Huge cost of scaling up entire health system in Sub-Saharan Africa

December 04, 2015

"If we take the tasks physicians do that don't really require physician training - such as giving vaccinations or conducting health interviews - and shift them to nurses or community health workers, we can then free up doctors to do more complex tasks," said co-author Chris Brown Mahoney, who conducted the research while she was a post-doctoral scholar at the Global Center. "We see this concept of task shifting in the United States, where patients are increasingly seen by nurse practitioners. Here, it's happening primarily for money reasons. In Africa, there are so few physicians, it would be more efficient for them to focus on more serious health needs."

"A large increase in the number of mid-level and community health workers is a more cost-effective policy," added study co-author Mario Dal Poz, coordinator of human resources for health at the WHO. "This is especially true when you consider that they require less training and are more likely to stay in their own countries, and practice in traditionally underserved rural communities."

The consequences of insufficient health resources are dire. Every year, 500,000 women die from complications related to pregnancy and childbirth, 3 million babies are stillborn and 2.9 million people die from HIV/AIDS, according to figures from WHO.

"Without intervention, many African countries will take until 2030 to reach the health-related (United Nations) Millennium Development Goal targets," said co-author Alexander Preker, head of health investment policy and lead economist at The World Bank. "Billions of dollars currently spent on global public health priorities would be wasted if the human resources crisis is not given a higher priority on the development agenda."

The study was supported by WHO and the Global Center. The National Institute of Mental Health provided funding for Mahoney's post-doctoral research.

The study in Health Affairs is online at content.healthaffairs/cgi/content/abstract/hlthaff.28.5.w849.