2016年-世界发展银行全球_Global_Health_Workforce_Labor_Market_Projections_for_2030_40页_1mb

2030 Global Health Workforce Labor Market Projections Summary

Core Content

This paper provides labor market projections for the global health workforce up to 2030, focusing on the dynamics of demand and supply. It highlights the critical role of health workers in achieving health development goals and the challenges posed by shortages and maldistribution, particularly in low- and middle-income countries. The study uses an economic model to project the demand for health workers based on economic growth, demographics, and health coverage, and compares these projections with the expected supply of health workers and the "needs" estimates by the World Health Organization (WHO) to achieve universal health coverage (UHC).

Main Views

• Health Workforce Shortage: The model predicts that the global demand for health workers will rise to 80 million by 2030, double the current stock (as of 2013). However, the supply is expected to reach only 65 million, resulting in a global shortage of 15 million health workers.
• Regional Disparities: Upper-middle-income countries will experience the largest predicted shortages due to economic growth and population aging. Low-income countries, despite lower growth in demand and supply, will also face shortages because their "needs" exceed both supply and demand.
• Paradox of Surplus and Shortage: Some low-income countries may have a surplus of health workers due to an oversupply relative to their demand, but this does not mean they are not in need of health services, highlighting a mismatch between supply and demand in the labor market.
• Labor Market Rigidities: The health labor market is often rigid due to fixed wages, institutional constraints, and regulatory frameworks, which can prevent the market from clearing, leading to either shortages or surpluses.

Key Information

Demand Projections

• Factors Influencing Demand: Economic growth (GDP per capita), private out-of-pocket (OOP) health spending, and the size of the population aged 65 or over.
• Income Elasticity: A 10% increase in GDP per capita (lagged 1 year) is associated with a 2.3% increase in physician density.
• OOP Spending Elasticity: A 10% increase in OOP health expenditures (lagged 2 years) is associated with a 1.0% decrease in physician density.
• Aging Population: A 10% increase in the population aged 65 or over (lagged 3 years) leads to a 5.2% increase in physician density.
• Model Selection: The study uses a generalized linear model (GLM) with a maximum likelihood estimator, and the optimal model is selected based on minimizing prediction errors.

Supply Projections

• Projection Method: Historical growth rates of health worker densities are assumed to continue into 2030.
• Data Sources: WHO Global Health Observatory data for 1990–2013, and UN population data for historical and projected population figures.
• Supply Estimation: For countries with insufficient data, the study uses global ratios based on WHO data. For example, the ratio of nurses/midwives to physicians is 2.517, and multipliers for all other health workers (AOWs) are based on World Bank income groups.
• Model Assumptions: The model assumes linear growth and excludes other structural factors such as migration and attrition due to data unavailability.

Policy Implications

• Financing Constraints: Lower income countries face more severe resource constraints, limiting their ability to expand the health workforce.
• Need for Policy Interventions: The study emphasizes the importance of labor market analysis to identify mismatches and inform more effective policy design.
• Global Competition: The predicted shortages in upper-middle-income countries may lead to global competition for skilled health workers.

Summary of Findings

• Regional Shortages:

  • East Asia and Pacific: 8.3 million
  • South Asia: 3.2 million
  • Latin America and Caribbean: 2.6 million
  • Europe and Central Asia: 1.2 million

• Income Group Shortages:

  • Upper-middle income: Highest
  • Lower-middle income: Second highest
  • Low-income countries: Also face shortages despite lower growth in supply and demand

Conclusion

The study underscores the need for a comprehensive labor market approach to health workforce planning, considering both economic and demographic factors. It highlights the limitations of traditional "needs-based" planning and advocates for policies that address the mismatch between supply and demand in the health labor market to ensure effective health service delivery and support the achievement of the Sustainable Development Goals (SDGs) for health and well-being.