Health Workforce Resiliency for maintaining HIV gains and responding to future threats

USAID, through PEPFAR, has been on the forefront of advancing Human Resources for Health (HRH) by strengthening host-country government health workforces and systems for optimal planning, management and training.


Health workers have been central to the advances made in controlling the HIV/AIDS epidemic. Sufficient health workforce and robust institutional capacity to support health workers within countries are critical for sustaining gains made and ensuring resiliency for the future. However, countries and health care workers themselves face significant challenges. By 2030, there will be an estimated global gap of 10 million health workers, 50 percent shouldered by Africa. Today, health worker shortages across PEPFAR-supported countries threaten those countries’ ability to sustain the gains of their HIV responses. Health and healthcare workers need safe, healthy, supportive working environments to do their jobs, yet, we know that across the globe health workers have to work in difficult, sometimes dangerous conditions with inadequate rights and protections—from under remuneration and inadequate safeguards and equipment to a lack of access to mental health and psychosocial support. These challenges disproportionately fall on women, who comprise 70 percent of the global health workforce.

Our Approach and Results

For nearly twenty years, USAID, through PEPFAR, has been at the forefront of advancing the field of Human Resources for Health (HRH). USAID has been a significant contributor to PEPFAR’s efforts to strengthen host-country government health workforces and systems for optimal planning, management, and training. This includes PEPFAR’s achievement of training more than 290,000 new health workers and creating more resilient health systems that respond to service delivery demands. It also includes supporting provision of critical HIV and essential health services through the 327,000 health workers PEPFAR directly supports

USAID works to guide strategic investments in the PEPFAR-supported health workforce aligned with the PEPFAR five-year strategy, Fulfilling America’s Promise to End the HIV/AIDS Pandemic by 2030, and with broader U.S. Government commitments to support and invest in the global health workforce detailed in the Global Health Worker Initiative, launched by the White House in May 2022.

USAID supports partner country priorities and needs for a sufficient and robust multidisciplinary health workforce that is well safeguarded, protected, and retained for making sustained HIV progress. Our support includes the following: 

  • Engage with governments and other stakeholders to advance enabling policy environments that ensure fair remuneration and adequate safeguards for health worker well-being.

  • Support professionalization of community health workers who deliver HIV with other essential services. 

  • Work with national and subnational government entities to strengthen health workforce planning and management capacity.

  • Support strengthening of multi-disciplinary workforce capacity for integrated HIV service delivery.

    • USAID is working to ensure that HRH investments for HIV services are aligned with partner-country and regional priorities and that health services are increasingly delivered through country health systems to reach HIV epidemic control targets and sustain impact. 

  • Strengthen leadership and engagement of health workers in decision-making that supports quality HIV service provision.

    • Through the PEPFAR Nursing Leadership Initiative and other efforts, USAID is working to increase representation of health workers as key stakeholders in planning and implementation of the HIV response. 

USAID’s efforts to strengthen the global health workforce have led to achievements in the following areas:

  • In FY23, USAID through PEPFAR supported over 200,000 health workers and staff, an important part of the multidisciplinary workforce needed to provide HIV services across countries. USAID continues to collaborate with partner governments and key stakeholders to ensure that the significant health workforce investments through PEPFAR are well coordinated, aligned with national plans and priorities, and progressively integrated into the delivery of comprehensive  primary health care services.

  • Supported the development and launch of the PEPFAR Nursing Leadership Initiative, a new funded initiative in 7 countries to strengthen the role of nurses and midwives in leadership for the HIV response. 

Resources

Banner photo: A community health worker applies a blood pressure cuff as part of a multi-disease screening and health education session in in Bingerville, Côte d’Ivoire.  / Miléquêm Diarassouba for USAID