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HEALTH TOPICS A TO Z
The global shortage of health workers and its impact
Who are health workers?
Health workers are all people whose main activities are aimed at enhancing health. They include the people who provide health services -- such as doctors, nurses, pharmacists, laboratory technicians -- and management and support workers such as financial officers, cooks, drivers and cleaners. Worldwide, there are 59.8 million health workers. About two-thirds of them (39.5 million) provide health services; the other one-third (19.8 million) are management and support workers. Without them, prevention and treatment of disease and advances in health care cannot reach those in need.
Extent of the shortage and its consequences
Fifty-seven countries, most of them in Africa and Asia, face a severe health workforce crisis. WHO estimates that at least 2 360 000 health service providers and 1 890 000 management support workers, or a total of 4 250 000 health workers, are needed to fill the gap. Without prompt action, the shortage will worsen.
Health workers are inequitably distributed throughout the world, with severe imbalances between developed and developing countries. This global workforce shortage is made even worse by imbalances within countries. In general, there is a lack of adequate staff in rural areas compared to cities.
Sub-Saharan Africa faces the greatest challenges. While it has 11 percent of the world's population and 24 percent of the global burden of disease, it has only 3 percent of the world's health workers.
There is a direct relationship between the ratio of health workers to population and survival of women during childbirth and children in early infancy. As the number of health workers declines, survival declines proportionately.
World distribution of health workers
This map is an approximation of actual country bordersSource: WHO (2006). The world health report 2006 – Working together for health. Geneva, World Health Organization.
The health workforce in the Americas versus sub-Saharan Africa
Source: WHO, 2006
A threat to global health
Pressing health needs across the globe cannot be met without a well-trained, adequate and available health workforce..
Millennium Development Goals (MDGs)
The MDGs are a blueprint agreed to by countries and leading development institutions to meet the needs of the world’s poorest people. The health-related MDGs aim to reduce child mortality, improve maternal health, combat HIV/AIDS and other diseases such as tuberculosis and malaria, and ensure access to essential medicines. The health worker shortage has been a major impediment to making progress on meeting these goals.
Recent concern about the threat of avian influenza has drawn attention to the devastating impact a global pandemic could have, given the current shortage of health workers, combined with their insufficient preparedness and often poor working conditions.
Sudden catastrophic events can quickly overwhelm local and national health systems already suffering from staff shortages or lack of funds.
Conflict often causes severe and long-lasting damage to the health workforce. Qualified personnel may be killed or forced to abandon their jobs. In protracted conflicts, a number of trends generally emerge: civilian workers flee health centres and hospitals in dangerous areas, and those in safer areas become overstaffed; management systems collapse; working environments deteriorate; and professional values are eroded.
Care of the chronically ill
Ageing populations and a steep increase in chronic diseases worldwide are placing new demands on a health workforce that is already inadequate and itself ageing, and whose numbers are stagnating.
TACKLING THE CRISIS: WHAT IS NEEDED
Sources: US Department of Health; The World Health Organization