In low- and middle-income countries, scaling essential health interventions to achieve health development targets is constrained by the lack of skilled health professionals to deliver services.
We take a labor market approach to project future health workforce demand based on an economic model based on projected economic growth, demographics, and health coverage, and using health workforce data (1990–2013) for 165 countries from the WHO Global Health Observatory. The demand projections are compared with the projected growth in health worker supply and the health worker “needs” as estimated by WHO to achieve essential health coverage.
The model predicts that, by 2030, global demand for health workers will rise to 80 million workers, double the current (2013) stock of health workers, while the supply of health workers is expected to reach 65 million over the same period, resulting in a worldwide net shortage of 15 million health workers. Growth in the demand for health workers will be highest among upper middle-income countries, driven by economic and population growth and aging. This results in the largest predicted shortages which may fuel global competition for skilled health workers. Middle-income countries will face workforce shortages because their demand will exceed supply. By contrast, low-income countries will face low growth in both demand and supply, which are estimated to be far below what will be needed to achieve adequate coverage of essential health services.
In summary, trends in the predicted health worker demand, supply, and needs by income level are illus- trated in Fig. 2. Growth in both demand for and supply of health workers is predicted to be the slowest in low- income countries, and these are projected to remain significantly below the WHO SDG threshold of 4.45 workers per 1000. As a result, these low-income coun- tries might experience a paradoxical situation in which they face a shortage of health workers needed to provide basic health services, but also have unemployed health workers due to the limited national capacity to employ the available supply of workers. Middle-income coun- tries are predicted to experience the largest increase in net shortages (per demand projections) over this time period, reaching 3.7 million workers in lower-middle- income countries and 11.9 million workers in upper middle-income countries by 2030. Although these countries will generate sufficient demand for health workers that meet and exceed the WHO SDG threshold density, their challenges will be in producing sufficient numbers of qualified health workers to meet projected demand. The model predicts that high-income countries would have a relatively balanced growth in both demand and supply of health workers. However, it should be pointed out that the supply projections used in this analysis used only the net increase in the supply of health workers and did not take into account changes in the attrition and retirement rates of the health workers. Estimates for the European Union that take into account these workforce dynamics suggest that many high-income countries will face substantial short- ages of health workers by 2020 due to rapid aging of the current stock of health workers if the rate of production is not increased to compensate for anticipated higher exit rates.
In many low-income countries, demand may stay below projected supply, leading to the paradoxical phenomenon of unemployed (“surplus”) health workers in those countries facing acute “needs-based” shortages. Opportunities exist to bend the trajectory of the number and types of health workers that are available to meet public health goals and the growing demand for health workers.
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