Findings from a Survey of an Uncategorized Cadre of Clinicians in 46 Countries – Increasing Access to Medical Care with a Focus on Regional Needs Since the 17th Century

Abstract

With the United Nations Development Programme (UNDP) Post-2015 Development Agenda upon us, it is increasingly important to address the worldwide deficit of human resources for health. Ironically, there is a unique subset of regionally trained healthcare providers that has existed for centuries, functioning often as an “invisible” workforce. These practitioners have been trained in an accelerated medical model and serve their communities in over 46 countries worldwide. For the purpose of this paper, “medical model” is defined as the evidence-based and scientific manner of training and practice that defines physicians globally. Inconsistent nomenclature, however, has resulted in these workers practicing as a virtually unidentified and disjointed cadre on the margins of health policy planning. We use the term Accelerated Medically Trained Clinician (AMTC) here as a categorical designation to encompass these professionals who have been referred to by various titles. We conducted an exploratory, systematic review for AMTCs in over 70 counties to asses if there is such a cadre, the name or title of their cadre, period of and curricula of training and existence of credentialing. This paper reports our findings and aims to serve as a springboard for future, in-depth studies on how we can better categorize and utilize these clinicians. Introduction The escalating global crisis of the health workforce shortage is alarming. The Global Health Workforce Alliance (GHWA) estimates that by 2035, the global shortage of healthcare providers will be well over 12.9 million (Global Health Workforce Alliance Strategy 2013-2016 2012). Current estimates indicate that over one billion people do not have access to healthcare providers today (Crisp and Chen 2014). The paucity of appropriately trained healthcare providers worldwide limits access to fitfor-purpose healthcare. Maldistribution and migration of skilled healthcare workers, as well as limited-skills training, also contribute to the current health workforce deficit. The International Labour Organization (2015) recently published Global Evidence on Inequities in Rural Health Protection: New Data on Rural Deficits in Health Coverage for 174 Countries, noting that the “fundamental rights to health and social protection remains largely unfulfilled for rural populations.” It goes on to note, “while 56% of the global rural population lacks health coverage, only 22% of urban populations are not covered.” They estimate that “23% of the worlds’ health workforce are sent to rural areas, while more than 50% of the population live there.” One of the most significant inferences of this paper is a worldwide call for additional fit-for-purpose health workers to meet this basic fundamental right (Scheil-Adlung 2015). The importance of a more harmonized system for data collection of human resources for health was also a key point.