Giorgio Solimano

Human resources for health: overcoming the crisis

In this analysis of the global workforce, the Joint Learning Initiative-a consortium of more than 100 health leaders-proposes that mobilisation and strengthening of human resources for health, neglected yet critical, is central to combating health crises in some of the worlds poorest countries and for building sustainable health systems in all countries. Nearly all countries are challenged by worker shortage, skill mix imbalance, maldistribution, negative work environment, and weak knowledge base. Especially in the poorest countries, the workforce is under assault by HIV/AIDS, out-migration, and inadequate investment. Effective country strategies should be backed by international reinforcement. Ultimately, the crisis in human resources is a shared problem requiring shared responsibility for cooperative action. Alliances for action are recommended to strengthen the performance of all existing actors while expanding space and energy for fresh actors.

Responding to the global human resources crisis.

The global community is in the midst of a growing response to health crises in developing countries, which is focused on mobilising financial resources and increasing access to essential medicines. However, the response has yet to tackle the most important aspect of health-care systems--the people that make them work. Human resources for health--the personnel that deliver public-health, clinical, and environmental services--are in disarray and decline in much of the developing world, particularly in sub-Saharan Africa. The reasons behind this disorder are complex. For decades, efforts have focused on building training institutions. What is becoming increasingly clear, however, is that issues of supply, demand, and mobility (transnational, regional, and local) are central to the human-resource problem. Without substantial improvements in workforces, newly mobilised funds and commodities will not deliver on their promise. The global community needs to engage in four core strategies: raise the profile of the issue of human resources; improve the conceptual base and statistical evidence available to decision makers; collect, share, and learn from country experiences; and begin to formulate and enact policies at the country level that affect all aspects of the crisis.

The School of Public Health at the University of Chile: Origins, Evolution, and Perspectives

With the support of and in accordance with the model of the Rockefeller Foundation, the School of Public Health of the University of Chile was established in 1943 as a training center for public health institution administrators. From the beginning its academic leaders also took the lead in the country’s health institutions, allowing the increasing knowledge of public health to be brought directly into practice concurrently with training. The military coup of 1973 halted this cycle and broke and destroyed the links between the school and national governance and policymaking; despite this, the university continued to consolidate its role as the major training institution for public health professionals. During that time the Master’s Programs in Public Health and in Biostatistics were launched, attracting students throughout the country and Latin America, but very few professors had adequate research training. Only in 2000, a decade after the return to democracy, a strategic plan was implemented to renew the School of Public Health (SPH) and reshape it for the new public health scenario in Chile. Since then efforts have been made to bring research skills up to date through PhD training and sending young professors to study abroad. Also, a PhD program was created in the SPH in 2003, and graduates are being rapidly hired in universities and the Health Ministry. The recovery of at least part of a leading role of the public health agenda should be based on the capacity to generate relevant new knowledge and advocate for its implementation.

Salud Global en las instituciones académicas latinoamericanas: hacia un desarrollo e identidad propia

Salud Global es un campo relativamente nuevo en las instituciones academicas de America Latina y su expansion ha sido lenta en comparacion con el explosivo desarrollo que esta disciplina ha experimentado en paises de Europa y Norteamerica. Este articulo presenta una vision general de los principales programas de docencia e investigacion en Salud Global en universidades e institutos de la Region que han surgido durante los ultimos 10 anos. Asimismo, se describe la creacion de ALASAG, una red de instituciones academicas con programas en Salud Global, a traves de la cual se esta haciendo sentir la voz de Latinoamerica en los foros mundiales de Salud Global. Los autores plantean que el quehacer de las instituciones academicas debe, necesariamente, inscribirse dentro de una conceptualizacion e identidad regional propia y distintiva. La perspectiva Latinoamericana de la Salud Global debe partir de una posicion critica frente al fenomeno de globalizacion economica capitalista manejado desde la ideologia neoliberal. Desde dicha perspectiva se propone un listado de aereas prioritarias en docencia, investigacion y abogacia en Salud Global para la Region, entre otras: la equidad en el acceso a la salud; la globalizacion economica en America Latina y sus efectos en la equidad en salud; y la liberacion y proteccion del comercio internacional en contraposicion con la proteccion de la salud humana y el medio ambiente.

Construyendo la salud pública del futuro: Planificación estratégica en la Escuela de Salud Pública de la Universidad de Chile

This article presents the experience in academic management 2000-2010 at the School of Public Health of University of Chile developing a Plan based on a participatory methodology of strategic planning. The three objectives were to promote academic excellence, to strengthen relationships with other actors and to establish a modern organization that would serve the academic community. Several achievements are identified, including advanced human resources training, strengthening of the academic body, expanded external relationships and professionalizing academic management. It identifies those factors facilitating and those restricting the implementation of the plan and strategies to overcome them. In conclusion, this experience was an important contribution to the modernization of the School and the design, management and evaluation of public policies in an academic setting.