“Globally, the needs-based shortage of health-care workers in 2013 is estimated to be about 17.4 million, of which almost 2.6 million are doctors, over 9 million are nurses and midwives, and the remainder represent all other health worker cadres. The largest needs-based shortages of health workers are in South-East Asia at 6.9 million and Africa at 4.2 million. The shortage in absolute terms is highest in South-East Asia due to the large populations of countries in this Region, but in relative terms (i.e. taking into account population size) the most severe challenges are in the African Region. The global needs-based shortage of health-care workers is projected to be still more than 14 million in 2030 (a decline of only 17%). Hence, current trends of health worker production and employment will not have sufficient impact on reducing the needs-based shortage of health-care workers by 2030, particularly in some countries: in the African Region the needs-based shortage is actually forecast to worsen between 2013 and 2030, while it will remain broadly stable in the Eastern Mediterranean Region.
“Assessing health workforce needs in relation to service requirements in countries of the Organisation for Economic Co-operation and Development (OECD)
“All countries in the OECD have a density of health workers above the SDG index threshold of 4.45 physicians, nurses and midwives per 1000 population. Their health systems, however, have a service delivery profile that goes beyond the provision of essential health services such as those to which the UHC tracer indicators refer.”
Source: World Health Organization. (2016). Global strategy on human resources for health: workforce 2030. World Health Organization.
“Despite repeated claims in the media and in public discussions of ‘growing shortages’ or ‘crisis’, the number of doctors and nurses has never been greater in OECD countries, both in absolute number and on a per capita basis. In 2013, a total of 3.6 million doctors and 10.8 million nurses were employed in OECD countries, up from 2.9 million doctors and 8.3 million nurses in 2000. The number of doctors and nurses has grown more rapidly than the overall population in nearly all countries, so the doctor-to-population and nurse-to-population ratios have increased. On average across OECD countries, there were 3.3 doctors per 1,000 population in 2013, up from 2.7 in 2000 (an increase of 20%), and 9.1 nurses per 1,000 population in 2013, up from 7.8 in 2000 (an increase of 15%).
“The growth in the number of doctors has been particularly rapid in some countries, such as Turkey, Korea and Mexico, which started with relatively low levels in 2000, thereby narrowing the gap with other OECD countries. The number of doctors has also increased strongly in the United Kingdom, by over 50% in absolute terms, so that the number of doctors per population in the United Kingdom now exceeds the number in the United States and Canada, although it still remains below the (rising) OECD average. The number of doctors has also increased in other OECD countries that already had a relatively large number of doctors in 2000 (such as Greece, Austria and Norway), albeit in some cases at a slower pace following the economic crisis that started in 2008-09 (Figure 1).”
Source: OECD (2016), Health Workforce Policies in OECD Countries: Right Jobs, Right Skills, Right Places, OECD Health Policy Studies, OECD Publishing, Paris. dx.doi.org/10.1787/9789264239517-en
“Similarly, the number of nurses has also increased in nearly all OECD countries, both in absolute number and on a per capita basis. This increase has occurred both in countries that had relatively low numbers in 2000 (such as Korea and Portugal) and in other countries that already had relatively high numbers (such as Switzerland, Norway and Denmark), although the growth rate has slowed down in some countries in the post-economic crisis period (such as Estonia, Ireland and Spain).
“The “skill mix” (or to be more precise, the occupational mix), as measured by the number of nurses per doctor, differs widely across OECD countries, reflecting different ways of organising health care delivery and the distribution of tasks among different health care providers. In half of the countries, there were between 2 to 4 nurses per doctor in 2013; yet, this ratio varied from less than one nurse per doctor in Greece to 4.5 nurses per doctor (or over) in Finland, Japan, Ireland and Denmark. Some countries (e.g., Finland, Ireland and the United States) clearly rely more on nurses to do some tasks that are still the prerogative of doctors or other health care providers in others.”
Source: OECD (2016), Health Workforce Policies in OECD Countries: Right Jobs, Right Skills, Right Places, OECD Health Policy Studies, OECD Publishing, Paris. dx.doi.org/10.1787/9789264239517-en
“Nurses tend to be the main providers of primary health care services in many countries, and therefore will have a key role to play in its expansion (1–3). A Cochrane systematic review showed nurses to be effective in the delivery of a wide range of services to address communicable and noncommunicable diseases, including clinical decision-making roles, health care education and preventive services (4). Nurses provide a wide variety of basic nursing services at the primary level, such as wound care, vaccination and health promotion, but are also effective at providing more specialized care, including through nurse-led services (5). For example, nurse-led HIV services (assessment of eligibility for antiretroviral therapy (ART); initial prescriptions for ART; and follow-up care for ART) has been significantly associated with good quality of care and increased retention of HIV patients at 12 months (6). As part of interprofessional primary care teams, nurses lead the coordination of care for patients with complex chronic diseases and work with such patients for 6–12 months to reach stabilization and self-efficacy (7).
“Nurse-led primary care services can, in certain settings and under the right circumstances, lead to similar or in some cases even better patient health outcomes and higher patient satisfaction than traditional care delivery models (4). The same systematic review found that nurses probably also have longer consultations with patients. The introduction of nurse-led heart failure clinics at the primary care level reduced heart failure-related emergency room visits, hospital admissions (by 27%), and the length of stay in the hospital (8). Nurses in Kenya, Malawi and the United Republic of Tanzania demonstrated high productivity in performing trichiasis surgery after training by an expert and with appropriate supervision (9). Increasingly, nurses have a more prominent role in the delivery of primary care: for example, over an eight-year period, the percentage of nurse practitioners in primary care practices in the United States of America rose from 17.6% to 25.2% in rural areas and from 15.9% to 23% in urban areas (10).”
Source: State of the world’s nursing 2020: investing in education, jobs and leadership. Web Annex. Nursing roles in 21st-century health systems. Geneva: World Health Organization; 2020. Licence: CC BY-NC-SA 3.0 IGO.
“The LTC [Long Term Care] sector suffers from shortages of workers, and this is likely to get worse in the future. In three-quarters of OECD countries, growth in the number of LTC workers has been outpaced by the growth in numbers of elderly people between 2011 and 2016. Demand for care will likely keep going up and put more pressure on the LTC sector. The number of people aged over 80 years will climb from over 57 million in 2016 to over 1.2 billion in 2050 in 37 OECD countries. Keeping the current ratio of five LTC workers for every 100 people aged 65 and older across OECD countries would imply that the number of workers in the sector will need to increase by 13.5 million by 2040.”
Source: OECD (2020), Who Cares? Attracting and Retaining Care Workers for the Elderly, OECD Health Policy Studies, OECD Publishing, Paris. doi.org/10.1787/92c0ef68-en.
Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and several other nations.
Page last updated April 14, 2022 by Doug McVay, Editor.
