August 21, 2016

No Child, No Health Worker Left Behind

Written by Baby Science Live Coverage Team

“During the Ebola crisis response, we were in a room talking about many things, from vaccines to drones,” said Dr. Keith Martin of the Consortium of Universities for Global Health, “Then the gentleman next to me, from Sierra Leone leaned over to me and whispered, ‘we don’t have soap.’”

At the International Congress of Pediatrics (ICP) in Vancouver, the challenges in filling unmet needs in global child health were on full display in a thought-provoking discussion of overlooked gaps in both low-income and high-income settings.

According to information presented by Dr. Martin, the world may face a health human resources deficit of at least 6 million by the year 2030. Yet even if we are able to entirely alleviate the health worker shortage, there will remain an unacceptable deficit in health care resources. A lack of ventilators, sterilization equipment and other essential clinical supplies will most significantly affect the quality of care delivered in low-income settings. Gaps like these present a challenge to the health children, hampering the global pediatrics community from offering consistent, accessible, quality care in a world where 16,000 children already die every day, disproportionately in low-income countries.

“I went to a teaching hospital that serves 2 million – they had 3 ventilators for the whole facility,” recalled Dr. Martin, offering a poignant example of inequity. Dr. Martin made a powerful call for health care professionals in high-income countries to find the “clever, smart, creative things we can do that will benefit our institutions and dramatically benefit colleagues overseas,” and “enter an entirely new paradigm in how we can engage each other in care for those who need it most.”

But of course, inequity doesn’t exist only between high-income and low-income settings. As described by Nick Brown, Consultant Pediatrician with Salisbury Foundation Trust, inequity within high-income countries also exists; although perhaps more masked by the way we measured success under the Millennium Development Goals (MDGs).

The MDGs have generally been marked by a degree of success, with notable improvements made in the global reduction of child mortality and enrollment in primary education. Yet when examining MDG success, evaluation against country-level targets may show an aggregate net improvement while masking stagnation or regression within the poorest communities in high-income settings.

“We need to avoid the same repetitious cycles in the next generation of goals,” urged Mr. Brown, “where children [in high-income countries] have been left behind.” Therefore, implementation in the Sustainable Development Goals era must take into account evidence that the greatest gaps in health equity take place within high-income countries if we are to ensure all children are healthy and can thrive.

While no single study or symposium can tackle the prodigious challenges of inequities in child health, Dr. Martin reminded us that it is up to every healthcare professional to act as an advocate for increased and equitable resourcing to improve the health of our future generations. From strengthening local institutions to addressing social determinants of child health – such as improving roads pediatricians need to reach children in their communities – the political will to specifically serve the most marginalized must be bolstered.

As Dr. Martin said in a strong call to action, “We as medical practitioners need to be much more active in engaging political decision makers and the public. The public moves the political…we need to engage them to move policy.”

Using your voice to join the conversation at ICP is one way that every pediatric health professional can be an advocate. Join the online conversation using #IPA2016 and through the Crowd 360 hub.