Abstract
BackgroundThe effect of health workers on health has been proven to be important for various health outcomes (e.g. mortality, coverage of immunisation or skilled birth attendants). The study aim of this paper is to assess the relationship between health workers and disability-adjusted life years (DALYs), which represents a much broader concept of health outcome, including not only mortality but also morbidity.MethodsCross-country multiple regression analyses were undertaken, with DALYs and DALYs disaggregated according to the three different groups of diseases as the dependent variable. Aggregate health workers and disaggregate physicians, nurses, and midwives were included as independent variables, as well as a variable accounting for the skill mix of professionals. The analysis also considers controlling for the effects of income, income distribution, percentage of rural population with access to improved water source, and health expenditure.ResultsThis study presents evidence of a statistically negative relationship between the density of health workers (especially physicians) and the DALYs. An increase of one unit in the density of health workers per 1000 will decrease, on average, the total burden of disease between 1% and 3%. However, in line with previous findings in the literature, the density of nurses and midwives could not be said to be statistically associated to DALYs.ConclusionsIf countries increase their health worker density, they will be able to reduce significantly their burden of disease, especially the burden associated to communicable diseases. This study represents supporting evidence of the importance of health workers for health.
Highlights
The effect of health workers on health has been proven to be important for various health outcomes
The purpose of this study is to conduct a cross country study in order to analyse descriptively and econometrically the relationship between human resources for health and population health outcomes, focusing especially on the burden of disease (i.e. disability-adjusted life years (DALYs)), and compare these results with the results for other outcome indicators previously analysed in the literature
The differences in terms of burden of disease are dramatic, from a country with a burden of disease of less than 100 DALYs per 1000 populations (Iceland) to a country that presents a burden of disease almost nine times higher (i.e. 824 DALYs per 1000 populations in Sierra Leone)
Summary
The effect of health workers on health has been proven to be important for various health outcomes (e.g. mortality, coverage of immunisation or skilled birth attendants). The study aim of this paper is to assess the relationship between health workers and disability-adjusted life years (DALYs), which represents a much broader concept of health outcome, including mortality and morbidity. The World Health Report 2006 defines health workers as ‘all people engaged in actions whose primary intent is to enhance health’ [[2], p.1]. In this context, the health workforce includes health services providers (e.g. physicians, nurses, midwives, and laboratory technicians) as well as health management and support workers (e.g. accountants in a hospital, administrative professionals, and drivers).
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