Do we have enough health workers?
It is not an easy question to answer. If you are wondering about it for sometimes, and could not find the answer, you have come to right place. Let us have the conversation starts.
To answer the above question, we need to have the clear definition of health workers. To evaluate if we have enough health workers, we need to clarify what are the focusing healthcare objectives. In other words, to evaluate whether we have enough health workers, we need to define who they are, what they do and what is the ratio of health workers to the population they need to take care.
First, we need to clarify the definition of health workers.
When defining health workers, we quickly associate health workers with Licensed Physicians. With the available statistic, we select a time frame and identify the reported licensed physicians at that point and the population at that time, we get the licensed physician per population ratio. For example, as of April 2016, the licensed physicians in the US was 908,508 including 434,840 primary care physicians and 473,668 specialists according to the Henry J. Kaiser Family Foundation. US Population in April 2016 was 323,454,755 based on the US Census Bureau. That was 2.81 physicians per 1,000 populations in US April 2016. To get the data for around the world, you can check the data on World Bank, you can get the number of physician per 1000 people for the year 2009 and 2011. In 2011, It was 1.5 physician per 1000 people in China and 2.5 physician per 1000 people in US. However, the answer is still incomplete because licensed physicians are not the only professionals taking care of the health of the population, other people also involve in caring the health of that community. They are nurses, midwives, medical assistants, medical technicians, pharmacists, health care administrators, public health workers and home caregivers.
To further evaluate, if we have enough health workers, we also need to define the targeted health conditions because different goals require resources.
Second, we need to select a healthcare target
WHO selected twelve key population health indicators as the health target for Sustainable Development Goals (SDG) and used those indicators to define the minimum needs of the health workers as 4.45 doctors, nurses and midwives per 1,000 populations.
The twelve key population health indicators are
1. Family Planning
2. Antenatal care coverage
3. Skilled birth attendance
4. DTP3 (Diphtheria Tetanus Pertussis) immunization
5. Tobacco Smoking
6. Potable Water
8. Antiretroviral therapy
9. Tuberculosis treatment
10. Cataract Surgery
12. Hypertension Treatment
Third, we evaluate what is the density of health workers
Healthcare workers and resources are distributed unevenly around the world. A population density analysis of the data by WHO shows: Africa and South-East Asia, which are the world’s poorest regions have the greatest burdens of preventable disease have the lowest density of health workers (health workers per 1000 population) (2.2 and 3.3 respectively), and that Europe and the Americas, the wealthiest and healthiest regions, have the greatest density of health workers (14.0 and 9.6 respectively). Health workers were defines as doctors, nurses and midwives in the report.
The Higher density of the health workers resulting in better health outcome. We also see a close relationship of the financial for the region and the density of health workers in that region.
If you live in Europe and America, you are not seeing the shortage of health professionals as you would if you are in Africa and South-East Asia. The healthcare resources are not distributed evenly in the regions of the world; it is also distributed unevenly within the same country due to geographic, financial conditions and other factors. While increasing numbers of the health care workers are needed especially in Africa and South-East Asia region, the improvement of the quality of care and care delivery system are also critical for the improvement of healthcare delivery in all parts of the world.
The collaborations between regions of the world and within the country in training and resource allocation are the keys to solving the healthcare worker shortage issues. Digital health especially Telemedicine will pay a vital role in solving the problem of health worker shortage in the 21st century.
[Total Professionally Active Physicians], The Henry J. Kaiser Family Foundation, assessed 10/23/16 http://kff.org/other/state-indicator/total-active-physicians/
[U.S. and World Population Clock] US Census Bureau Accessed 10/23/2016 http://www.census.gov/popclock
[Physician Per 1000 People] The world Bank Assessed 10/23/16 http://data.worldbank.org/indicator/SH.MED.PHYS.ZS
[HEALTH WORKFORCE REQUIREMENTS FOR UNIVERSAL HEALTH COVERAGE AND THE SUSTAINABLE DEVELOPMENT GOALS] World Health Organization October 2016