Global Health Workforce Labor Market Projections for 2030

Abstract

Background: In low- and middle-income countries, scaling essential health interventions to achieve health development targets is constrained by the lack of skilled health professionals to deliver services.

Methods: We take a labor market approach to project future health workforce demand based on an economic model based on projected economic growth, demographics, and health coverage, and using health workforce data (1990-2013) for 165 countries from the WHO Global Health Observatory. The demand projections are compared with the projected growth in health worker supply and the health worker "needs" as estimated by WHO to achieve essential health coverage.

Results: The model predicts that, by 2030, global demand for health workers will rise to 80 million workers, double the current (2013) stock of health workers, while the supply of health workers is expected to reach 65 million over the same period, resulting in a worldwide net shortage of 15 million health workers. Growth in the demand for health workers will be highest among upper middle-income countries, driven by economic and population growth and aging. This results in the largest predicted shortages which may fuel global competition for skilled health workers. Middle-income countries will face workforce shortages because their demand will exceed supply. By contrast, low-income countries will face low growth in both demand and supply, which are estimated to be far below what will be needed to achieve adequate coverage of essential health services.

Conclusions: In many low-income countries, demand may stay below projected supply, leading to the paradoxical phenomenon of unemployed ("surplus") health workers in those countries facing acute "needs-based" shortages. Opportunities exist to bend the trajectory of the number and types of health workers that are available to meet public health goals and the growing demand for health workers.

Keywords: Global health; Health workforce; Labor market projections.

Fig. 1

Health worker static labor market theoretical framework. Legend: Demand (D) and supply (S) interact to determine the number of workers (H*) that will be employed at a market wage rate (W*). At a wage rate (W^L) that is lower than the market optimum (W*), a shortage of workers results, and the number of workers demanded (H^D) exceeds the number supplied (H^S). To alleviate shortages in this market, either (1) additional compensation could be given to increase wages to W* and attract more workers into the market, or (2) the production of workers could be increased such that supply shifts outward (S²) and the quantity demand (H^D) is achieved while keeping wages at W^L

Fig. 2

Trends in the projected demand, supply, and need-based number of health workers by World Bank income group, 2013–2030. Legend: Middle-income countries are predicted to experience the largest and most rapidly increasing demand and subsequent labor market shortages over this time period. The average annual growth in the supply of health workers is lower in high- and upper middle income countries than in the lower-middle income countries, but the comparatively higher growth in demand will lead to the largest health worker shortages in the labor market in upper middle-income countries. The growth in the supply for workers is predicted to be the slowest in low-income countries, but the growth in demand is also slow. As a result, the net shortage of health workers in low-income countries will reduce by 2030, but still fall significantly below the threshold level (4.45 health workers per 1000 population) estimated by WHO [31] to be required to meet the basic health care needs