KP in need of more, better health staff: report

PESHAWAR:  The province of Khyber-Pakhtunkhwa (KP) faces massive shortage and quality of human resource in key areas, particularly after the merger of the tribal areas, a report on human resource for health in Khyber-Pakhtunkhwa (KP) jointly filed by KP and federal health officials suggested.

KP, including the former federally administered tribal areas (Fata), has a population of 35.5 million people per the 2017 census with more than 83.4 percent of the population residing in the rural areas.

To extend universal health coverage (UHC) as per the Sustainable Development Goals (SDGs), the province needs 39,405 physicians and 118,570 nurses, lady health visitors and midwives and with the population expected to soar above 50.3 million by 2030, the number of physicians required for ensuring universal health coverage and meeting SDGs targets would rise drastically.

Health officials say that while short, the gap to their target for doctor-to-patient ratios was not as large as expected. Hence, there was no issue with the number of doctors available or the gap of the required doctors, particularly in light of some 20 medical colleges — in both public and private sector — who are producing doctors every year.

However, there was a greater gap for nurses and paramedics who number only 13,673 around the province. Hence, a major challenge in KP is the low production of nurses and midwives. To add to this, most of those who graduate out of the few nursing schools are women, hence there is a dearth of male nurses in KP as well.

Moreover, the report stated that “another challenge is lack of regular and structured continuous professional development (CPD) assessments and plans across all types and levels,” adding that high attrition rate amongst graduates (as a result of migration for jobs and women physicians who do not continue with the profession) is another issue which needs to be investigated.

The institutional imbalances and poor quality health professional education have led to inequity and inconsistency of health professional’s availability, it read, adding that by the end of 2017, the annual production capacity of medical institutions for graduate courses was 2,050 indicating that 24,600 physicians can be produced in the next 12 years.

To ensure UHC in the shortest possible time, emphasis should also be given to having maximum coverage of LHWs along with system strengthening investments and required changes in the scope of their work.

“Guaranteeing rights to all health workers, including service structure, safe and decent work environment and freedom from all kinds of discrimination and violence,” it suggested besides addressing broader societal barriers that prevent women from joining the health workforce.

“Barriers include security issues, sexual harassment in the workplace, women requiring permission from the family to work and provisions for life events such as maternity leave,” it said and suggested ensuring development and implementation of standards with the minimum of one qualified nurse for three general hospital beds.

The indicators for the SDGs’ target for 2030 outlines the ideal number of health workers in the province including physicians, specialists, dentists, pharmacists, nurses, midwives, lady health workers by gender, and district.

It added that for sustainable development, it was not only required that the adequate number of doctors and nurses were available, but that there was a well-distributed workforce with an appropriate mix of skills to provide quality services.

“Though there have been attempts in scaling up the production of health professional that has not been sufficient enough to keep the pace with the increasing population, thus, it is critical to address health workforce challenges rapidly,” the report jointly filed by KP and federal health officials.

The report suggests that KP establish a provincial health workforce planning and development capability which provides strategies, governance mechanism, legislation and resources to deliver a health workforce of sufficient size, composition, capability and distribution to meet the health needs of the population.