Health workforce
2.1 Introduction
The ability of a country to meet its health goals depends largely on the knowledge, skills, motivation and
deployment of the people responsible for organizing and delivering health services. Numerous studies show
evidence of a direct and positive link between the numbers of health workers and population health outcomes
(1, 2). Many countries, however, lack the human resources needed to deliver essential health interventions for
a number of reasons, including limited production capacity, migration of health workers within and across
countries, poor mix of skills and demographic imbalances. The formulation of national policies and plans
in pursuit of human resources for health development objectives requires sound information and evidence.
Against this backdrop of an increasing demand for information, building knowledge and databases on the health
workforce requires coordination across sectors. WHO is working with countries and partners to strengthen the
global evidence base on the health workforce — including gaining consensus on a core set of indicators and a
minimum data set for monitoring the stock, distribution and production of health workers.
The health workforce can be defined as “all people engaged in actions whose primary intent is to enhance
health” (3). These human resources include clinical staff, such as physicians, nurses, pharmacists and dentists,
as well as management and support staff, i.e. those who do not deliver services directly but are essential to the
performance of health systems, such as managers, ambulance drivers and accountants (Box 2.1). Presently,
comprehensive and robust methodologies are not available for assessing the adequacy of the health workforce to
respond to the health-care needs of a given population. However, a shortage of health workers can be perceived
from the inadequate numbers and skills mix of people being trained or maldistribution of their deployment, as
well as losses caused by death, retirement, career change or out-migration. It has been estimated that countries
with fewer than 23 physicians, nurses and midwives per 10 000 population generally fail to achieve adequate
coverage rates for selected primary health-care interventions, as prioritized by the MDGs (3).