicos se han marchado de la ciudad, pero señaló que basta con recorrer algunas avenidas para ver cuántos consultorios están cerrados o abandonados.

Dijo que por la falta de médicos especialistas que se han marchado de la ciudad, por aquellos que han pedido su cambio de plaza a otras partes del país o por aquellos no quieren venir a trabajar a Ciudad Juárez, han encontrado dificultades para la operación del Hospital Infantil de Especialidades y el Hospital General Regional 66 del Instituto Mexicano del Seguro Social.

"Desde hace tiempo hemos estado diciendo que la inseguridad está afectando la atención a la salud de los juarenses y simplemente el hecho de que se estén cerrando consultorios en ciertas avenidas de la ciudad, ya son zonas que se están quedando sin atención médica más cercana", expresó.

Señaló que los hospitales públicos ya estaban saturados desde antes y en la actualidad están completamente rebasados. "Para una cita con un especialista tarda meses y las mismas cirugías que se van alargando meses, ya que en ese momento puede surgir una emergencia y estas intervenciones se van difiriendo o cambiando de fecha, porque no se tiene el equipo suficiente, los recursos ni el personal de salud suficientes para atender a la cantidad de pacientes", mencionó .

Dijo que la falta de médicos especialistas se ve claramente en los cardiólogos, ya que es una especialidad en la que no se han cubierto las vacantes y lo mismo ocurre en otras especialidades e incluso en el servicio de psicología y psiquiatría.

"Lamentablemente sigue habiendo las agresiones hacia los médicos, sigue habiendo asaltos, extorsiones, secuestros y muertes de médicos, por lo que emigran de la ciudad junto con sus familias", agregó.

Dijo que hay avenidas como las Américas, Adolfo López Mateos y Plutarco Elías Calles, en las que estaban instalados una gran cantidad de consultorios que fueron asaltados en serie, ya que iban asaltando consultorio por consultorio, y en la actualidad ya están cerrados.


2
Más que hospitales, falta presupuesto: SS
Diario Ciudad Victoria, Mexico
05/10/2010

José Gregorio Aguilar/Ángel Nakamura López

Más que gestionar mayores recursos para construir más obras hospitalarias para Tamaulipas lo que hace falta es garantizar que cada hospital cuente con un presupuesto propio para su operación y para el pago de sueldos y prestaciones de los trabajadores argumentó el secretario de Salud, Juan Mansur Arzola.

Entrevistado en relación a la petición del secretario federal, José Ángel Córdova Villalobos, quien solicitó a la Cámara de Diputados más recursos para concluir obras hospitalarias que actualmente están en proceso de construcción, Mansur Arzola respondió que es más importante garantizar la operación de los hospitales.

“Lo más importante es que los nuevos hospitales que están en funcionamiento o a punto de iniciar operaciones, cuenten con un presupuesto inamovible e irreductible en lo que se refiere a sueldos y prestaciones para todos los trabajadores”.

No obstante, dijo que el crecimiento poblacional y el aumento de cierto tipo de enfermedades requieren pensar en proyectos hospitalarios para los próximos años.

La propuesta de la Secretaría de Salud de Tamaulipas, es la de construir tres hospitales materno infantil: uno en la zona conurbada de Tampico Madero Altamira, uno más en Nuevo Laredo y el otro en Ciudad Victoria.

Asimismo, Mansur Arzola dijo que la entidad requiere de otro nosocomio oncológico en Nuevo Laredo.

FALTA DE PERSONAL AQUEJA JURISDICCIONES SANITARIAS
La falta de personal médico en Tamaulipas afecta a diez de los 43 municipios del estado y a dos de las ocho jurisdicciones sanitarias en las que se divide nuestra entidad, aseguró el dirigente de la Sección 51 del Sindicato Nacional de Trabajadores de la Secretaría de Salud, Adolfo Sierra Medina.

De acuerdo al líder del organismo que representa a los empleados con base que laboran en los centros médicos tamaulipecos, el crecimiento de la población en los últimos años rebasó por mucho, el número de personas que ofrecen sus servicios en los hospitales y unidades de salud.

“Es innegable que falta personal en los centros de atención médica
del estado, tenemos plantillas de arranque de hace 25 años que con el crecimiento poblacional ahora son obsoletas, la demanda de la sociedad nos rebasa en cuanto a la atención”.

Dijo que las jurisdicciones donde más se presenta este problema son la sexta de Ciudad Mante, que abarca los municipios de Antiguo Morelos, Gómez Farías, Nuevo Morelos, Ocampo y Xicoténcatl, así como la séptima con sede en San Fernando, que incluye a las localidades de Burgos, Cruillas y Méndez.

El dirigente sindical mencionó que “se ha avanzado en este tema, se han generado muchos contratos, simplemente a partir de junio del 2006, identificamos a dos mil trabajadores eventuales y de estos se han basificado hasta el momento a mil 200; continúa la contratación, y a la vez la demanda de atención”.


3
Seguidilla de paros pone en jaque sistema de salud cruceño
El Mundo, Bolivia
05/10/2010

Estefany Claros Aldana

Pasillos vacíos, salas cerradas, personal ausente y ambiente de total silencio, fue lo que se observó el día de ayer en las instalaciones del hospital Japonés que cerró sus puertas negando todo tipo de atención, como una medida de protesta para ser escuchados por las autoridades, ante la notable falta de equipos y personal.
Las personas desesperadas llegaban hasta el hospital Japonés para recibir ayuda, pero se encontraban con la sorpresiva noticia del paro en el que se encontraban los trabajadores de la Salud del mismo, lo cual los obligaba a salir a buscar ayuda en otros cetros de salud.
El hospital Japonés, considerado como el hospital más grande del país, pasó su primer día de paro sin prestar atención médica al público.

JAPONÉS EN EMERGENCIA
El Japonés presenta un panorama crítico, todas las salas se encuentran copadas, ya no hay camillas en donde recibir a los enfermos y si las hay están malogradas, los techos están descubiertos y para finalizar muchas puertas y ventanas se encuentran quebradas.
Los trabajadores de la Salud del hospital Japonés iniciaron un paro de 48 horas, con posibilidad de aumentar la cantidad de horas de suspensión de actividades.
El secretario ejecutivo del sindicato de trabajadores de salud del hospital Japonés, Robert Hurtado, mencionó que las medidas tomadas son por no recibir el apoyo debido de las autoridades en la dotación de elementos para su trabajo.
Agregó que lo que más precisa el nosocomio son ítems para el personal requerido, equipos en las diferentes salas e insumos.
Señaló además que más de cien personas por día llegan al hospital para recibir atención, las mismas que no pueden ser atendidas como se debe, por el colapso de todas las salas.
“El paro continúa en nuestra institución, para pedir la atención de las autoridades, ésta es una atención como si estuviéramos en época de guerra porque los familiares les están dando respiración artificial a sus enfermos por falta de equipos”, expresó Hurtado.
Pero la crisis hospitalaria no sólo afecta al hospital Japonés, puesto que hoy se suman a la medida que ha tomado el mismo, los trabajadores de salud del hospital San Juan de Dios, Hospital Frances, hospital de Niños, hospital Oncológico y la Maternidad Percy Boland.

MATERNIDAD MEDIDAS
La secretaria ejecutiva de los trabajadores de salud de la Maternidad Percy Boland, Marlene Salvatierra, informó que el paro de los hospitales se llevará a cabo en todo el territorio departamental.
Indicó que en la maternidad es aún más grave, porque una sola enfermera atiende a más de 60 mujeres y niños, además que no hay equipos médicos y el espacio suficiente para la atención de las pacientes.
“Nosotros nos sumamos a las medidas tomadas por nuestros compañeros de otros hospitales. No podemos seguir trabajando bajo esas condiciones, necesitamos que las autoridades escuchen nuestras peticiones”, expresó Salvatierra.

SAN JUAN DE DIOS SE SUMA
Por su lado, la representante de los trabajadores de salud del hospital San Juan de Dios, Delicia Mendoza, aseguró que hoy los trabajadores del mismo, se unen a la medida del paro de salud, acompañado de una marcha que partirá desde el hospital San Juan de Dios, hasta las instalaciones de la Prefectura.
“Estamos tomando medidas más duras, todos los trabajadores de la Salud estamos en emergencia, vamos a marchar juntos para que las autoridades nos escuchen, no es posible que sigamos atendiendo a la población en malas condiciones”, declaró Mendoza.
Ante el mismo problema, el presidente del colegio médico, Guider Salas, confirmó que en el sector Salud del departamento cruceño existen muchas falencias desde hace muchos años.
Así mismo aseguró que si el problema no es resuelto por parte de las autoridades, hasta los médicos, podrían ingresar a un paro de actividades.
“Las condiciones no están dadas para que nosotros hagamos nuestro trabajo, en Santa Cruz hay un aproximado de cinco mil médicos, pero que sólo trabajan mil 500 en los hospitales públicos”, dijo al finalizar Salas.

AUTORIDADES SE MANIFIESTAN
Por otro lado ante la crítica situación hospitalaria, las autoridades departamentales mencionan que la administración, insumos y funcionamiento de los nosocomios son responsabilidad del municipio cruceño, mientras que los ítems de salud son atribuciones gubernamentales.
El secretario de Salud de la Gobernación, Óscar Urenda, criticó al Gobierno Central porque hasta la fecha no cumplió con los cuatro mil ítems que debe al departamento de Santa Cruz y al pretender confrontar a las instituciones locales.
“Este año pedimos mil ítems y sólo nos dieron 100 de los cuales sólo 20 son de médicos para cubrir 56 municipios. Esto es vergonzoso porque el Gobierno afirma que hay nueve mil millones de dólares en reservas”, enfatizó Urenda.

HOSPITALES QUE PARAN HOY:
Hospital Japonés.
Hospital Francés.
Hospital de Niños.
Hospital Oncológico.
Hospital San Juan de Dios.
Maternidad Percy Boland.

TEXTUAL
Este viernes nos reunimos en el hospital San Juan de Dios con el municipio y directores de los hospitales, además de  administradores y personal de recursos humanos para marcar una ruta de definición de transferencias”.

Oscar Urenda
Secretario de Salud Gobernación

Nosotros nos sumamos a las medidas tomadas por nuestros compañeros de otros hospitales, no podemos seguir trabajando bajo esas condiciones, necesitamos que las autoridades escuchen nuestras peticiones”

Marlene Salvatierra
Sindicato de trabajadores Maternidad

Estamos tomando medidas más duras, todos los trabajadores de salud estamos en emergencia, vamos a marchar juntos para que las autoridades nos escuchen, no es posible que sigamos atendiendo a la población en malas condiciones”

Delicia Mendoza
Sindicato del hospital San Juan de Dios

El paro continúa en nuestra institución, para pedir la atención de las autoridades, ésta es una atención como si estuviéramos en época de guerra porque los familiares les están dando respiración artificial a sus enfermos por falta de equipos”

Robert Hurtado
Sindicato del hospital Japonés


4
Es alta la mortalidad en prematuros
La Nación, Argentina
01/10/2010

Fabiola Czubaj

En la última década, en el país descendió la mortalidad de los bebes que nacen varias semanas antes de completar su gestación en la panza materna. Sin embargo, para Unicef Argentina, esa tendencia avanza muy lentamente porque existen intervenciones de probada efectividad que no se están aplicando.
De hecho, el 60% de las muertes de bebes prematuros en la primera semana de vida se podría evitar si se generalizara un modelo de maternidad segura centrada en la familia, como el que aplica desde hace años el Hospital Materno-Infantil Ramón Sardá e imitan desde febrero otras 50 maternidades en cinco provincias.
"Ya no se trata solamente de salvarle la vida a un prematuro, sino de proteger también su derecho a crecer con la menor cantidad de secuelas posibles [en su desarrollo]. Queremos que los indicadores de mortalidad infantil se reduzcan aún más en la Argentina y eso se logra con medidas como una mayor participación de la mamá, el papá y los hermanos en la atención de estos bebes", dijo ante periodistas el representante de Unicef Argentina, Andrés Franco.

Fue durante el lanzamiento de la Semana del Prematuro, iniciativa a la que adhieren más de 70 maternidades del país para reducir la mortalidad en estos bebes. A partir del próximo lunes, realizarán actividades de actualización y difusión sobre cómo prevenir un parto anticipado y, si ocurre, qué servicios deberían recibir la mamá y el bebe, y de qué se trata el seguimiento después del alta de la unidad de cuidados neonatales.
Según la Organización Mundial de la Salud (OMS), un bebe es prematuro cuando nace antes de completar las 37 semanas de gestación (un embarazo normal dura entre 40 y 41 semanas), contadas desde el primer día de la última menstruación de la mujer antes de quedar embarazada. Si no recuerda la fecha, la edad gestacional del bebe se puede calcular con dos ecografías (una, en los primeros meses y otra cuando el embarazo está avanzado).

Se considera prematuro a un bebe que nace con menos de 2,5 kilos. Esto, a la vez, incluye a los de alto riesgo: los que nacen con muy bajo peso (entre 1 y 1,5 kilos) y bajo peso extremo (menos de 0,5 kilos).
Según los datos del Ministerio de Salud que utilizó Unicef Argentina, cada año nacen unos 56.000 prematuros (8%) y más de 6000 con menos de 1,5 kilos. "En los 90, teníamos 1000 bebes nuevos por año de menos de 1,5 kilos; en 2005, unos 4000 y, ahora, más de 5000", dijo a LA NACION la doctora Gabriela Bauer, coordinadora de la campaña y pediatra del hospital Garrahan. Y según apuntó Zulma Ortiz, especialista en salud y nutrición de Unicef, las tres causas identificadas son el embarazo adolescente, el consumo de sustancias tóxicas (cigarrillos y drogas) y la reducción del período entre embarazos (menos de 2 años).
Pero aunque existen medidas para tratar de evitarlo, la prematurez sigue siendo la primera causa de mortalidad infantil: la mitad de los menores de un año que mueren anualmente son prematuros con menos de 2,5 kilos al nacer. La tercera parte son prematuros de menos de 1,5 kilos. El mayor descenso se da en los prematuros que nacen con más de 1,5 kilos.

"Esto está ocultando grandes brechas, inequidades, por lo que podríamos decir que la mortalidad no sólo no disminuyó lo necesario en esos prematuros de alto riesgo, sino que hasta podría haber aumentado", explicó Ortiz. Señaló también que el 60% de la mortalidad en los prematuros es evitable porque "tiene que ver con la calidad de la atención".

De hecho, un relevamiento de las 711 maternidades del país revela que sólo el 35% (donde se realizan más de 1000 partos por año) cumple con las condiciones obstétricas y neonatales esenciales que recomienda la OMS. Eso, para Unicef, se debe a la falta de enfermeras especializadas en neonatología, una insuficiente capacitación y actualización profesional, y la falta de la regionalización de los servicios especializados.
"Hoy, la sobrevida de los bebes que nacen con 1-1,5 kilos es del 90%, mientras que en los que nacen con 0,75-1 kilo es del 80 por ciento. Por eso, tendríamos que estar mucho mejor -indicó Bauer-. Es muy importante que sobrevivan, pero con un porcentaje fijo y aceptable de secuelas evitables", como los problemas del aprendizaje, de la audición o respiratorios, entre otros.
Dijo el doctor Bernardo Chomsky, de la Alianza Argentina para la Salud de la Madre, el Recién Nacido y el Niño: "Con que tengamos una excelente supervivencia con la menor cantidad de secuelas en bebes con 28 semanas de gestación, nos podríamos dar por más que satisfechos".


5
Llegar antes de tiempo
Diario La Prensa, Argentina
03/10/2010

Por Agustina Sucri 

De los 700.000 nacimientos que se producen cada año en la Argentina, entre un 8 y un 10 por ciento corresponde a bebés prematuros, con menos de 2.500 gramos de peso. Y de los bebés que nacen con menos de 1.500 gramos, muere un 40%. Teniendo en cuenta que en los países desarrollados y en los buenos servicios de neonatología -tanto públicos como privados- el porcentaje de mortalidad de niños prematuros no supera el 15%, los expertos reclaman cambios en la atención sanitaria que permitan reducir la cantidad de muertes evitables.

En ese mismo sentido, más de 70 maternidades en todo el país celebrarán a partir de mañana la "Semana del Prematuro", un festejo -impulsado por Unicef- con el objetivo de informar a la comunidad sobre los derechos de los bebés y sus mamás frente a esta problemática que constituye en el país la principal causa de muerte en la infancia.

Los bebés prematuros son aquellos que nacen antes de las 37 semanas de edad gestacional, es decir que no completan las 40 semanas que duran los embarazos que llegan a término. Al no completar el ciclo, son recién nacidos que dejan el útero materno sin haber desarrollado plenamente el aparato respiratorio, son más vulnerables frente a los virus y suelen tener bajo peso: en casos extremos, no llegan a los 1.000 gramos.

Sobre las razones de la prematurez y las medidas necesarias para evitar un número considerable de muertes entre los bebés prematuros, dialogó con La Prensa el doctor Néstor Vain, vicepresidente de la Fundación para la Salud Materno Infantil (Fundasamin), una de las organizaciones que trabaja junto a Unicef en la iniciativa.

- ¿Cuáles pueden ser las causas de los nacimientos prematuros?
- En la mayoría de los casos, la causa del parto prematuro es desconocida. De todas formas, existen también causas conocidas: ciertas enfermedades de la mamá (como diabetes, hipertensión), o cuando las ecografías muestran que el bebé no está creciendo bien el médico puede decidir -si es riesgoso para el bebé seguir en la panza- interrumpir el embarazo. Otras veces, las infecciones pueden aumentar la frecuencia de nacimientos antes de tiempo y además hay factores sociales: sabemos que en el bajo medio social, en las mamás que están desnutridas o en aquellas que tienen el hábito de fumar o consumir ciertas drogas, se puede producir la interrupción del embarazo.

En tanto, en el alto medio social un posible factor de prematurez son los tratamientos de esterilidad, que muchas veces dan lugar a embarazos múltiples, los cuales más comúnmente generan un nacimiento antes de término.

- ¿Cuál es el tiempo de gestación mínima necesario para que el bebé pueda sobrevivir?
- En los países con los mejores resultados o en los centros con mejores resultados de nuestro país, el "límite de la viabilidad", es decir lo más chiquito que podría ser para sobrevivir, es cuando tiene entre 23 y 24 semanas de gestación. Esto no quiere decir que las posibilidades sean enormes ni que a los chicos que nacen con ese tiempo de embarazo les vaya súper bien. Al contrario, no es ideal, pero existen chicos que sobreviven. En los lugares con mejores posibilidades, sobrevive un 35 a un 40% de los bebés que nacen con ese tiempo de embarazo y, a medida que pasa una semana más, la posibilidad de supervivencia va aumentando. En los chicos que tienen más de 26 semanas, la sobrevida supera el 90 por ciento.

- ¿Cuáles son los cuidados básicos que deben recibir los bebés prematuros?
- Siempre se fantasea con que lo principal es el equipamiento o la estructura del hospital. El hospital tiene que tener una estructura básica para poder atender porque los chicos necesitan que se les saquen radiografías, que se le hagan análisis, un buen banco de sangre, hemoterapia, un buen laboratorio y también tiene que haber un equipamiento esencial -incubadoras, respiradores, etcétera-. Pero lo más importante y lo que marca la diferencia en términos de las posibilidades de estos bebés es la cantidad y calidad del recurso humano. Porque si tengo la infraestructura y el equipamiento pero tengo una enfermera para atender a 15 chicos, no voy a tener posibilidades de darle a los chicos más chiquitos y más enfermos todo lo que necesitan para sobrevivir. Si bien hay progresos en equipamiento, el mayor progreso de la neonatología es el conocimiento que los médicos y enfermeras tenemos de cómo hay que cuidar a estos chicos y estar alerta ante cada señal que nos dan sobre sus necesidades.

DISTINTAS REALIDADES
- ¿Es justamente en materia de recursos humanos que el sistema sanitario argentino presenta falencias?

- En toda Latinoamérica hay mucha diferencia de un país a otro y dentro de nuestro país hay una problemática a la que llamo "de los promedios". En la Argentina la mortalidad de todos los recién nacidos es de algo menos que el 9 por mil. Pero esto mezcla el 5 por mil de la Ciudad de Buenos Aires con el 15 por mil de la provincia de Formosa; incluso dentro de la Ciudad de Buenos Aires no es la misma realidad de un lado de la calle que del otro.

Esto tiene que ver con la estructura de las instituciones, ya sean públicas o privadas: cuando hay una buena cantidad de profesionales que está atendiendo a los chicos y están bien formados, es una cosa; ahora si el mismo médico o la misma enfermera tiene que correr de un lado a otro para poder atender, las posibilidades del bebé no son las mismas. En 2008 hubo un reconocimiento público de la necesidad de personal de enfermería y el intento de formar gente en este área ya lleva un tiempo, pero hay mucho por hacer.

- ¿De qué forma se trabaja en la capacitación de profesionales para la atención de prematuros?
- Unicef junto con el Ministerio de Salud de la Nación, el grupo médico de neonatología del Hospital Garrahan, y Fundasamin estamos trabajando, yendo al interior del país, a hospitales muy pobres o con una estructura limitada pero con muchos nacimientos, a entrenar el recurso humano. Vamos a trabajar con ellos. Van dos enfermeras con un médico neonatólogo, en algunos casos cuando obstetricia es un problema llevamos un médico obstetra y durante una semana o cuatro días trabajamos al lado de ellos a toda hora, ocupándonos de que vean cómo se debe cuidar a estos recién nacidos. Hacemos un trabajo de capacitación en terreno. Pero esto tampoco es suficiente si no va unido a una decisión política de nombrar a la cantidad de gente que se necesita y de pagarle un ingreso que le permita trabajar de eso, porque sino nosotros formamos vanamente a la gente y la gente se va a hacer otra cosa.

ESTRUCTURA IDEAL
- ¿Cuántas personas se necesitan para atender correctamente a un bebé prematuro y cuántas son las que trabajan en la mayoría de los hospitales y sanatorios?

- En una estructura ideal, un chiquito que nace prematuro muy temprano, por ejemplo al final del sexto mes (27 semanas), con un promedio de un kilo de peso y tiene dificultad para respirar, requiere una medicación especial y luego requiere el respirador, necesita una enfermera todo el tiempo para cuidarlo. Una para él. Y si en algún momento está muy mal, necesita dos. Por supuesto, que tiene que haber un médico cerca, no exclusivo, pero cerca y cuando se lo necesita, también exclusivo.

Luego, a medida que el chico se va descomplejizando -es decir, que le puedo sacar el respirador, que está dentro del respirador pero está muy estable-, es necesaria una enfermera cada dos bebés. Y cuando el chico está fuera de la terapia intensiva, en las etapas que llamamos de cuidado intermedio, necesitamos una enfermera cada cuatro bebés. En el período de puro crecimiento, uno cada seis.

La realidad marca que este ideal se cumple poco, porque hay escaso recurso humano entrenado. Se calcula que en nuestro país faltan alrededor de 5.000 enfermeros y enfermeras entrenados en neonatología. Se está trabajando en formarlas, pero es un problema muy complejo.

- ¿Qué otros factores aumentan la tasa de mortalidad de bebés prematuros?
- Otro de los problemas es el lugar donde nacen. Nuestro país ocupa un territorio muy extendido, poco poblado, y muchas veces los bebés prematuros no tienen demasiados problemas pero nacen en hospitales pequeños que están a mucha distancia del hospital regional. Entonces hay que trasladarlos 200 ó 300 kilómetros para que reciban atención y eso hace que se separe de la mamá, que ésta no lo pueda alimentar a pecho, y quizás la mamá no tiene plata para tomar un colectivo para ir a verlo o tiene cinco hijos más... de modo que la distancia puede ser un factor perjudicial para la salud del prematuro.

En ese sentido, se están haciendo planes desde el departamento de Maternidad e Infancia y se está tratando de lograr una "regionalización", es decir que los bebés prematuros de más riesgo nazcan en menos número de lugares, para que tengan una estructura adecuada y se los pueda atender. No obstante, en un país tan extendido como el nuestro, no es algo sencillo de resolver.

En estos últimos años se está tomando más conciencia sobre estos cambios necesarios y de ahí la importancia de la "Semana del Prematuro" para concientizar a toda la sociedad.


6
Se intensificará durante octubre la lucha contra el cáncer de mama
Notisistema, Mexico
04/10/2010

Durante este mes de octubre se intensificará la lucha contra el cáncer de mama en el mundo.
En México esta enfermedad mata cada dos horas a una mujer y es que a pesar de que es curable si se detecta a tiempo, el diagnóstico en la mayoría de los casos es tardío y por esto fallecen tantas mujeres, pero también porque hacen falta médicos o técnico radiólogos que sepan interpretar una mamografía, lamenta el subdirector del programa de mama a nivel federal, Mario Gómez Zepeda.

“Nos hacen falta más radiólogos, son ellos los que interpretan la mastografía, nos hacen falta más mastrógrafos, ahorita el problema no es el tratamiento sino en realidad la detección y para la detección sí harían falta más técnicos radiólogos para tomarlas y más médicos y medicas radiólogos para poder interpretar y hacer los diagnósticos…”.

Durante este mes se intensificará la promoción de las mamografías y autoexploraciones. (Por Rocío López Fonseca)


7
Más de 500 habitantes de Kankí padecen por la falta de médico
Tribuna Campeche, Meixo
02/10/2010

KANKI, Tenabo.— Los servicios de salud en la comunidad han agravado sus deficiencias, porque los más de 500 habitantes carecen de médico y fármacos. Anteriormente un galeno ingresaba a Kankí una vez al mes para atender a la población, pero actualmente suspendió sus visitas y en su lugar quedó una enfermera responsable de la Casa de Salud, quien proporciona medicamentos básicos a la gente enferma de gripa y fiebre.

La unida de salud perteneciente al IMSS-Oportunidades no mejora sus servicios, por el contrario tiende a empeorar, acusó el agente municipal José Antonio Haas Chan.

Dijo que es indignante que se carezca de lo básico en atención médica, sobre todo en estas épocas que se presentan diversidad de enfermedades.

Al aproximarse la temporada de frío y con ella el incremento de los padecimientos respiratorios, no hay médico en la Casa de Salud.

Para recibir atención médica la gente necesariamente tiene que trasladarse a la cabecera municipal, lo que representa gastos extras, pero que en muchos casos se carece de recursos para ello.

Se espera que el director del IMSS-Oportunidades, Jorge Carlos Vera Pacheco, gestione para que la comunidad de Kankí disponga de un médico, por lo menos dos o tres veces a la semana.

Además de la falta de médico, la Casa de Salud no cuenta con el equipo necesario para brindar una consulta. En el pequeño edificio sólo se encuentra una enfermera que proporciona un jarabe o una pastilla para la gripe o fiebre, pero en males graves no puede recetar y los enfermos obligadamente van en busca de atención a la ciudad.


8
La salud pública en crisis
La Prensa, Bolivia
02/10/2010

Una situación de virtual colapso confronta la atención en los principales hospitales públicos de todo el país, exponiendo a muy graves riesgos la salud de miles de pacientes, en su gran mayoría de escasos recursos, que son atendidos en muy precarias condiciones, según se ha podido constatar recientemente una vez más. El panorama tiende a agravarse por el incremento de afectados con problemas respiratorios y otros por la prolongada contaminación del medio ambiente, por la quema indiscriminada en vastas zonas del territorio nacional.

La falta de infraestructura, de equipos, medicamentos y de una mayor cantidad de médicos y enfermeras ha puesto en crítica situación a los hospitales públicos, cuyos funcionarios se ven obligados a reiteradas declaratorias de emergencia junto a otras medidas de presión reclamando la atención de las autoridades nacionales. Ya se sabe que los efectos de tales medidas se dejan sentir, principalmente, entre los sufridos pacientes.

Enfermos de edad diversa, muchos niños entre ellos, atendidos en los pasillos; médicos que, por falta de espacio, están obligados declarar “en alta” a pacientes recién operados y cuyo estado de salud requiere mayor cuidado, laboratorios cerrados o equipos sin funcionar por falta de personal, medicamentos o de algún repuesto configuran un cuadro desolador y angustiante en los diferentes centros urbanos del país donde, en pleno siglo XXI, la salud de más de diez millones de habitantes parece ocupar un renglón secundario.

Como para corroborar tan lamentable hecho —y eso lo reiteran los sucesivos informes de entidades como la Organización Mundial de la Salud—, Bolivia es uno de los países que registran las peores condiciones sanitarias a escala mundial. Una de las causas tiene que ver con los exiguos presupuestos asignados para la atención de la salud, en comparación con los previstos para otras

áreas. Recursos millonarios del TGN no parecen faltar para la adquisición de material bélico para la “defensa” nacional, según las previsiones de gastos por realizarse. Sin embargo, el hospital de niños de La Paz debe rechazar pacientes que han llegado en busca de una atención, no hay espacios y el dinero necesario se lo desembolsa con cuentagotas o tarde, mal y nunca para la dotación de ítems, medicamentos, equipos, instrumental y otros materiales que se requieren con dramática urgencia en los nosocomios públicos.




Constitucionalmente hablando, la salud es un derecho y, en consecuencia, el Estado nacional está obligado a su observancia y a la entrega de los recursos suficientes para garantizar la atención en los hospitales, correspondiendo a los diferentes gobiernos departamentales y municipales los aspectos administrativos.

La Carta Magna define con claridad las competencias en tal sentido y, en consecuencia, no hay dónde perderse para la inmediata y oportuna adopción y aplicación de políticas que esencialmente mejoren en forma sustancial el funcionamiento del sistema de sanidad.

Si cada nivel de competencias cumple con la parte que le toca, la gestión en provecho de la salud pública arrojará mejores resultados en beneficio directo del ciudadano y de su derecho a gozar de una atención médica óptima cuando la requiera.


Back to top


-----------------------------------------------------------------------

The weekly news is a compilation of selected articles on the issue of the health workforce crisis, and is provided for information purposes only. The Alliance is not responsible for the content on third party web sites, and any link to external web sites does not imply any endorsement by the Alliance. If you wish to receive the Alliance weekly news compilation in your e-mail, please send a request to ghwa@who.int. You can also suggest or contribute articles that should be in the compilation, by writing to ghwa@who.int, for inclusion in the next distribution.

With the information we provide about   2016 /2017 heib loans to be reflected 

, We hope you can be helped and hopefully set a precedent with you . Or also you can
see our other references are also others which are not less good about  HIGHER EDUCATION LOANS BOARD


, So and we thank you for visiting.


open student loan :  philipus.de/mohprof.eu/LIVE/DATA/Newsletter/GHWA2010.10.08

Comments