3.3.4 Health workforce and training

Health systems during emergencies also experience a significant decrease of available health workers in addition to having supplies and facilities issues. Many of the countries experiencing a humanitarian crisis are already wrestling with low resources, resulting in a weak health system with strained human resources for health. Emergencies exacerbate these shortages and compromise human and infrastructure safety, capacity and quality. Moreover, crises and emergencies can greatly increase the percentage of the population in need of immediate health care. A competent and capable workforce is necessary to implement essential health services during these time periods, including services for sexual and reproductive health.

Trained obstetric and gynaecologists are qualified human resources for providing comprehensive reproductive health services. These include being able to provide a full range of clinical services including Caesarean Section for complicated pregnancies, as well as other gynaecological surgeries required for saving women’s lives. Health facilities need to be fully equipped to provide this highest level of services. However, most of the maternal deaths occur due to a few frequently occurring complications, which if managed properly and in a timely manner can be prevented. Almost all of maternal deaths occur in low resource setting and in developing countries. Getting the right health care provider, especially skilled birth attendants, is a proven best practice for preventing excessive maternal deaths.

In addition to Obstetricians and gynaecologists, other providers like general practitioners, mid-wives, nurses, clinical officers and health assistants can also provide good quality reproductive health services. During a humanitarian emergency, these providers who are trained in sexual and reproductive health skills can provide valuable health services to prevent maternal and neonatal deaths. As far as possible, during an emergency every effort should be made to hire trained providers who can provide good quality sexual and reproductive health services.

At the onset of a crisis, it is essential to find providers who are well trained in SRH skills to initiate quality service delivery as quickly as possible. There is very little scope for introducing training for providers at this stage. Once the situation has stabilized and the emergency response is better resourced, more in-depth training can occur to increase the workforce and include more local workforce to assist in efforts to meet demand for services. High intensity refresher training in sexual and reproductive health care can be organized to cover skills with discreet modules of basic emergency obstetric care (BEmOC), contraceptive counselling, and other basic integrated SRHR services. High intensity refresher training for long acting reversible contraceptive (LARC) methods can also be conducted to meet the demand for these services. Ensuring a competent health workforce for SRHR services is essential for preventing and reducing high maternal mortality and morbidity in humanitarian settings. For example, ensuring skilled birth attendants (SBA) to assist in births is considered best practices to reduce maternal mortality and morbidity. For SRHR program design and training needs COs can contact the SRHR global team for assistance. Ref to contact information at the beginning of the Health and SRHR section.