Skip to main content Accessibility help
×
Hostname: page-component-7479d7b7d-rvbq7 Total loading time: 0 Render date: 2024-07-11T04:00:18.694Z Has data issue: false hasContentIssue false

Chapter 6 - Health Workforce in Low and Middle Income Countries

Concepts and Dynamics Unpacked

from Section 1 - Analyzing Health Systems: Concepts, Components, Performance

Published online by Cambridge University Press:  08 December 2022

Sameen Siddiqi
Affiliation:
Aga Khan University
Awad Mataria
Affiliation:
World Health Organization, Egypt
Katherine D. Rouleau
Affiliation:
University of Toronto
Meesha Iqbal
Affiliation:
UTHealth School of Public Health, Houston
Get access

Summary

A well performing health workforce is critical for the success of any health system. A higher density of health workers vis-à-vis the population is associated with improved service coverage and health outcomes. This chapter highlights key considerations in identifying the critical health workforce challenges and the factors that influence them. It provides an overview of some of the conceptual underpinnings for a deeper understanding of the workforce issues, followed by a synopsis of specific low- and middle-income country (L&MIC) challenges and determinants related to workforce availability, distribution, and performance to improve service delivery and coverage goals. The desired health workforce should be able to effectively respond to the shifting health priorities of the population, given evolving disease burden and epidemiology, and deploy technological resources rationally and cost-effectively. This requires effectively matching the supply and skills of health workers to population needs, now and in the future.

Type
Chapter
Information
Making Health Systems Work in Low and Middle Income Countries
Textbook for Public Health Practitioners
, pp. 83 - 101
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

World Health Organization. The World Health Report 2006: Working Together for Health. Geneva, World Health Organization, 2006. www.who.int/whr/2006/en/ (accessed December 15, 2020).Google Scholar
Chen, L., Evans, T., Anand, S., et al. Human resources for health: overcoming the crisis. Lancet 2004; 364(9449): 19841990.Google Scholar
Anand, S., Bärnighausen, T.. Human resources and health outcomes: cross-country econometric study. Lancet 2004; 364(9445): 16031609.Google Scholar
World Health Organization. Global Strategy on Human Resources for Health: Workforce 2030. Geneva, World Health Organization, 2016. www.who.int/hrh/resources/pub_globstrathrh-2030/en/ (accessed December 18, 2020).Google Scholar
Scheffler, R. M., Herbst, C. H., Lemiere, C., et al. Health Labor Market Analyses in Low-and Middle-Income Countries: An Evidence-Based Approach. Washington, DC, World Bank, 2016.Google Scholar
Ghebreyesus, T. A., Scheffler, R. M., Soucat, A. L.. Labor market for health workers in Africa: new look at the crisis. 2013. https://openknowledge.worldbank.org/handle/10986/13824 (accessed November 12, 2020).Google Scholar
Smith, A., Cannan, E., Lerner, M.. An Inquiry into the Nature and Causes of the Wealth of Nations. New York, The Modern Library, 1937.Google Scholar
McPake, B., Maeda, A., Araújo, E. C., et al. Why do health labour market forces matter? Bull World Health Organ 2013; 91: 841846.Google Scholar
Lehmann, U., Dieleman, M., Martineau, T.. Staffing remote rural areas in middle- and low-income countries: a literature review of attraction and retention. BMC Health Serv Res 2008; 8(1): 110.Google Scholar
Marshall, A.. Principles of Economics. London, Macmillan, 1890.Google Scholar
Hongoro, C., Norman, C., Health workers: building and motivating the workforce. In Jamison, D. T., Breman, J. G., Measham, A. R., et al., eds., Disease Control Priorities in Developing Countries, 2nd ed. New York, Oxford University Press, 2006.Google Scholar
Andalón, M., Fields, G.. A labor market approach to the crisis of health care professionals in Africa. 2011. www.econstor.eu/bitstream/10419/46097/1/662489454.pdf (accessed December 11, 2020).Google Scholar
Bruckner, T., Liu, J., Scheffler, R. M.. Demand-based and needs-based forecasts for health workers. In Scheffler, R. M., Herbst, C. H., Lemiere, C., et al. eds., Health Labor Market Analyses in Low- and Middle-Income Countries: An Evidence-Based Approach. Directions in Development. Washington, DC, World Bank, 2016.Google Scholar
Leonard, K. L., Masatu, M. C., Herbst, C. H., et al. The systematic assessment of health worker performance: a framework for analysis and its application in Tanzania. 2015. https://openknowledge.worldbank.org/handle/10986/24076 (accessed December 18, 2020).Google Scholar
Cooper, R. A., Getzen, T. E., Laud, P.. Economic expansion is a major determinant of physician supply and utilization. Health Serv Res 2003; 38(2): 675696.Google Scholar
Getzen, T. E.. Macro forecasting of national health expenditures. Adv Health Econ Health Serv Res 1990; 11: 2748.Google Scholar
Newhouse, J. P.. Medical-care expenditure: a cross-national survey. J Hum Resour 1977; 12(1): 115125.Google Scholar
World Health Organization. Skilled health personnel: data by country. 2021. https://apps.who.int/gho/data/view.main.HWF10v (accessed June 17, 2021).Google Scholar
Liu, J. X., Goryakin, Y., Maeda, A., et al. Global health workforce labor market projections for 2030. Hum Resour Health 2017; 15(1): 11.Google Scholar
Evans, T., Araujo, E. C., Herbst, C. H., et al. Addressing the challenges of health professional education: opportunities to accelerate progress towards universal health coverage. 2016. https://interprofessional.global/wp-content/uploads/2019/11/WISH-2016-Health-Professional-Education-Report-ADDRESSING-THE-CHALLENGES-OF-HEALTH-PROFESSIONAL-EDUCATION-OPPORTUNITIES-TO-ACCELERATE-PROGRESS-TOWARDS-UNIVERSAL-HEALTH-COVERAGE.pdf (accessed December 14, 2020).Google Scholar
Bailey, N., Mandeville, K. L., Rhodes, T., et al. Postgraduate career intentions of medical students and recent graduates in Malawi: a qualitative interview study. BMC Med Educ 2012; 12: 87.Google Scholar
Krajewski-Siuda, K., Szromek, A., Romaniuk, P., et al. Emigration preferences and plans among medical students in Poland. Hum Resour Health 2012; 10: 8.Google Scholar
Kizito, S., Mukunya, D., Nakitende, J., et al. Career intentions of final year medical students in Uganda after graduating: the burden of brain drain. BMC Med Educ 2015; 15: 122.Google Scholar
Huntington, I., Shrestha, S., Reich, N. G., et al. Career intentions of medical students in the setting of Nepal’s rapidly expanding private medical education system. Health Policy Plan 2012; 27(5): 417428.Google Scholar
Burch, V. C., McKinley, D., van Wyk, J., et al. Career intentions of medical students trained in six sub-Saharan African countries. Educ Health (Abingdon) 2011; 24(3): 614.Google Scholar
Serneels, P., Montalvo, J. G., Pettersson, G., et al. Who wants to work in a rural health post? The role of intrinsic motivation, rural background and faith-based institutions in Ethiopia and Rwanda. Bull World Health Organ 2010; 88(5): 342349.Google Scholar
Dossajee, H., Obonyo, N., Ahmed, S. M.. Career preferences of final year medical students at a medical school in Kenya: a cross sectional study. BMC Med Educ 2016; 16: 5.Google Scholar
Akl, E. A., Maroun, N., Major, S., et al. Why are you draining your brain? Factors underlying decisions of graduating Lebanese medical students to migrate. Soc Sci Med 2007; 64(6): 12781284.Google Scholar
Santric-Milicevic, M. M., Terzic-Supic, Z. J., Matejic, B. R., et al. First- and fifth-year medical students’ intention for emigration and practice abroad: a case study of Serbia. Health Policy 2014; 118(2): 173183.Google Scholar
Lievens, T., Serneels, P., Butera, J. D., et al. Diversity in Career Preferences of Future Health Workers in Rwanda: Where, Why, and for How Much? Washington, DC, World Bank, 2010.Google Scholar
Sudhinaraset, M., Ingram, M., Lofthouse, H. K., et al. What is the role of informal healthcare providers in developing countries? A systematic review. PLoS One 2013; 8(2): e54978.Google Scholar
Scheil-Adlung, X.. Global evidence on inequities in rural health protection: new data on rural deficits in health coverage for 174 countries. 2015. https://reliefweb.int/report/world/global-evidence-inequities-rural-health-protection-new-data-rural-deficits-health (accessed December 28, 2020).Google Scholar
Strasser, R., Neusy, A. J.. Context counts: training health workers in and for rural and remote areas. Bull World Health Organ 2010; 88: 777782.Google Scholar
Xierali, I. M., Maeshiro, R., Johnson, S., et al. Public health and community medicine instruction and physician practice location. Am J Prev Med 2014; 47(5 Suppl. 3): S297S300.Google Scholar
Agyei-Baffour, P., Kotha, S. R., Johnson, J. C., et al. Willingness to work in rural areas and the role of intrinsic versus extrinsic professional motivations: a survey of medical students in Ghana. BMC Med Educ 2011; 11: 56.Google Scholar
Jack, W., De Laat, J., Hanson, K., et al., Incentives and dynamics in the Ethiopian health worker labor market. 2010. https://openknowledge.worldbank.org/handle/10986/5951 (accessed December 22, 2020).Google Scholar
Rockers, P. C., Jaskiewicz, W., Kruk, M. E., et al. Differences in preferences for rural job postings between nursing students and practicing nurses: evidence from a discrete choice experiment in Lao People’s Democratic Republic. Hum Resour Health 2013; 11: 22.Google Scholar
YHEC. Discrete choice experiment (DCE). 2016. https://yhec.co.uk/glossary/discrete-choice-experiment-dce (accessed January 9, 2022).Google Scholar
Abimbola, S., Baatiema, L., Bigdeli, M.. The impacts of decentralization on health system equity, efficiency and resilience: a realist synthesis of the evidence. Health Policy Plan 2019; 34(8): 605617.Google Scholar
Kisakye, A. N., Tweheyo, R., Ssengooba, F., et al. Regulatory mechanisms for absenteeism in the health sector: a systematic review of strategies and their implementation. J Healthc Leadersh 2016; 8: 81.Google Scholar
McPake, B., Russo, G., Hipgrave, D., et al. Implications of dual practice for universal health coverage. Bull World Health Organ 2016; 94(2): 142.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×