Counting health workers: definitions, data, methods and global results

Health services depend critically on the size, skills, and commitment of the health workforce. Yet, in many countries relevant information on health workers remain far from adequate limiting the capacity of governments to monitor access to adequately trained and motivated health workers in their respective jurisdictions. Many countries are now experiencing demographic and epidemiological transitions; these affect the demand for health service providers in these countries. Health sector reforms, globalization of the health labour market as well as new medical technologies and new models of care add extra dimension to this already expanding world-wide need for health workers. Accurate and timely information is therefore vital as stakeholders strive to assess the impact of these changes on the workforce and formulate and implement responsive strategies. Owing to the critical importance of the health workforce, the World Health Organization (WHO) decided to dedicate its annual flagship report, the World health report, to the health workforce in 2006. To provide the information needed for the report and also address the international community's growing need for improved data, in 2005 the WHO Department of Human Resources for Health undertook intensive efforts to gain access to available data on health workers in all 192 Member States. This resulted in a more comprehensive and up-to-date global database on health workers than was previously available. Counting the health work force has, however, several challenges [Dubois & Mckee 2006: 59- 78; Diallo et al., 2003]. For one thing, the data had to be assembled from a variety of sources for which the quality of information, the manner of collection and the criteria for coding and categorizing are highly variable. In addition, there are differences in definitions between countries not only regarding health workers in general but also on specific health occupations. This background paper first describes the approaches followed in assembling the global database as well as some preliminary analysis of the content of the source data. We then proceed to briefly examine the broad picture – including number and characteristics – of health workers worldwide. In the final part of the paper, some useful strategies for improving health