Factors Affecting Health Worker Density: Evidence from a Quantitative Cross-Country Analysis

Abstract

In 2006 the World Health Organization identified 57 countries with critical shortage of health workforce. A number of cross-country studies have explored the effect of the health workforce density on countries’ health outcomes. However, little is known about the factors driving health workforce density. The objective of this study was to identify the factors affecting the density of health workforce, which would provide broader understanding of the underlying causes of this crisis and help formulate appropriate policies in order to mitigate the challenge. This study analysed data from 183 UN member countries to assess the association between the various demographic, economic and political factors and the health workforce density. Out of 183 countries, 66 (36%) had a heath workforce density below the WHO recommended threshold of 2.3 per 1,000 people. The adult literacy rate (p-value<0.01), total health expenditure (p-value<0.01) and social stability (p-value=0.04) are statistically significant. Total health expenditure had the greatest (33%) effect on the density of health workforce, followed by literacy rates (25%) and social stability (11%). This cross-country study provides a snapshot of the potential factors affecting health workforce density. Two of the three significant factors (adult literacy rate and social stability) are not directly related to countries’ health system, which indicates that a holistic and integrated approach is required in order to alleviate the health workforce crisis. Further studies triangulating various quantitative and qualitative data would extend the understanding of the topic.