Over 43 million additional health workers are needed to cover the health worker shortage globally, due to political unrest, violence, and lack of training
According to a study by the Institute for Health Metrics and Evaluation (IHME), large gaps in healthcare and health worker shortages have been observed across sub-Saharan Africa, South Asia, North Africa and the Middle East.
Looking at health worker shortages in four categories: physicians, nurses and midwives, dental personnel, and pharmaceutical personnel, researchers estimate that over 130 countries had shortages of physicians and more than 150 had shortages of nurses and midwives in just 2019.
Factors which have contributed to health worker shortages include out-migration of health workers, war and political unrest, violence against healthcare workers, and insufficient incentives for training and retention.
“We found that the density of health care workers is strongly related to a nation’s level of social and economic development.”
Over 130 countries had shortages of physicians
The researchers estimated a shortage of more than 43 million healthcare workers, including 30.6 million nurses and midwives and 6.4 million physicians when comparing current levels of healthcare workers to the minimum levels needed to meet a target score of 80 on the universal health coverage (UHC) effective service coverage index.
This is more than a 10-fold difference in the density of health care workers across and within regions in 2019.
Densities ranged from 2.9 physicians for every 10,000 people in sub-Saharan Africa to 38.3 per 10,000 in Central Europe, Eastern Europe, and Central Asia. In particular, Cuba stood out, with a density of 84.4 per 10,000 compared to 2.1 in Haiti.
Comparable disparities were also observed when measuring the numbers 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 care workforce between 1990 and 2019, substantial gaps persisted.
Lead author Dr. Annie Haakenstad, Assistant Professor of Health Metrics Sciences at IHME, said: “We found that the density of health care workers is strongly related to a nation’s level of social and economic development.
“There are different strategies and policy approaches that may help with addressing worker shortages, and these should be tailored to the individual situation in each country. We hope that these estimates can be used to help prioritize policy interventions and inform future planning.”
The COVID-19 pandemic only made worker shortages worse
A recommendation to avoid this healthcare catastrophe was that high-income locations should follow WHO guidelines on responsible recruitment of health personnel to avoid contributing to workforce gaps in lower-income regions.
Senior author Dr. Rafael Lozano, Director of Health Systems at IHME, said: “These are the most comprehensive estimates to date of the global health care workforce. Health care workers are essential to the functioning of health systems, and it’s very important to have these data available so that countries can make informed decisions and plan for the future.”
To worsen these statistics, global healthcare was undoubtedly ill-prepared when the COVID-19 pandemic swept across the world, taxing health systems that already were short of crucial frontline workers.
Additionally, there is still much to know about the impact of the pandemic on the health workforce, including gender dynamics in human resources for health, and how the departure of women from formal employment for care-taking duties at home may have depleted the health workforce, among other stressors on HRH during the pandemic.
