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      Global Health Workforce Labor Market Projections for 2030

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          Abstract

          Background

          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.

          Methods

          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.

          Results

          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.

          Conclusions

          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.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12960-017-0187-2) contains supplementary material, which is available to authorized users.

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          Most cited references22

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          The health worker shortage in Africa: are enough physicians and nurses being trained?

          OBJECTIVE: To estimate systematically the inflow and outflow of health workers in Africa and examine whether current levels of pre-service training in the region suffice to address this serious problem, taking into account population increases and attrition of health workers due to premature death, retirement, resignation and dismissal. METHODS: Data on the current numbers and types of health workers and outputs from training programmes are from the 2005 WHO health workforce and training institutions' surveys. Supplementary information on population estimates and mortality is from the United Nations Population Division and WHO databases, respectively, and information on worker attrition was obtained from the published literature. Because of shortages of data in some settings, the study was restricted to 12 countries in sub-Saharan Africa. FINDINGS: Our results suggest that the health workforce shortage in Africa is even more critical than previously estimated. In 10 of the 12 countries studied, current pre-service training is insufficient to maintain the existing density of health workers once all causes of attrition are taken into account. Even if attrition were limited to involuntary factors such as premature mortality, with current workforce training patterns it would take 36 years for physicians and 29 years for nurses and midwives to reach WHO's recent target of 2.28 professionals per 1000 population for the countries taken as a whole - and some countries would never reach it. CONCLUSION: Pre-service training needs to be expanded as well as combined with other measures to increase health worker inflow and reduce the rate of outflow.
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            Medical-Care Expenditure: A Cross-National Survey

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              Forecasting the global shortage of physicians: an economic- and needs-based approach.

              Global achievements in health may be limited by critical shortages of health-care workers. To help guide workforce policy, we estimate the future demand for, need for and supply of physicians, by WHO region, to determine where likely shortages will occur by 2015, the target date of the Millennium Development Goals. Using World Bank and WHO data on physicians per capita from 1980 to 2001 for 158 countries, we employ two modelling approaches for estimating the future global requirement for physicians. A needs-based model determines the number of physicians per capita required to achieve 80% coverage of live births by a skilled health-care attendant. In contrast, our economic model identifies the number of physicians per capita that are likely to be demanded, given each country's economic growth. These estimates are compared to the future supply of physicians projected by extrapolating the historical rate of increase in physicians per capita for each country. By 2015, the global supply of physicians appears to be in balance with projected economic demand. Because our measure of need reflects the minimum level of workforce density required to provide a basic health service that is met in all but the least developed countries, the needs-based estimates predict a global surplus of physicians. However, on a regional basis, both models predict shortages for many countries in the WHO African Region in 2015, with some countries experiencing a needs-based shortage, a demand-based shortage, or both. The type of policy intervention needed to alleviate projected shortages, such as increasing health-care training or adopting measures to discourage migration, depends on the type of shortage projected.
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                Author and article information

                Contributors
                +1 650 380-0762 , Jenny.Liu2@ucsf.edu
                +33 1 45 24 76 43 , yevgeniy.goryakin@oecd.org
                +33 1 85 55 45 03 , akiko.maeda@oecd.org
                +1 949 824 6434 , tim.bruckner@uci.edu
                +1 510 643 4100 , rscheff@berkeley.edu
                Journal
                Hum Resour Health
                Hum Resour Health
                Human Resources for Health
                BioMed Central (London )
                1478-4491
                3 February 2017
                3 February 2017
                2017
                : 15
                : 11
                Affiliations
                [1 ]ISNI 0000 0001 2297 6811, GRID grid.266102.1, Institute for Health and Aging, Department of Social and Behavioral Sciences, , University of California, San Francisco, ; 3333 California Street, Suite 340, San Francisco, CA 94118 United States of America
                [2 ]Health Division, Labour and Social Affairs, Organization for Economic Co-operation and Development, 2 rue Andre Pascal, 75775 Paris, Cedex 16 France
                [3 ]ISNI 0000 0001 2107 4242, GRID grid.266100.3, School of Public Health, , University of California, ; 635 E. Peltason Dr., Irvine, CA 92697-3957 United States of America
                [4 ]ISNI 0000 0001 2181 7878, GRID grid.47840.3f, School of Public Health, Goldman School of Public Policy, , University of California, Berkeley, ; 50 University Hall MC7360, Berkeley, CA 94704 United States of America
                Article
                187
                10.1186/s12960-017-0187-2
                5291995
                28159017
                e715ae76-308f-49e1-ae6f-4150cfa76c93
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 23 November 2016
                : 25 January 2017
                Funding
                Funded by: World Bank Group (US)
                Award ID: P152250
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2017

                Health & Social care
                health workforce,labor market projections,global health,j210,j230,j440
                Health & Social care
                health workforce, labor market projections, global health, j210, j230, j440

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