Women accounted for nearly 70 percent of the global health workforce in 2023, but the world still faced a shortage of 34.4 million health workers needed to achieve moderate levels of universal health coverage, according to a new global analysis.
The study, published in The Lancet Public Health, covered 204 countries and territories between 1990 and 2023. It found that the global health workforce grew from 40.9 million workers in 1990 to 122.1 million in 2023, an increase of more than 81 million.
Women drove 71.4 percent of that growth, with their participation especially increasing in nursing, midwifery and community health work.
The research estimated that women would make up 68.9 percent of all health workers in 2023. They represented 80.7 percent of nurses, 96 percent of midwives and 89.5 percent of community health workers, compared to 43.9 percent of doctors.
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Despite this growth, researchers estimated a global shortfall of 34.4 million healthcare workers. This included 23.9 million nurses and midwives, 7.1 million doctors, 1.8 million dentists and 1.6 million pharmacists.
Shortages were particularly severe in South Asia and sub-Saharan Africa. South Asia is estimated to need 2.6 million additional doctors and 10 million nurses and midwives, while sub-Saharan Africa needs 2.5 million more doctors and 5.7 million additional nurses and midwives. The region also faced a shortage of about 600,000 dentists and 500,000 pharmacists.
The study found large disparities in the availability of health workers between countries. Nursing density in 2023 was estimated at 3.2 workers per 10,000 people in Chad and 3.3 in Madagascar, compared to 171.7 in Belgium and 161.4 in the United States.
The researchers also found considerable variation in gender distribution between professions and countries.
Women represented more than 70 percent of doctors in Russia and some countries in Eastern Europe and Central Asia. In contrast, women represented 20 to 30 percent of doctors in countries such as Ethiopia, Mali and Chad, as well as Afghanistan, Pakistan and Japan.
The researchers said women remained concentrated in occupations with fewer opportunities to advance to leadership positions, creating a disparity between the gender composition of the healthcare workforce and health systems leadership.
They also identified inadequate compensation, workplace violence and harassment, disparities in leadership opportunities, and caregiving responsibilities as factors that could deter women from entering or remaining in the health workforce.
The analysis was based on data from population surveys, censuses, administrative sources and scientific literature. It provided estimates disaggregated by sex for 20 cadres of health workers in 204 countries and territories during the period 1990-2023.
The researchers said the findings underscored the need for sustained investment in the education, recruitment and retention of health workers, along with policies that address working conditions and gender disparities.
The study added that sex-disaggregated workforce data is essential for health system planning and to ensure that women’s growing contribution to healthcare is reflected in workforce policies and leadership.
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