The health workforce status in the WHO African Region: findings of a cross-sectional study

Abstract

IntroductionSeveral efforts have been made globally to strengthen the health workforce (HWF); however, significant challenges still persist especially in the African Region. This study was conducted by the WHO Regional Office for Africa to present the status of the HWF in 47 countries as a baseline in measuring countries’ progress in implementing the Global Strategy for HWF by 2030.MethodsThis was a cross-sectional survey of 47 countries in the African Region using a semistructured questionnaire. Data were collected from January 2018 to April 2019. Before data collection, a tool was developed and piloted in four countries. The completed tools were validated in the countries by relevant stakeholders in the 47 countries. Data were collated and analysed in Epi Info and Microsoft Excel.ResultsThe total stock of health workers was approximately 3.6 million across 47 countries. Among these, 37% of the health workers were nurses and midwives, 9% were medical doctors, 10% were laboratory personnel, 14% were community health workers, 14% were other health workers, and 12% were administrative and support staff. Results show uneven distribution of health workers within the African Region. Most health workers (85%) are in the public sector. Regional density of physicians, nurses and midwives per 1000 population was 1.55, only 4 countries had densities of more than 4.45 physicians, nurses and midwives per 1000 population.ConclusionThis survey has demonstrated that the shortage and maldistribution of health workers in the WHO African Region remain a big challenge towards the attainment of universal access to health services. This calls for the need to substantially increase investment in the HWF based on contextual evidence in line with the current and future health needs.

Achieving Universal Health Coverage in Low- and Middle-Income Countries: Challenges for Policy Post-Pandemic and Beyond

“… 52 The majority of African countries have a health worker density less than 1/3rd of the WHO threshold. 53 Despite estimates of a reduced health workforce shortage by 2030, developing countries benefit the least. By 2030, the global health workforce shortage will decrease by 33%.…”

Health Awareness: A Significant Factor in Chronic Diseases Prevention and Access to Care

“…ii) African countries suffer from a serious shortage of health professionals both in quality and quantity [62], and from a forced migration of health workers to overseas for better opportunities [63]. For instance, health worker ratio in Africa is 1.55 to 1000 people which is far below the threshold of 4.45 recommended for effective essential health services [64]. There is also a maldistribution of health workers in favor of the urban cities which pose greater constraints to the number of health extension workers to remote villages.…”

The need for more medical schools in medically underserved regions in Africa

“…Medically underserved regions have been defined as an area with shortage of health care services indicated by high infant mortality rate, the proportion of the population living in poverty and the percentage of the elderly population, as well as a low health provider to population ratio [ 3 ]. There has been a persistent physician shortage in African nations, with about 0.31 million doctors across the continent [ 4 ]. The majority of countries in the continent have fewer than the WHO-recommended density of 4.45 health workers per 1000 people, which is required to provide basic services with only four nations: Seychelles, Namibia, Mauritius, and South Africa having an adequate number of health care workers [ 4 , 5 ].…”

“…There has been a persistent physician shortage in African nations, with about 0.31 million doctors across the continent [ 4 ]. The majority of countries in the continent have fewer than the WHO-recommended density of 4.45 health workers per 1000 people, which is required to provide basic services with only four nations: Seychelles, Namibia, Mauritius, and South Africa having an adequate number of health care workers [ 4 , 5 ]. Somalia, which has only 0.023 physicians for every 1000 people, ranks first on this list of nations with the fewest physicians per person worldwide, followed by other twenty African countries with a physician-to-population ratio ranging from 0.036 to 0.093 per 1000.…”

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