July 3rd 2008
The world will have sufficient doctors by 2015… but not in the right places
The global shortage of health workers—about 4.3 million according to the 2006 World Health Report—has received much attention, and many countries have now committed to scaling up. But what is the projected result of current strategies to increase the numbers of health workers, and will they have the right effect in the right places?
An analysis in the July issue of the WHO Bulletin suggests some good news and some bad. Using historical data on physician numbers for each country, they project that 12.7 million doctors will be supplied by 2015 globally. They then use two forecasting strategies—one based on needs (the number of physicians required to enable 80% of livebirths to be attended by a skilled health worker) and one based on demands (as determined by economic growth)—to estimate the number actually required worldwide. By the needs-based approach, the predicted requirement was 3.8 million, and by the more conservative demand-based approach it was 10.8 million. In other words, hooray! A surplus!
But not so fast. As could probably have been predicted without the use of fancy equations, the distribution of these physicians was the problem. Depending on the forecasting strategy, 37–45 countries would have less than 80% of the physicians they need by 2015. Most were in Africa, although countries experiencing rapid economic growth such as China were also predicted to suffer.
Despite the gloom, the researchers hope that, by spelling out what type of shortage is expected (ie, needs-based or demand-based), a country’s health workforce policies could be tailored more appropriately. I hope they are right.
Zoë Mullan
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