The pandemic affected the health sector the most as health systems became overburdened with the requirements of patients needing care, even as the health workers themselves were also at risk from the disease. Many of the first casualties of the COVID-19 were those who had attended to patients, especially in the first six months of its onset, exacerbating the already problematic staffing of health facilities around the world.
As the epidemic slowly transitions into endemic state, countries are now taking stock of their health human resource and the shortage is felt, especially the lack of nurses. Their response is to intensify recruitment process from other countries to plug their gaps. As the Philippines is one of the major sources of health professionals globally, this is depleting the local health facilities of their staff and facing big challenges in their operation. More importantly, this will deprive Filipinos of health services they need.
While this problem may be partially addressed by the adoption of telehealth, technology and other digital applications, they can only go so far. In the end, there is a reason why the service is universally called health care—a recognition that ‘caring’ is integral to health, and that is one aspect that can never be replaced by technology, no matter how sophisticated they may be.
With all these coming to a head with the still persistent COVID-19 and its variants, the way health services are delivered and accessed, and how they will be deployed and managed will have to be reconfigured. They also signal the need to look at the health systems with a new lens and identify opportunities for innovation long being called for to address the persistent imbalances in access, equity and quality. While international standards and health protocols will always be an integral part of the health processes, these should be viewed from regional, national and local perspectives on how these health services can be delivered, considering our unique conditions and using the resources that are available.
The health educational system will be called upon to play a pivotal role in bringing about these needed transformations and innovations to address the shortages in health human resource. The competencies and skill sets will need to match, adapt and respond to these new requirements and challenges. Failure to rise to this call of the times will compromise the stability of the health system, the cost to access services and the quality of care.
There are the long-standing challenges in health education that the pandemic magnified:
• how learning is provided, acquired and assessed have been changed by the acceleration of digital and other technologies;
• the continuing rise in the cost of education that has become unaffordable to many students and their families; and
• how to retool and reskill the educators and the institutions into adapting to the changing demands of learning and education.
Shaping the education of the future health workforce will require that institutions address not only those challenges, but also ensure that they become adept at using the technologies whose deployment the pandemic has hastened. The learning environment will need to be restructured to fuse the virtual and the physical, without sacrificing the hands-on training that is critical when the responsibility is to save lives. They will have to be agile enough to turn the academe into learning hubs where skills and competencies are honed, and to use innovative applications and methodologies to deliver this. Needless to say, these have to be done—and fast—to stem the staffing drain and put the health system back on track.
The way forward
It is a different world and the way forward will require deeper structural transformations. Therefore, addressing these disruptions necessitate collaboration and synergy between the service providers (health facilities) and the learning providers (educational institutions).
1.Recalibrate the training. The most pressing problem is bringing up to speed the students whose academic preparation might not be in line with the needed clinical training and experiences that the two years of pandemic transformed. To get them ready for actual work, there is a need for institutional transitions that will supplement and hasten the largely theoretical learning that the virtual system provided.
2.Innovate learning methodologies. Health education must evolve by introducing innovations in both instructions and clinical experiences provided to students and the pioneering spirit that can challenge status quo and tradition.
3.Optimize the hybrid system. Educational institutions should likewise establish pathways that will institutionalize the hybrid system—physical and digital—and how best to optimize both to achieve the quality of preparation that patient care requires. This is especially critical in the health-care setting where the mantra is always getting it right the first time and all the time because there are no do-overs when it comes to patients’ lives.
4.Make education accessible. Diversity, equity and inclusion should be embedded into the academic DNA, and institutions must work toward making education more affordable and accessible, especially to those students with potential but can ill-afford the cost. Exploring linkages with other institutions, private, nongovernmental organizations, and the public sector within and outside the country, can be a fertile ground to enable this. After all, education should have no boundaries.
5.Prepare the global health workforce. Philippines is a recognized brand in health services. It has always been one of, if not the biggest source of nurses and doctors serving in the health systems of various countries. Both hospitals and educational institutions must join hands in preparing the future global health workforce, through solid academic preparation, systematic and hands-on training and deployment that will provide experience in all facets of health care. This will ensure that our country’s needs are prioritized and first to benefit from their know-how, skills and competent service. It will also render the local health system less vulnerable to brain drain, instead assuring that if and when they decide to explore the bigger responsibility to caring for patients offshore, there are readily available trained replacements that can assume their places.
This transformed health education system will take on the big responsibility of training the health professionals of the future who will be taking care of the people here and all over the world. The pace with which these systems will be made operational will be critical because sick patients do not have the time to wait. INQ
The author is the 2022 vice chair of the MAP health committee, chair of the MAP CEO conference committee, president and CEO of Health Solutions Corp., and former undersecretary of the Department of Tourism. Feedback at map@map.org.ph and
alma.almadrj@gmail.com.