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Annie Haakenstad, Caleb Mackay Salpeter Irvine, Megan Knight, Corinne Bintz, Aleksandr Y. Aravkin, Peng Zheng, Vin Gupta, Michael R.M. Abrigo, Abdelrahman Ibrahim Abushouk, Oladimeji Adebayo and 176 more
BACKGROUND: Human resources for health (HRH) include a range of occupations that aim to promote or improve human health. The UN Sustainable Development Goals (SDGs) and the WHO Health Workforce 2030 strategy have drawn attention to the importance of HRH for achieving policy priorities such as universal health coverage (UHC). Although previous research has found substantial global disparities in HRH, the absence of comparable cross-national estimates of existing workforces has hindered efforts to quantify workforce requirements to meet health system goals. We aimed to use comparable and standardised data sources to estimate HRH densities globally, and to examine the relationship between a subset of HRH cadres and UHC effective coverage performance. METHODS: Through the International Labour Organization and Global Health Data Exchange databases, we identified 1404 country-years of data from labour force surveys and 69 country-years of census data, with detailed microdata on health-related employment. From the WHO National Health Workforce Accounts, we identified 2950 country-years of data. We mapped data from all occupational coding systems to the International Standard Classification of Occupations 1988 (ISCO-88), allowing for standardised estimation of densities for 16 categories of health workers across the full time series. Using data from 1990 to 2019 for 196 of 204 countries and territories, covering seven Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) super-regions and 21 regions, we applied spatiotemporal Gaussian process regression (ST-GPR) to model HRH densities from 1990 to 2019 for all countries and territories. We used stochastic frontier meta-regression to model the relationship between the UHC effective coverage index and densities for the four categories of health workers enumerated in SDG indicator 3.c.1 pertaining to HRH: physicians, nurses and midwives, dentistry personnel, and pharmaceutical personnel. We identified minimum workforce density thresholds required to meet a specified target of 80 out of 100 on the UHC effective coverage index, and quantified national shortages with respect to those minimum thresholds. FINDINGS: We estimated that, in 2019, the world had 104·0 million (95% uncertainty interval 83·5-128·0) health workers, including 12·8 million (9·7-16·6) physicians, 29·8 million (23·3-37·7) nurses and midwives, 4·6 million (3·6-6·0) dentistry personnel, and 5·2 million (4·0-6·7) pharmaceutical personnel. We calculated a global physician density of 16·7 (12·6-21·6) per 10 000 population, and a nurse and midwife density of 38·6 (30·1-48·8) per 10 000 population. We found the GBD super-regions of sub-Saharan Africa, south Asia, and north Africa and the Middle East had the lowest HRH densities. To reach 80 out of 100 on the UHC effective coverage index, we estimated that, per 10 000 population, at least 20·7 physicians, 70·6 nurses and midwives, 8·2 dentistry personnel, and 9·4 pharmaceutical personnel would be needed. In total, the 2019 national health workforces fell short of these minimum thresholds by 6·4 million physicians, 30·6 million nurses and midwives, 3·3 million dentistry personnel, and 2·9 million pharmaceutical personnel. INTERPRETATION: Considerable expansion of the world's health workforce is needed to achieve high levels of UHC effective coverage. The largest shortages are in low-income settings, highlighting the need for increased financing and coordination to train, employ, and retain human resources in the health sector. Actual HRH shortages might be larger than estimated because minimum thresholds for each cadre of health workers are benchmarked on health systems that most efficiently translate human resources into UHC attainment. FUNDING: Bill & Melinda Gates Foundation.
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Haakenstad, A., Irvine, C. M. S., Knight, M., Bintz, C., Aravkin, A. Y., Zheng, P., Gupta, V., Abrigo, M. R., Abushouk, A. I., Adebayo, O., Agarwal, G., Alahdab, F., Al‐Aly, Z., Alam, K., Alanzi, T. M., Rabanal, J. E. A., Alipour, V., Alvis‐Guzmán, N., Amit, A. M. L., … Lozano, R. (2022). Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet, 399(10341), 2129–2154. https://doi.org/10.1016/s0140-6736(22)00532-3
Haakenstad, Annie, et al. "Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019." The Lancet, vol. 399, no. 10341, 2022, pp. 2129–2154, https://doi.org/10.1016/s0140-6736(22)00532-3.
Haakenstad, Annie, Caleb Mackay Salpeter Irvine, Megan Knight, Corinne Bintz, Aleksandr Y. Aravkin, Peng Zheng, Vin Gupta, et al. "Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019." The Lancet 399, no. 10341 (2022): 2129–2154. https://doi.org/10.1016/s0140-6736(22)00532-3.
Haakenstad A., Irvine C. M. S., Knight M. [и др.] Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019 // The Lancet. — 2022. — Vol. 399, № 10341. — P. 2129–2154. — URL: https://doi.org/10.1016/s0140-6736(22)00532-3
@article{haakenstad2022measuring,
title = {{Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019}},
author = {Annie Haakenstad and Caleb Mackay Salpeter Irvine and Megan Knight and Corinne Bintz and Aleksandr Y. Aravkin and Peng Zheng and Vin Gupta and Michael R.M. Abrigo and Abdelrahman Ibrahim Abushouk and Oladimeji Adebayo and Gina Agarwal and Fares Alahdab and Ziyad Al‐Aly and Khurshid Alam and Turki M Alanzi and Jacqueline Elizabeth Alcalde Rabanal and Vahid Alipour and Nelson Alvis‐Guzmán and Arianna Maever L. Amit and Cătălina Liliana Andrei and Tudorel Andrei and Carl Abelardo T. Antonio and Jalal Arabloo and Olatunde Aremu and Martin Amogre Ayanore and Maciej Banach and Till Bärnighausen and Celine M Barthelemy and Mohsen Bayati and Habib Benzian and Adam E. Berman and Kelly Bienhoff and Ali Bijani and Boris T. Bikbov and Antonio Biondi and Archith Boloor and Reinhard Busse and Zahid A Butt and Luis Alberto Cámera and Ismael Campos‐Nonato and Rosario Cárdenas and Félix Dias Carvalho and Collins Chansa and Soosanna Kumary Chattu and Vijay Kumar Chattu and Dinh‐Toi Chu and Xiaochen Dai and Lalit Dandona and Rakhi Dandona and William James Dangel and Ahmad Daryani and Jan‐Walter De Neve and Meghnath Dhimal and Isaac Oluwafemi Dipeolu and Shirin Djalalinia and Hoa Do and Chirag Doshi and Leila Doshmangir and Elham Ehsani‐Chimeh and Maha El Tantawi and Eduarda G. R. Fernandes and Florian Fischer and Nataliya A Foigt and Artem Alekseevich Fomenkov and Masoud Foroutan and Takeshi Fukumoto and Nancy Fullman and Mohamed M Gad and Keyghobad Ghadiri and Mansour Ghafourifard and Ahmad Ghashghaee and Thomas Glucksman and Houman Goudarzi and Rajat Das Gupta and Randah R Hamadeh and Samer Hamidi and Josep Maria Haro and Edris Hasanpoor and Simon Iain Hay and Mohamed I. Hegazy and Behzad Heibati and Nathaniel J Henry and Michael K. Hole and Naznin Hossain and Mowafa Said Househ and Olayinka Stephen Ilesanmi and Mohammad Hasan Imani-Nasab and Seyed Sina Naghibi Irvani and Sheikh Mohammed Shariful Islam and Mohammad Ali Jahani and Ankur Joshi and Rohollah Kalhor and Gbenga Ayodele Kayode and Nauman Khalid and Khaled Khatab and Adnan Kısa and Sonali Kochhar and Kewal Krishan and Barthélémy Kuate Defo and Dharmesh Kumar Lal and Faris Lami and Anders Larsson and Janet L Leasher and Kate E LeGrand and Lee‐Ling Lim and Narayan Bahadur Mahotra and Azeem Majeed and Afshin Maleki and Narayana Manjunatha and Benjamin Ballard Massenburg and Tomislav Meštrović and GK Mini and Andreea Mirică and Erkin Mirsaidovich Mirrakhimov and Yousef M. Mohammad and Shafiu Mohammed and Ali H. Mokdad and Shane Douglas Morrison and Mohsen Naghavi and Duduzile Edith Ndwandwe and Ionuţ Negoi and Ruxandra Irina Negoi and Josephine W Ngunjiri and Cuong Tat Nguyen and Yeshambel T. Nigatu and Obinna Emmanuel Onwujekwe and Doris V Ortega-Altamirano and Nikita S. Otstavnov and Stanislav S Otstavnov and Mayowa Ojo Owolabi and Abhijit P Pakhare and Veincent Christian Filipino Pepito and Norberto Perico and Hai Quang Pham and David M. Pigott and Khem Narayan Pokhrel and Mohammad Rabiee and Navid Rabiee and Vafa Rahimi‐Movaghar and David Laith Rawaf and Salman Rawaf and Lal Bahadur Rawal and Giuseppe Remuzzi and André M. N. Renzaho and Serge Resnikoff and Nima Rezaei and Aziz Rezapour and Jennifer Rickard and Leonardo Roever and Maitreyi Sahu and Abdallah M Samy and Juan Ramon Sanabria and Milena M Santric-Milicevic and Sivan Yegnanarayana Iyer Saraswathy and Soraya Seedat and Subramanian Senthilkumaran and Edson E Servan-Mori and Masood Ali Shaikh and Aziz Sheikh and Diego Augusto Santos Silva and Caroline Stein and Dan Joseph Stein and М. В. Титова and Stephanie M. Topp and Marcos Roberto Tovani‐Palone and Saif Ullah and Bhaskaran Unnikrishnan and Marco Vacante and Pascual Ruben Valdez and Tommi Juhani Vasankari and Narayanaswamy Venketasubramanian and Vasily Vlassov and Theo Vos and Jamal Akeem Yearwood and Naohiro Yonemoto and Mustafa Z Younis and Chuanhua Yu and Siddhesh Zadey and Sojib Bin Zaman and Taddese Alemu Zerfu and Zhi-Jiang Zhang and Arash Ziapour and SANJAY P. ZODPEY and Stephen S Lim and Christopher J L Murray and Rafael Lozano},
journal = {The Lancet},
year = {2022},
volume = {399},
number = {10341},
pages = {2129--2154},
doi = {10.1016/s0140-6736(22)00532-3},
url = {https://doi.org/10.1016/s0140-6736(22)00532-3}
}TY - JOUR AU - Haakenstad, Annie AU - Irvine, Caleb Mackay Salpeter AU - Knight, Megan AU - Bintz, Corinne AU - Aravkin, Aleksandr Y. AU - Zheng, Peng AU - Gupta, Vin AU - Abrigo, Michael R.M. AU - Abushouk, Abdelrahman Ibrahim AU - Adebayo, Oladimeji AU - Agarwal, Gina AU - Alahdab, Fares AU - Al‐Aly, Ziyad AU - Alam, Khurshid AU - Alanzi, Turki M AU - Rabanal, Jacqueline Elizabeth Alcalde AU - Alipour, Vahid AU - Alvis‐Guzmán, Nelson AU - Amit, Arianna Maever L. AU - Andrei, Cătălina Liliana AU - Andrei, Tudorel AU - Antonio, Carl Abelardo T. AU - Arabloo, Jalal AU - Aremu, Olatunde AU - Ayanore, Martin Amogre AU - Banach, Maciej AU - Bärnighausen, Till AU - Barthelemy, Celine M AU - Bayati, Mohsen AU - Benzian, Habib AU - Berman, Adam E. AU - Bienhoff, Kelly AU - Bijani, Ali AU - Bikbov, Boris T. AU - Biondi, Antonio AU - Boloor, Archith AU - Busse, Reinhard AU - Butt, Zahid A AU - Cámera, Luis Alberto AU - Campos‐Nonato, Ismael AU - Cárdenas, Rosario AU - Carvalho, Félix Dias AU - Chansa, Collins AU - Chattu, Soosanna Kumary AU - Chattu, Vijay Kumar AU - Chu, Dinh‐Toi AU - Dai, Xiaochen AU - Dandona, Lalit AU - Dandona, Rakhi AU - Dangel, William James AU - Daryani, Ahmad AU - Neve, Jan‐Walter De AU - Dhimal, Meghnath AU - Dipeolu, Isaac Oluwafemi AU - Djalalinia, Shirin AU - Do, Hoa AU - Doshi, Chirag AU - Doshmangir, Leila AU - Ehsani‐Chimeh, Elham AU - Tantawi, Maha El AU - Fernandes, Eduarda G. R. AU - Fischer, Florian AU - Foigt, Nataliya A AU - Fomenkov, Artem Alekseevich AU - Foroutan, Masoud AU - Fukumoto, Takeshi AU - Fullman, Nancy AU - Gad, Mohamed M AU - Ghadiri, Keyghobad AU - Ghafourifard, Mansour AU - Ghashghaee, Ahmad AU - Glucksman, Thomas AU - Goudarzi, Houman AU - Gupta, Rajat Das AU - Hamadeh, Randah R AU - Hamidi, Samer AU - Haro, Josep Maria AU - Hasanpoor, Edris AU - Hay, Simon Iain AU - Hegazy, Mohamed I. AU - Heibati, Behzad AU - Henry, Nathaniel J AU - Hole, Michael K. AU - Hossain, Naznin AU - Househ, Mowafa Said AU - Ilesanmi, Olayinka Stephen AU - Imani-Nasab, Mohammad Hasan AU - Irvani, Seyed Sina Naghibi AU - Islam, Sheikh Mohammed Shariful AU - Jahani, Mohammad Ali AU - Joshi, Ankur AU - Kalhor, Rohollah AU - Kayode, Gbenga Ayodele AU - Khalid, Nauman AU - Khatab, Khaled AU - Kısa, Adnan AU - Kochhar, Sonali AU - Krishan, Kewal AU - Defo, Barthélémy Kuate AU - Lal, Dharmesh Kumar AU - Lami, Faris AU - Larsson, Anders AU - Leasher, Janet L AU - LeGrand, Kate E AU - Lim, Lee‐Ling AU - Mahotra, Narayan Bahadur AU - Majeed, Azeem AU - Maleki, Afshin AU - Manjunatha, Narayana AU - Massenburg, Benjamin Ballard AU - Meštrović, Tomislav AU - Mini, GK AU - Mirică, Andreea AU - Mirrakhimov, Erkin Mirsaidovich AU - Mohammad, Yousef M. AU - Mohammed, Shafiu AU - Mokdad, Ali H. AU - Morrison, Shane Douglas AU - Naghavi, Mohsen AU - Ndwandwe, Duduzile Edith AU - Negoi, Ionuţ AU - Negoi, Ruxandra Irina AU - Ngunjiri, Josephine W AU - Nguyen, Cuong Tat AU - Nigatu, Yeshambel T. AU - Onwujekwe, Obinna Emmanuel AU - Ortega-Altamirano, Doris V AU - Otstavnov, Nikita S. AU - Otstavnov, Stanislav S AU - Owolabi, Mayowa Ojo AU - Pakhare, Abhijit P AU - Pepito, Veincent Christian Filipino AU - Perico, Norberto AU - Pham, Hai Quang AU - Pigott, David M. AU - Pokhrel, Khem Narayan AU - Rabiee, Mohammad AU - Rabiee, Navid AU - Rahimi‐Movaghar, Vafa AU - Rawaf, David Laith AU - Rawaf, Salman AU - Rawal, Lal Bahadur AU - Remuzzi, Giuseppe AU - Renzaho, André M. N. AU - Resnikoff, Serge AU - Rezaei, Nima AU - Rezapour, Aziz AU - Rickard, Jennifer AU - Roever, Leonardo AU - Sahu, Maitreyi AU - Samy, Abdallah M AU - Sanabria, Juan Ramon AU - Santric-Milicevic, Milena M AU - Saraswathy, Sivan Yegnanarayana Iyer AU - Seedat, Soraya AU - Senthilkumaran, Subramanian AU - Servan-Mori, Edson E AU - Shaikh, Masood Ali AU - Sheikh, Aziz AU - Silva, Diego Augusto Santos AU - Stein, Caroline AU - Stein, Dan Joseph AU - Титова, М. В. AU - Topp, Stephanie M. AU - Tovani‐Palone, Marcos Roberto AU - Ullah, Saif AU - Unnikrishnan, Bhaskaran AU - Vacante, Marco AU - Valdez, Pascual Ruben AU - Vasankari, Tommi Juhani AU - Venketasubramanian, Narayanaswamy AU - Vlassov, Vasily AU - Vos, Theo AU - Yearwood, Jamal Akeem AU - Yonemoto, Naohiro AU - Younis, Mustafa Z AU - Yu, Chuanhua AU - Zadey, Siddhesh AU - Zaman, Sojib Bin AU - Zerfu, Taddese Alemu AU - Zhang, Zhi-Jiang AU - Ziapour, Arash AU - ZODPEY, SANJAY P. AU - Lim, Stephen S AU - Murray, Christopher J L AU - Lozano, Rafael TI - Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019 JO - The Lancet VL - 399 IS - 10341 SP - 2129 EP - 2154 PY - 2022 DA - 2022/05/23 DO - 10.1016/s0140-6736(22)00532-3 UR - https://doi.org/10.1016/s0140-6736(22)00532-3 ER -
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