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SWOT Analysis of World Health Organization, Research Paper Example

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Words: 2261

Research Paper

The WHO is controlled by the World Health Assembly, which comprises representatives from the UN member nations and meets once a year (Geer, et al, 2011, p. 583). The operations of the WHO are overseen by a director general who is nominated by a thirty-four-member executive board and approved by the World Health Assembly and who has no set term of office (p. 583). Looking at the current situation of the WHO, this paper draws several conclusions from a brief SWOT analysis.

Strengths

The WHO is one of the sixteen specialized agencies brought into relationship with the United Nations by an official agreement. It is one of the four ‘large’ specialized agencies, together with the International Labor Organization (ILO), the United Nations Organization for Food and Agriculture (FAO) and the United Nations Organization for Education, Science and Culture (UNESCO) (Beigbeder, et al, 1998, p. xix).

In 1978, 30 years after the WHO was established, the Alma Ata Declaration on primary health care for all came into effect. A further 30 years later, in 2008, the WHO reaffirmed the importance of primary health care for all, highlighting the success of the Declaration and the global disparities in how health care is provided (Kebede-Francis, 2011, p. 164). When the most developed and the least developed countries are compared, there is a gap of 30 to 40 years in life expectancy. It is important to note that every country has increased life expectancy since 1978, attributable to the Alma-Ata Declaration (p. 165)

The public health dilemmas are global, not local (Schneider, 2011, p. 680). The WHO’s global strength include the vast array of technology and data at their disposal. Most importantly, its objectives to expand into the entire world have been triumphant. The WHO has provided successfully a nexus for the orderly collection and dissemination of global health information, often gleaned from its own surveillance systems or assembled from those of national health authorities.

The WHO has identified its strengths as its neutral status and nearly universal membership of 197 countries, its impartiality and its strong convening power (WHO, 2011). It has a large repertoire global normative work and many countries rely on WHO standards and assurances in medicine (McKenzie, et al, 2011, p. 35). Based on evidence of where the WHO could make the biggest difference to health outcomes, 35 areas of work were identified within four strategic priorities directly linked to the mandate (p. 35). The WHO’s work is clearly described through the 21 objectives in purpose and work of the World Health Organization (p. 36).

The WHO recognized that good planning of human resources based on actual and projected needs is essential to effective program implementation at country level and have improved staff mobility and rotation to address this issue (McKenzie, et al, 2011, p. 37). The Organization has taken an active part in the UN reform process as a member of the UN Developing Group (UNDG). Papers to the January and May 2007 Executive Boards outlines the WHO’s views on UN reform, and their engagement, including in the pilots, to date. These demonstrate movement and a change of position over the previous months. The country support network have agreed a strategy for building capacity of country teams and addressing the harmonization and alignment agenda.

TheWHO has made vital contributions to the field through its work to delineate the connections between climate change and human health, advocate for greater attention and research to this topic, and consider the most effective interventions for promoting human health (WHO, 2009a). The WHO has committed itself to promoting and supporting production of scientific evidence and partnering with other UN agencies and “sectors other than the health sector at national, regional and international levels, in order to ensure that health protection and health promotion are central to climate change adaptation and mitigation policies” (WHO, 2009b, supra note 46).

Weaknesses

The WHO’s mainweak point is adistinctworldwide environment in which they are operating, where statesgreatly differ in terms of their capacity of infrastructures, human and financial resources, and vow to public wellbeing. They are also inundated by the disconnection between “going over” and “action” (Jacobsen, 2008, p. 19), which is furtherworsened by the mistaken belief of inspection as anobjective, rather than as a way to an end.

Furthermore, despite ever-increasing expansion into new countries and regions, theWHO continues to focus much of its attention on the United States or most developed countries, where it is headquartered, and this may lead to future problems related to longevity and success.

Projected expendituresof the WHO in the biennium 2010-2011 was $US 3700 million with 50% of estimated cost spent at staff salaries, 15% of direct financial cooperation at country level, 12% on research and consultancies, 10% on medical supplies, 8% on travel expenditures; and the remaining 5% on other expenses (WHO, 2010). There is an unhelpful resource ration of 18% to 82% between assessed contributions and voluntary contributions (Shashikant, 2011) – funding which is largely earmarked for specific activities – which severely hampers the WHO’s ability to carry out its core work. The WHO intends to redress the imbalance of earmarked funding, and the restrictions this places on activities by 2013 (Shashikant, 2011). However, the latest proposed program budget for biennium 2010-2011 shows even greater imbalance (Shashikant, 2011). This poses a major threat to the WHO’s financial health.

Inequalities in health, differences in health experience and health status, exist at many levels. Some of these differences are avoidable, unfair, and unjust and are referred to as weaknesses of the WHO (Jacobsen, 2008, p. 20). Limited money or insurance coverage, inability to take time off from work and home responsibilities, and lack of access to transportation may delay diagnosis and treatment, so by the time poor people see a doctor, their disease conditions tends to be at an advanced stage that is harder to treat. People from marginalized populations may receive inadequate explanations of their health conditions due to language barriers, and often cannot afford referrals for second medical opinions or specialized care.

Each year the WHO publishes updated population and health statistics by country and region and uses those indicators to highlight a particular global health concern (Jacobsen, 2008, p. 21). Consider the disparities in the deaths of children during the first five years of life, what health workers call “under-5 mortality” (WHO, 2011, p. 24). Although North America (the United States and Canada), Europe, and Japan represent only about 18% of the world’s population, these regions account for nearly 88% of drug sales (Jacobsen, 2008, p. 25). Although Asia, Africa, the Middle East, and Oceania make up nearly 73% of the world’s population, only about 8% of drug sales are to these regions (p. 25).

Opportunities

The WHO’s key opportunity lies in the hope of building an overarching, integrated, andcomprehensive surveillance plan that will take the WHO out of their punitive silos – a surveillance plan that sets main concerns based on universalconsiderations. These main concernsinevitably balance the possibleinfluence on and the extentof buy-in from the states or society that they areabout to serve. As Lemon et al (2007, p. 224) stressed, “Ideal solutions lacking community support will fail, while popular, partial solutions will succeed”.

The WHO alsohad a great opportunity to promote a new group of public health managers worldwide who will catalyze organization through uniquepatternsthan those held nowadays. Improvement toward in-line surveillance will be hurriedby active trans-disciplinary management development programs in universal health.

In terms of the key issue of health systems strengthening, theWHO needs to define and play its role vis-à-vis the roles of other agencies such as the World Bank (World Bank, 2011, p. xviii). With the effects of climate change becoming more apparent WHO will have a key role to play in the response to global health security resulting from it. It is to be expected to see a positive response at regional and country level. The WHO needs to continue to demonstrate leadership in helping to simplify the current complex health architecture and proliferation of global health partnerships. The WHO has seen many successes at the global level and some success at the regional and country levels; however lack of information makes it difficult to counter the perception of variable country level performance.

Improving Financial Resources management is a priority area. Individual donations are one of the largest donations for theWHO. This includes time-sensitive pledges and one-time donations. Individual donations can include volunteerism and financial gifts, and can come from members or non-members. A good way to gather potential donors is to offer a membership service that provides relevant information from annual or semi-annual dues.

Government grants come from federal, state, and local governments. At the federal level, funds are raised through the grant application that shows how the WHO has solved or sought to solve a particular problem and what the results or anticipated results are, as well as establishes a specific need. At the state level, grants are often repeated on a yearly basis and, while under the same premise as federal grant applications, may also include political involvement. Local government grants for theWHO are the smallest of grant resources, especially in rural areas and are often specific to a certain program rather than a solution to a problem.

Threats

Progress toward integrated, global surveillance is threatened by the potential for unintended consequences. The potential for surveillance to deepen the first-world/third-world divide is a huge threat to global coordination and collaboration. Thus the WHO needs to discuss the possible consequences – both intended and unintended – with their stakeholders and the beneficiaries they serve, both domestically and globally.

One of the biggest threats for the WHO is demographic transition. The world population has increased exponentially, particularly from 1950 onwards. In 1750, the world population was only 700 million (Kebede-Francis, 2011, p. 166). One hundred years later, it had reached 1.2 billion, a modest increase of approximately .5 million people. One hundred years later, by 1950, the world population had more than doubled, reaching 2.55 billion, which was an increase of 1.35 billion. But it took only 60 years, from 1950 to 2010, for the world population to increase from 2.55 billion to more than 6 billion, an increase of more than 3.5 billion people in just 60 years (p. 166).

Although between 1950 and 2010 the world population more than doubled, there is evidence to suggest that it will not double again in the next 50 years of the 21st century (Kebede-Francis, 2011, p. 167). This is because most countries have either completed or are in process of completing their demographic transition periods. For example, Europe, most of the Americas, the Middle East and Arab states, and the FSU states and some developing countries have completed their demographic transition periods (p. 167). In this respect, the WHO, governments of least developed countries, NGOs, and the medical communities must focus their attention on demographic trends, especially fertility rates.

How to Manage Change?

There are two possible ways to assess each of the above forces analyzed. They are ‘potency or strength’ (Packard, 2010). If there are more potent forces particularly forces that threaten to restrain change then more attention will have to be given to these matters.

Areas, such as the staff development, will take longer to see significant changes.This paper draws a line which reflects the current situation of the WHO and another line which represents the future situation of the WHO. Inductions and ongoing training for the WHO’s staff in interpreting and delivering Health Action in Crisis (HAC) emergency mandate needs to be enhanced and delivered at the national level whenever possible and additional focus and resourced need to beidentified to support these activities (Haytmanek, & McClure, 2010, p. 175). Health Action in Crisis is a mid-term evaluation of the three year program to improve the performance of the WHO in crisis (p. 175).

Properly trained employees are more willing to adjust to change. Training packages for staff at national level need to be further developed to improve capacity to create quality proposals to donors. The training program will have to be credible and organized in a manner that is fun and informative all at once.  Training should involve every rank and files of the WHO.  It is a necessary tool for helping all concerned to understand and appreciate change, the need for change and the benefits of change. It also helps with transition and adjustments.

References

Beigbeder, Yves, &Nashat, Mahyar, &Orsini, Marie-Antoinette, & Tiercy, Jean-Francois, et al (1998). The World Health Organization. Martinus Nijhoff Publishers. pp. xix-xx

Geer, John G., & Schiller, Wendy J., &Segal, Jeffrey A. (2011). Gateways to Democracy: An Introduction to American Government. Cengage Learning. pp. 583-584.

Haytmanek, Elizabeth, & McClure, Katherine. (2010). Mitigating the Nutritional Impacts of the Global Food Price Crisis: Workshop Summary. National Academies Press.  pp. 175-180.

Jacobsen, Kathryn H. (2008). Introduction to Global Health. Jones & Bartlett Learning. 20-30.

Kebede-Francis, Enku. (2011). Global Health Disparities: Closing the Gap through Good Governance. Jones & Bartlett Publishers. pp. 164-170.

McKenzie, James F., &Pinger, Robert R., & Kotecki, Jerome E. (2011). An Introduction to Community Health. Jones & Bartlett Publishers.  pp. 35-40.

Packard, Thomas. (2010). Staff Perceptions of Variables Affecting Performance in Human Service Organizations. Nonprofit and Voluntary Sector Quarterly, 39 (6): 971-990.

Schneider, Dona. (2011). Public Health: The Development of a Discipline, Volume 2, and Twentieth-Century Challenges. Rutgers University Press. pp. 682-684

Shashikant, Sangeeta. (28 July 2011). WHO: Vague and Inadequate Reform Plans Criticized, Nothing on Financing. South-North Development Monitor. Retrieved from http://www.sunsonline.org/contents.php?num=7197

WHO. (2011). World Health Statistics. World Health Organization. Retrieved from http://www.who.int/whosis/whostat/EN_WHS2011_Full.pdf

WHO. (2010). Implementation of Program Budget 2010-2011: Update. Retrieved from < http://apps.who.int/gb/ebwha/pdf_files/EB128/B128_23-en.pdf>

WHO. (2009a). Protecting Health From Climate Change: Global Research Priorities. World Health Organization: Geneva, Switzerland. Retrieved from <http://www.who.int/globalchange/publications/9789241598187/en/index.html>

WHO (2009b). WHO Workplan on Climate Change and Health. Retrieved from <http://www.who.int/global-change/wha_plans_objectives/en/print.html>

World Bank. (2011). World Development Indicators. World Bank Publications. Retrieved from http://data.worldbank.org/data-catalog/world-development-indicators

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