Regional meeting on upgradation of training of training of community-based health workers within the context of revitalization of primary health care.

Message from Dr Samlee Plianbangchang Regional Director, WHO South-East Asia At the Regional Meeting on Upgradation of Training of Community-based Health Workers within the Context of Revitalization of Primary Health Care 1-3 June 2010, Paro, Bhutan (DELIVERED BY DR POONAM KHETRAPAL SINGH, DEPUTY REGIONAL DIRECTOR, WHO/SEARO) 1 Regional Meeting on Upgradation of Training of Community-based Health Workers within the Context of Revitalization of Primary Health Care 1-3 June 2010, Paro, Bhutan Message from Dr Samlee Plianbangchang, Regional Director, WHO South-East Asia (DELIVERED BY DR POONAM KHETRAPAL SINGH, DEPUTY REGIONAL DIRECTOR, WHO/SEARO ------------- Over the past few decades the world and countries in the South-East Asia have witnessed rapid demographic, environmental, social, economic, political and epidemiological changes. This transition necessitates a relook at the health agenda to customize our responses to the current health development needs. There is widespread consensus that the overarching principles of primary health care: social equity, universal coverage, intersectoral coordination and people’s participation remain valid and that health systems strengthening should be based on PHC values, principles, and approaches. Epidemiological transition, wherein countries face the dual burden of communicable and noncommunicable diseases, frequent occurrence of pandemics, ageing populations, lifestyle changes, rapid urbanization, high burden of injuries, effects of globalization, climate change and the economic crisis, mandate a fresh examination of options that countries need to consider in their ongoing health development initiatives. Revitalization of Primary Health Care with innovative action to address these issues is a vehicle through which health systems can be strengthened to meet the new and emerging health challenges in an equitable, efficient and effective manner. 2 Member States of the South-East Asia Region have reaffirmed their commitment to revitalizing primary health care in various forums. Notable among these is the adoption of resolution on primary health care in 2008 by the WHO Regional Committee for South-East Asia that enjoins Member States and WHO to continue to work towards strengthening primary health care in the Region. Other seminal events including the Regional Conference on Revitalizing Primary Health Care held in Indonesia in August 2008, and the earlier Regional Meeting on Revisiting Community-based Health Workers and Community Health Volunteers held in Thailand in October 2007, recognized the importance of these categories of health-care providers in the delivery of primary care in the prevailing epidemiological context. It was recognized that strengthening community-based health workers and Community Health Volunteers form the cornerstone of revitalizing primary health care. Countries in the South-East Asia Region recognize the pivotal role that the community-based health workforce can play in realizing national and international health goals. Not only does this category of workers play a critical role in providing the continuum of health-care services but also effective and imaginative utilization of their services provides an efficient mechanism for countries to accelerate efforts towards the realization of the Millennium Development Goals. The resurgence of interest in primary health care provides a platform to revisit the agenda of community and population-based health services. The current situation needs attention to address the dual burden of communicable and noncommunicable diseases and the public health responses to current issues such as climate change and disaster 3 preparedness. The emerging public health imperatives necessitate a relook at the capacity- building and service-related factors that impact the effectiveness of the existing community- based workforce. Upgraded training programmes for new entrants into this workforce are also a need of the hour. Like several other countries of the Region, Bhutan has been successful in the development of a community-based health workforce. Large numbers of health assistants, auxiliary nurse midwives and basic health workers have greatly contributed to the successful development and implementation of community-based services in the country. They have contributed significantly to the visible improvements in the health status of the Bhutanese people. Currently, about 90 per cent of the population is covered by primary health care services. This has led to the significant increase in life expectancy from 47.5 years in 1984 to 66.1 years in 2005. Infant mortality has decreased from 70.7 per 1000 live births in 1994 to 40 in 2005. Maternal mortality has declined from 380 per 100 000 live births in 1994 to 225 in 2000. As in several other countries, till very recently, the avenues of career advancement for community-based health workers in Bhutan were rather limited. In this regard, the Royal Government of Bhutan took an important step in April 2010 to launch the Bachelor’s Degree Programme in Public Health. This course will be offered to the community-based health workers. The Royal Government of Bhutan deserves all congratulations for this very important milestone in the history of health development in the country. Improving the education of the community-based workforce in Bhutan is a very welcome step towards professionalizing it. It will not only provide better career avenues to the workers but also 4 better upgraded skills and competencies and would contribute immensely to further improve the health status of the people of Bhutan. The Regional Meeting on Upgardation Training of Community-based Health Workers within the Context of Revitalization of Primary Health Care will provide a platform to deliberate on several facets of upgradation of the community-based health workforce in South-East Asia with specific attention on upgrading training programmes. The Bachelor’s Degree Programme in Public Health will provide a backdrop for the discussions. The rich experience and expertise that participants bring from Member States of the WHO South- East Asia Region, will contribute to the deliberations and that the recommendations will help chart a roadmap to upgrade and professionalize the community health workforce in South-East Asia. On my behalf, I take this opportunity to thank the Royal Government of Bhutan for their hospitality and the excellent arrangements made for the Meeting. I extend my best wishes to the participants on behalf of the Regional Director and on my personal behalf for successful deliberations and a satisfying outcome of the meeting.