Saarah Khan - The Health Factor in Developing Human Capital

The Health Factor in Developing Human Capital

The Link between Health Care and Sustainable Economic Reward

“In any sector, employees who enjoy greater health, job satisfaction, and mental well-being are more inclined to perform better and with greater effort, in a way that is more efficient and sustainable for future growth” ...

While human capital is often defined as the economic value of the skills, knowledge and experience of a population, a key aspect is often overlooked and placed at the bottom of the priority list when it comes to boosting human capital, and that is health. Commonly, as it pertains to human capital, when companies want increased productivity, and therefore economic growth, they invest firstly in training and education for their workers. Similarly, some governments recognise the link between the economy and human capital and provide free or subsidised access to higher education, as often further education leads to higher salaries which in turn leads to a greater disposable income to stimulate the economy.

In recent years there has been a shift in the understanding that good physical and mental health and well-being is also a significant factor in the development of human capital and therefore more inclusive, productive societies. Studies have shown that investments in health from the early stages of life, especially when sustained throughout the life course, is key in the creation of the foundation for sustainable economic growth and competitiveness of nations.1 However, based on a 2017 report by the World Health Organisation, at least half of the world’s population is still without access to essential health services. Discussing the findings of this report, the then World

by Saarah Khan

Bank Group President, Dr Jim Yong Kim, indicated a need for a radical change in the way that resources are mobilised and utilised with respect to health and human capital at the country level.

Need for resilient public health systems

According to the findings of the World Bank’s Human Capital Index (HCI) 2020, although the Latin American and Caribbean region has improved the human capital outcomes, since the HCI’s launch, to ensure continued advancement and overcome the difficulties presented by the COVID-19 Pandemic, nations will need to build resilient public health systems, as a major step forward. The 3rd Annual Universal Health Coverage (UHC) Financial Forum in 2018, estimated that essential health services cost approximately US$90 per person per year. Regionally, only 3.8% of GDP, on average, is spent on public health care.2

It is clear, therefore, that the funding towards the health sector needs to increase, however attention should also be given to the allocation and efficiency of use of funds. This can be achieved through innovative partnerships with the private sector along with innovations in technology and new approaches to organisational systems and thinking. For example, in 2016, by utilising a partnership with a private sector robotics company

1. Building human capital starts with health. (2018). https://blogs.worldbank.org/ health/building-human-capital-starts-health 2. Human Capital Index. (2020). https://www.worldbank.org/en/publication/humancapital#Index

called Zipline, Rwanda became the first country incorporate drone technology into its health care system, by delivering blood packs aerially to hospitals.3 This was previously done via road transportation, making it difficult to transport quickly to rural areas. This procedure has been adapted by many other countries, most recently to deliver personal protective equipment (PPE) and vaccines with the advent of the COVID-19 Pandemic.

Health equity

A joint report by the WHO, World Bank Group (WBG) and the Organisation for Economic Co-operation and Development (OECD), emphasised the need for a collaborative effort between governments, health care services and providers, and everyday citizens to ultimately strengthen the quality of care available. A whole-of-government approach across multiple sectors of society, such as governmental ministries, non-governmental organisations (NGOs), private sector companies, etc. is required to improve population health and health equity, as there is a relationship between how these elements affect health outcomes. This can be observed in the transformation of Turkey’s health care system over the last two decades. The Turkish government utilised a public-private partnership, with financial and technical support from international NGOs and other subsequent inventors, to improve legislation and regulation and upgrade infrastructure and technology across the whole health care sector. Thereby also encouraging economic growth through the subsequent increase in private hospitals, complementary specialised services, job opportunities, etc. As a result of this initiative, healthcare access for the population increased to 98%.4

When we think of investment in the health care sector, the first thought generally involves infrastructure or capacity – i.e., more hospitals, health centres, doctors, nurses etc. While these are important, a holistic examination of the system will help assess the best type of investment for the most valuable returns. Access to service does not automatically guarantee the quality of care necessary to ensure optimal development. For example, instead of increasing the number of hospitals or clinics, perhaps it is better to assess the needs of a community to better provide services in the existing centres. This can have a profound impact

on not only the reactive measures provided in health care but also the proactive and preventative measures available to the population.

Caring for the caregivers

Wellness centres and programmes can be a key investment in health care, as they can provide communities with health services for both the body and the mind, providing mental health care services with access to counselling and psychologists, physical fitness classes and facilities, physical therapy and chiropractic services, dieticians, and nutritionists, etc. They can provide patients with activities and educational programmes that address the behavioural changes which can aid in treatment of an ailment, as opposed to only medication as a treatment option and can even highlight the preventative measures that can be taken to prevent and prolong development of a disease, such as nutrition and exercise information and facilities. They can also be a key resource for communities which may not otherwise have access to these services, such as the St Joseph Enhanced Health Centre in Trinidad and Tobago, which in addition to its regular clinic services, has on-site nutritionists and a gym facility.

These types of wellness programmes do not only apply to patients, but to the doctors, nurses and other health care staff that work tirelessly and often thanklessly in these positions. The hospital and health care environment is emotionally and mentally taxing, even more so since the pandemic. Health care workers have been asked to perform at superhuman levels, and while precautions have been taken to protect their physical health, little regard has been given to the toll this would take on their mental health. In any sector, employees who enjoy greater health, job satisfaction, and mental well-being are more inclined to perform better and with greater effort, in a way that is more efficient and sustainable for future growth.

In Trinidad and Tobago, many doctors and health care staff are contract workers, and therefore do not have access to benefits, like pension plans and the very health care services that they provide. Providing health care staff with benefits outside of monetary gains, such as on-site childcare, cafeterias or catering

3. Using drones to deliver blood in Rwanda. (2016). https://www.bbc.com/news/av/business-47631709

4. Turkey: Transforming Health Care for All. (2018). https://www.worldbank.org/en/about/partners/brief/turkey-transforming-health-care-for-all

services, access to mental health programmes and services, to name just a few, will have a great effect on the quality of service provided to patients. The Toronto East General Hospital in Canada launched its wellness programme in 2004, with an on-site fitness facility, including a physiotherapist, mental health professionals and services, employee assistance programmes and education programmes specifically designed for hospital staff to ensure they are at their optimal physical, mental, and emotional health levels. This facility has since received multiple awards which showcase its improvement to the health care providers’ quality of work life and the quality of care and service that they provide.

Health and education

The link between health and education is an important one and health education campaigns are a vital part of increasing the human capital and positive health outcomes in a population. Health education can equip individuals and communities to improve their quality of life, by improving physical, mental, emotional health, through increasing knowledge and influencing behavioural changes, to prevent communicable and noncommunicable diseases (NCDs) and illnesses. The benefits of a successful health education campaign can positively affect

communities for generations, and across multiple sectors of industry and segments of society and can be especially beneficial in rural communities. A study conducted in Jamaica, showed that the simple initiative of health workers in the community teaching parenting skills to the citizens can boost the income in that community by 25% over two decades.5 Similarly, the intense health campaign undertaken in Poland, which was first in the world in cigarette consumption with high rates of lung cancer and heart disease, with lung cancer being the main cause of death in males younger than 656, has been successful. The changes in the smoking behaviour and cigarette consumption have shown a significant improvement in the health of the Polish population, with the proportion of male smokers decreasing from 65% to 28% and from 32% to 18% for women, and lung cancer as the cause of death in males, dropping from 71.1 to 56.2 in every 100,0007

It is becoming increasingly evident that countries will find it difficult to compete in a global economy without a healthy, educated, and resilient population. While infrastructure or tangible investments may see quicker returns in the short term, investing in health systems that ensure access to quality affordable health care, will ultimately shape a thriving population that will generate sustainable gains over multiple generations.