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More than 43 million additional health workers are needed to achieve universal health coverage goals


More than 43 million additional health workers are needed to meet universal health coverage goals worldwide, according to a new peer-reviewed study from the Institute for Health Metrics and Evaluation (IHME) at the University of Medicine. the University of Washington which has been published. today in The Lancet. The largest gaps were observed in sub-Saharan Africa, South Asia, North Africa and the Middle East.

These are the most comprehensive estimates of the global health workforce to date. Health workers are essential to the functioning of health systems, and it is very important to have this data so that countries can make informed decisions and plan for the future.”

Dr. Rafael Lozano, Lead Author, Director of Health Systems at IHME

The researchers looked at shortages in four categories: doctors, nurses and midwives, dental personnel and pharmaceutical personnel. In 2019, they estimated that more than 130 countries lacked doctors and more than 150 lacked nurses and midwives. Comparing current levels of health care workers to the minimum levels needed to reach a target score of 80 on the Universal Health Coverage (UHC) Effective Service Coverage Index, researchers estimated a shortage of more than 43 million healthcare workers, including 30.6 million nurses. and midwives and 6.4 million physicians.

“We found that the density of healthcare workers is strongly related to a nation’s level of social and economic development,” said lead author Dr. Annie Haakenstad, assistant professor of health measurement sciences. at the IHME. “There are different strategies and policy approaches that can help address labor shortages, and these need to be tailored to each country’s individual situation. We hope these estimates can be used to help prioritize policy interventions and inform future planning.

The study found a more than 10-fold difference in healthcare worker density between and within regions in 2019. Densities ranged from 2.9 doctors per 10,000 people in sub-Saharan Africa to 38.3 per 10 000 in Central Europe, Eastern Europe and Central Asia. Cuba also stood out, with a density of 84.4 per 10,000 against 2.1 in Haiti.

Similar disparities were seen in the measurement of the number of nurses and midwives, with a density of 152.3 per 10,000 in Australasia compared to 37.4 per 10,000 in southern Latin America. Despite steady increases in the health workforce between 1990 and 2019, significant gaps have persisted.

The researchers cited existing literature that highlights factors that contribute to worker shortages, including emigration of health workers, war and political unrest, violence against health workers, and insufficient training and retention incentives. They noted that high-income settings should follow WHO guidelines on responsible recruitment of health workers to avoid contributing to labor shortages in low-income areas.

These results show how ill-prepared the world was when the COVID-19 pandemic swept the world, taxing health systems that were already short of essential frontline workers. Having these estimates available today will help policymakers, hospitals, and medical clinics prepare for future pandemics by focusing on training and recruitment. The authors also note that there is still much to learn about the impact of the pandemic on healthcare workers. This includes gender dynamics in human resources for health (HRH) and how the departure of women from formal employment for home-based care tasks may have exhausted the health workforce, among other stressors on HRH during the pandemic.


Institute of Health Metrics and Evaluation

Journal reference:

GBD 2019 Human Resources for Healthcare Workers., (2022) Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. doi.org/10.1016/S0140-6736(22)00532-3.