WHO renews alert on safeguards for health worker recruitment

GENEVA –The World Health Organization (WHO) has released an updated WHO health workforce support and safeguards list, identifying countries as vulnerable for availability of health workers required to achieve the UN Sustainable Development Goal target for universal health coverage (UHC) by 2030.

The i pact of C -1 and widespread disruptions to health services has resulted in a rapid acceleration in the international recruitment of health workers, WHO said.

For countries losing health personnel to international migration, this could negatively impact on health systems and hinder their progress towards achieving UHC and health security, WHO added.

f the countries, 3 are in the frican region, eight in the estern acific region, six in the astern editerranean region, three in the South-East Asia region and one is in the Americas. Eight countries have been newly added to the support and safeguards list since its original publication in 2020.

“Health workers are the backbone of every health syste , and yet countries with so e of the world s ost fragile health systems do not have enough and many are losing their health workers to international migration,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

“WHO is working with these countries to support them to strengthen their health workforce, and we call on all countries to respect the provisions in the WHO health workforce support and safeguards list,” the WHO chief said.

The list should be used to inform advocacy, policy dialogue at all levels and financing efforts in support of health workforce education and employment in these countries.

The countries included in the WHO health workforce support and safeguards list have a UHC service coverage index below and health workforce density below the global edian edical doctors, nursing and idwifery personnel per 1 people. These countries re uire priority support for health workforce development and health system strengthening, along with additional safeguards that limit active international recruitment.

The WHO health workforce support and safeguard list does not prohibit international recruitment, but recommends that government-to-government health worker migration agreements: be informed by health labour market analysis and the adoption of measures to ensure adequate supply of health workers in the source countries; engage Ministries of Health in the negotiation and implementation of agreements; and specify the health syste benefits of the arrangement to both source and destination countries.

WHO also recommends that these safeguards be extended to all low- and middle-income countries.

Implementation of the WHO Global code of practice on the international recruitment of health personnel (WHO Global Code) can ensure that international movement of health workers is ethically managed, supports the rights and welfare of migrant health workers and maintains health service delivery objectives.

The 2023 update is informed by the report of the WHO xpert dvisory roup on the elevance and ffectiveness of the WHO Global Code. WHO will update the list every three years, with the next update scheduled for publication in 2026.

This issue will be discussed at the upcoming Fifth Global Forum on Human Resources for Health, which will examine the required policy solutions, investments, and multisectoral partnerships to address health and care workforce challenges to advance health systems towards the attainment of UHC and health security. The outcomes of the Forum will inform the United Nations General Assembly’s High-Level Meeting on UHC in September 2023.

Are you depressed?

What is depression?

Are there screening tests for depression?

Heart of Hope

Depression is a state of emotion where the individual has some or all of the following senses, feelings or moods: downhearted, unhappy, anxious, irritable, unable to concentrate, socially withdrawn, empty inside, has inordinate fatigue and reduced interest in activities which used to be fun, hopelessness, indecision, impaired sleep, misery, helplessness, confusion, monosyllabic speech or abnormally quiet.

What is morbid mood?

The morbid mood in depression may be so severe that the patient is unable to cry (tears dry up) or to feel the usual emotions like pleasure, grief or joy. The whole world appears lifeless and colorless to the patient, who could be pre-occupied with a sense of guilt and self-denigrating and destructive ideas.

What is Melancholia?

It used to be called endogenous depression. Its features include marked slowness in thinking and activity, agitation, worthlessness, weight loss, restlessness, wringing of the hands, inability to experience pleasure or wellbeing, di culty falling asleep and has inso nia, following arousal from sleep, with diminished or loss of sexual desire. The patient usually has the feeling of guilt that he/she has committed a grave crime, with hallucinations (voices of people accusing the patient of bad deeds, or condemning him/her to death. Others believe that they have incurable diseases like cancer or AIDs). Very rarely, the patient with this psychotic depression kills family members (“to save them from future misfortunes in life”) and kills himself/ herself.

How rampant is depression?

n the nited tates, depression affects about 1 million Americans. In the Philippines, about ten percent of young adults have moderate to severe depression in 2022, about 3.6 illion of the population. ore than 2 3 or of the do not benefit fro proper therapy because of patient’s inability to seek counseling, misunderstanding of the condition or misdiagnosis. Most people do not seek professional help because the condition is very common and many of them mild or subclinical (with no obvious symptoms). Sometimes, even physicians miss making the correct diagnosis in earnest, thinking the patient’s complaints could be due to some medication interaction.

Yes, there are. Mental health specialists can administer preliminary tests such as the BDI (Beck Depression Inventory), or the HRS (Hamilton Rating Scale), which is composed of 20 questions to screen the patient. Today, co puteri ed phone interviews are gaining effectivity as a screening tool. These tests are only a small part of the evaluation process, because the specialists have the symptoms of the patient and other criteria to aid them make the correct diagnosis.

Don’t we all get depressed sometimes?

To some degree, when the situations demand it, normal people develop a mild form of depression, which is transient, self-terminating, and not a disease. As long as the resultant symptoms are trivial and temporary, and do not debilitate the person, the condition does not need any medical treatment.

What foods relieve depression?

Foods that are high in tryptophan, an amino acid involve in serotonin production, provide relief to some people with depression. Niacin (Vitamin B3), which is essential in the production of tryptophan, can be found in dried peas, beans, whole grains, dried fortified cereals, and especially in oily fishes like sal on and ackerel. t is reported that ega-3 polyunsaturated fatty acids in fish oil may actually reduce depression. PMS Escape, a high carbohydrate drink, is claimed to increase tryptophan level and may control the depression related to pre-menopausal syndrome for about hours. However, there are impurities in the L-tryptophan diet supplements that are associated with EMS (eosinophilia-myalgia syndrome), which increases the white blood cells and causes muscle pains.

Does calcium help alleviate depression?

Calciu supple ents and ita in -12 have been reported to reduce pre-menstrual depression. Also, some studies showed that among depressed people who drink caffeinated beverages have a lower incidence of suicide, which see s to suggest that coffee or tea reduces depression.

What are the therapy guidelines? ong adults who suffer fro a or or chronic depression, a trial of antidepressant drugs is used, together with psychotherapy that is designed for the patient. For those who do not improve with this strategy, ECT (electroconvulsive therapy have been found to be effective and safe. If this fails, psychosurgery might be indicated.

How about exercises?

Believe it or not, physical exercises may be as effective as psychotherapy in the anage ent of ild to moderate depression. Prolonged aerobic workouts lead to higher levels of serotonin, adrenalin, endorphins and do- pamine in the brain (producing the popular term “runner’s high”). Physical exercises, brisk walking, ballroom dancing, yoga, tai-bo, etc. lead to better emotional health. As an extra bonus from physical exercises, weight loss and improved muscle tone lead to the sense of well-being and higher self-esteem. Those individuals with strong spiritual faiths have a relatively lower predisposition to depression. These people ight benefit fro editation, yoga, and other techniques for obtaining spiritual security, inner peace, and happiness. ong adults who suffer fro a or or chronic depression, a trial of antidepressant drugs is used, together with psychotherapy that is designed for the patient. For those who do not improve with this strategy, ECT (electroconvulsive therapy have been found to be effective and safe. If this fails, psychosurgery might be indicated.

What are the therapy guidelines?

How about for children?

Children and adolescents with major depression have been found in clinical studies to respond as well to placebos (sugar pills) as to tricyclic antidepressants, especially the newer ones, the SSRIs (selective serotonin reuptake inhibitors. For these group of young patients, a trial of psychotherapy (cognitive-behavioral or supportive therapy) is preferred before they are placed on antidepressant drugs.

Do you have depression?

If you suspect you do, do not medicate yourself. It is ost prudent to seek edical help. The first thing to do it to consult your primary physician, who can help guide you. With early proper medication and/or advice, depression in ost cases can be anaged effectively and eli inated faster than one can imagine. Physicians today have invaluable tools in their armamentarium for the diagnosis and treatment of depression. Many individuals with depression, who have sought medical care, are “cured” with simple oral medications that they look, behave, function, and live as normally and happily as anybody else, lost in the sea of anonymity.

Philip Chua, MD, FACS, FPCS, a Cardiac Surgeon Emeritus based in Northwest Indiana and Las Vegas, Nevada, is an international medical lecturer/author, Health Advocate, newspaper columnist, and Chairman of the Filipino United Network-USA, a 501(c)3 humanitarian foundation in the United States. He was a decorated recipient of the Indiana Sagamore of the Wabash Award in 1995. Other Sagamore past awardees include President Harry Truman, President George HW Bush, Muhammad Ali, Astronaut Gus Grissom (Wikipedia). Websites: FUN8888. com, Today.SPSAtoday.com, and philipSchua.com Email: scalpelpen@gmail.com