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Is online education the missing key to a diverse health workforce?

New online healthcare courses are helping professionals in the Pacific to develop their skills and create a more diverse workforce.

Pacific Island countries are facing a serious skills gap. The global shortage of trained healthcare professionals is estimated to reach a deficit of 18 million workers by 2030. The World Health Organisation (WHO) estimates that 4.45 health workers are needed per 1000 people in order to achieve the full spectrum of essential, quality health services, from health promotion to prevention, treatment, rehabilitation, and palliative care, in other words, universal health coverage (UHC). The migration of health workers is also one of the key concerns. This does not only include immigration but internal migration; from rural to urban and migration within the region. Many Pacific countries are able to meet the threshold set by World health report 2006 of 2.28 physicians, nurses   and midwives per 1000 population. But, the same report also states that 57 countries are in critical shortages of skilled health professionals. Hence, the question is does workforce-to-population ratio capture the quality of the health workforce or just equity?

The twelfth Pacific health ministers meeting has endorsed Commitments for Action to ensure a quality health workforce to meet regional demand. This will:

  • Ensure more fit-for-purpose health workforce and more equitable distribution of health workers, especially for strengthening primary health care.
  • Strengthen health workforce management and improve health workforce data.
  • Ensure continuing professional development for the health workforce.
  • Task Pacific Heads of Health to explore the most appropriate regional coordination mechanism to address health workforce issues including clinical workforce that require regional governance.

However, the Pacific’s distinct and unique geography spreads over 180 million square kilometres, or a third of the world’s land mass. The region includes 22 Pacific island countries and territories (PICTs), of which there are more than 200 mountainous volcanic islands and approximately 2,500 flat islands and atolls. This makes providing access to quality health care services extremely challenging and nearly impossible to implement a “one size fits all” solution to overcome the health related challenges.

The smaller populations need a relatively higher health workers-to-population ratio to provide even basic primary and preventive care. Additionally, the recent shift in the scope of practice for the nurses is partly being driven by the other issues: non-communicable diseases, communicable diseases and diseases related to climate change. This has caused significant implication on the health budget for several Pacific countries. Nevertheless, in the recent years the Pacific has made big steps forward in expanding UHC, including increasing life expectancy, broadening vaccination rates and strengthening its hospital and health services. Key to this has been ensuring that the Pacific’s health workforce receives the most up-to-date and relevant training and skills development. More than 50,000 health workers have signed up for online classes since 2003, according to the Pacific Open Learning Health Net (POLHN) external evaluation by University of Technology, Sydney. That’s about 27,525 continuing professional development (CPD) free online health certificates, over 1,302 post graduate sponsorships and 362 graduates.

This platform, developed by WHO, enables colleges and universities that are looking to enter the online market in the area of medical, nursing and health science to host and deliver free online courses with a certificate of completion. Being governed by the outcomes of the regional bodies like Pacific Ministers of health and Head of Health provides POLHN with an advanced understanding of the skill gaps and other workforce constraints. This type of online education has dramatically changed the health sector. It has not only eased transitioning of workers into new roles but has also made education accessible and affordable. The 2017 POLHN external review by University of Technology, Sydney, identified that 75% of POLHN-sponsored post-graduates remained in their own countries during and after the study. Moreover, 87% of post-graduates stated that involvement in POLHN's free online certificate courses has been very or extremely useful for their health sector position. While some traditionalists may remain skeptical of the quality of online education, unsustainable and poor quality  programms are not available due to the stringent licensure system. Online education will become an essential component of a diverse workforce to bridge the skill gap for health-care professionals in the coming years, especially nurses. For more information, contact: Mr. Mohammed Yasin, Technical Officer, Pacific Open Learning Health Net, Division of Pacific Technical Support,