Put the Frontline Health Worker Into the Post-2015 Framework

This post previously appeared in the Huffington Post and on the Skoll World Forum.

 

As world leaders gather this week to discuss the achievement of the Millennium Development Goals and the Post-2015 Framework, no subject of conversation will be more important than the need for more frontline health care workers. In the last two decades, the world has made tremendous progress in reducing child and maternal mortality, due in no small part to the contributions of the local health worker delivering lifesaving care. Millions of people in impoverished countries are alive today because a midwife was by their side when they gave birth, or they were vaccinated as infants by a nurse, or because their families learned from a community health worker to adopt healthy behaviors like breastfeeding, hand washing, birth spacing, and sleeping under a mosquito net.

 

I saw the lifesaving power of local health workers first-hand last month when I visited Save the Children’s programs in Pakistan, a country with some of the worst health indicators on the planet. According to our latest State of the World’s Mothers report, the lifetime risk of maternal death–the probability that a 15 year old woman will eventually die from a maternal cause–is 1 in 110 in Pakistan. Compare this to the United States, where it’s 1 in 2,400 and you see my point. Pakistan’s children aren’t any better than their moms. For every 1,000 children born, 72 of them will die before they reach the pivotal age of five, more than ten times the rate of their American counterparts.

 

But as harrowing as these statistics are, you would never know it from visiting the maternal and child health clinic in Haripur district. It is one of the most impressive facilities I have seen anywhere in the world at the primary care, or village, level. The spotlessly clean unit is staffed by two female doctors and several nursing staff as well as a pharmacist–all health care workers. A warehouse stocked with supplies is available on-site and the facility provides services 24/7 as needed. Women come here for prenatal visits, for family planning counseling and products, and to give birth in a simple, clean and safe facility with excellent care. Three women were in labor the day I visited and when I saw the care they received, I knew I would have felt comfortable having one of my own children there.

 

Unfortunately, not everyone in Pakistan–or the rest of the world for that matter–is as lucky to have a health worker in such close proximity. By some estimates, there is a shortage of at least 1 million frontline health workers in the developing world. And many existing health workers are not trained, equipped and supported to deliver basic lifesaving care close to the community. The consequence of failing to close this gap is grave. Every 3 seconds, a child’s death is prevented thanks to care provided by a frontline health worker. When a health worker is not accessible, the situation is, predictably, far less rosy.

 

The challenge for all of us in the business of saving mothers’ and children’s lives is to ensure that every person, no matter where they live in the world, is within reach of a health worker. We can–and should–start at the UN General Assembly, and continue the drumbeat at the Third Global Forum on Human Resources for Health in Recife, Brazil in November. But, it will take more than a few high-level meetings to make this a reality. That’s why Save the Children, in partnership with the Frontline Health Workers Coalition, created The REAL Awards, a first-of-its-kind, annual global awards platform designed to develop greater respect and appreciation for the lifesaving care that health workers provide in the U.S. and around the world. Anyone can take a few moments to nominate an inspiring health worker and help spread the word about the countless unsung heroes who go above and beyond the call of duty. It will make a REAL difference.

And the REAL Award Goes to…

The following blog first appeared on The Huffington Post.

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Awards season is in full swing.

 

On Sunday night, Hollywood’s elite came together and celebrated last year’s accomplishments on the Big and Small screens at the 70th annual Golden Globe Awards. While millions from around the world tuned in and debated whether the most deserving winners were chosen, a smaller, but no less important, awards program was about to take place just a short drive south of the action.

 

The inaugural REAL Awards honorees were announced last night in Laguna Niguel, Calif., where nine U.S.-based health workers were named for their extraordinary service in health care. They may not be household names, but they matter enormously to the patients they serve. People like Carri Butcher, our winner in the hospice care category, who created a day spa at her own home in Arkansas for her dying patients so they could be treated to a little pampering before they passed. Or Esther Madudu, a midwife in rural Uganda, who is one of the nine global honorees we named last September. Esther’s clinic often has no power, so she delivers babies in the middle of the night by the light of her mobile phone screen.

 

The REAL Awards is a chance to shine the spotlight on the men and women who go to work every day to perform the greatest role of all — saving the lives of others. They may not grace the covers of magazines, but their work still deserves to be celebrated, especially since they’re needed now more than ever.

 

We’re currently experiencing a severe shortage of doctors in this country. While we can’t ignore this crisis, one way to address it, at least in the short term, is to rely more on other health workers — nurses, physician assistants, nurse practitioners, community health workers, pharmacists — to perform the tasks that don’t require a doctor, as a recent New York Times editorial suggests.

 

No one knows the importance of health workers more than those in the developing world, where the dearth of doctors is even more stark. By some estimates, the world is short more than millions of health workers, including one million frontline health workers, who deliver care in some of the hardest-to-reach communities, oftentimes with limited resources. In fact, frontline health workers are the first — and often, only — point of contact to the health care system for millions of people.

 

Their role is invaluable. It is estimated that every three seconds, a child death is prevented thanks to care provided by a