How the Diplomatic Community Can Help Solve the Health Workforce Crisis.

• Author: Gaye, Pape
• Position: Commentary & Analysis - Essay

March/April 2017

A few months back, I was in the Dominican Republic, standing before a crowd of government officials, local IntraHealth International staff members, and many others, as we talked about "ghost" workers.

A few years earlier, IntraHealth had worked with the Ministry of Health there, as part of a USAID-funded project, to conduct a payroll analysis. This may sound humdrum, but what we found was quite striking: some 10,000 individuals who were no longer working for the ministry were in fact still collecting salaries from it. These ghost workers, as we call them, were draining the public health sector of more than $6 million per year, and as a result, health care for Dominicans was suffering.

Once these data came to light, officials were able to address the issue and reinvest the savings back into the health sector, hiring new health workers and providing much-needed raises for its existing workforce. It was a great success. The national health system became stronger and more Dominicans gained access to essential health care. In fact, the number of family planning, prenatal, postpartum, and laboratory visits (including HIV testing) jumped by 517% in one region, from 1,981 visits to 12,237.

But it wasn't my account of these improvements that had the most profound effect on the officials gathered at that high-level event--it was the US ambassador's.

As then-Ambassador James Brewster spoke about those 10,000 ghost workers and reiterated the US's commitment to partnering with the Dominican Republic to reach universal health coverage, I could see the audience's response. The local government officials were focused, and energized to see this enthusiasm and commitment from such a high-level diplomat. They left eager to keep this thing we have together going.

Unfortunately, many of the Dominican Republic's health challenges are not unique. Worldwide, we face a looming shortage of some 18 million health workers, as well as chronically under-funded health sectors, lingering HIV epidemics, and alarming vulnerabilities to emerging health threats. International development organizations like IntraHealth are working hard to build local capacity for sustainable change, but we cannot do it alone.

The diplomatic community could be a key to resolving this crisis.

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