Dynamique du marché du travail en santé au Niger et perspective de couverture sanitaire universelle

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To analyse Health Labour Market dynamics (2010-2014) in Niger in the light of the processes and interrelations between training, recruitment, deployment and retention of health workers, and to estimate additional health workforce needs to achieve universal health coverage in 2030. This was a descriptive study based on data collected from health training institutions from the capital city (training dynamics), the Ministry of Public Health (labour market dynamics) and international institutions (health workforce dynamics and demographic dynamics). Between 2010 and 2014, approximately 8,570 health graduates were trained in Niger and 3,780 to 3,924 were recruited, representing less than 4% of the permanent jobs created at the national level. Between 14,300 to 15,070 graduates were unemployed or occupied precarious jobs, including 300 to 370 doctors. Health workers' remuneration, which is 13 to 25 times higher than the average national income, makes the public sector particularly attractive.The achievement of universal health coverage (UHC) in 2030 and population growth induce additional annual needs of: 23 to 30 midwives, 139 to 174 nurses and 169 to 186 physicians. The threshold of 23 health workers per 10,000 inhabitants increases these needs by 50%. The country is facing an underproduction of doctors and an overproduction of paramedical agents.Training, recruitment, deployment and retention of health workers policies are not effective, threatening achievement of UHC. Urgent actions are required to develop a health human resources information system, to better regulate the training sector, to operationalize the regionalization of budget centres and to strengthen the Ministry of Public Health leadership.