Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
Measuring the Availability of Human Resources for Health and Its Relationship to Universal Health Coverage for 204 Countries and Territories From 1990 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019 Publisher Pubmed



Haakenstad A1, 6 ; Irvine CMS1 ; Knight M1 ; Bintz C1 ; Aravkin AY1, 2, 3 ; Zheng P1, 3 ; Gupta V1, 3 ; Abrigo MRM7 ; Abushouk AI8, 11 ; Adebayo OM13 ; Agarwal G16 ; Alahdab F17 ; Alaly Z18, 19 ; Alam K20 Show All Authors
Authors
  1. Haakenstad A1, 6
  2. Irvine CMS1
  3. Knight M1
  4. Bintz C1
  5. Aravkin AY1, 2, 3
  6. Zheng P1, 3
  7. Gupta V1, 3
  8. Abrigo MRM7
  9. Abushouk AI8, 11
  10. Adebayo OM13
  11. Agarwal G16
  12. Alahdab F17
  13. Alaly Z18, 19
  14. Alam K20
  15. Alanzi TM21
  16. Alcalderabanal JE22
  17. Alipour V26, 27
  18. Alvisguzman N28, 29
  19. Amit AML30
  20. Andrei CL32
  21. Andrei T35
  22. Antonio CAT36, 37
  23. Arabloo J26
  24. Aremu O38
  25. Ayanore MA39, 40
  26. Banach M41, 42
  27. Barnighausen TW9, 43
  28. Barthelemy CM1
  29. Bayati M44
  30. Benzian H45
  31. Berman AE46
  32. Bienhoff K1
  33. Bijani A47
  34. Bikbov B48
  35. Biondi A49
  36. Boloor A50
  37. Busse R52
  38. Butt ZA53, 54
  39. Camera LA55
  40. Camposnonato IR23
  41. Cardenas R57
  42. Carvalho F58
  43. Chansa C43, 60
  44. Chattu SK61
  45. Chattu VK62, 63
  46. Chu DT64
  47. Dai X1, 3
  48. Dandona L1, 66, 67
  49. Dandona R1, 3, 66
  50. Dangel WJ1
  51. Daryani A68
  52. De Neve JW43
  53. Dhimal M69
  54. Dipeolu IO70
  55. Djalalinia S73
  56. Do HT74
  57. Doshi CP75
  58. Doshmangir L76
  59. Ehsanichimeh E78
  60. El Tantawi M82
  61. Fernandes E59
  62. Fischer F83
  63. Foigt NA84
  64. Fomenkov AA85
  65. Foroutan M86, 87
  66. Fukumoto T88
  67. Fullman N1
  68. Gad MM89, 90
  69. Ghadiri K91, 92
  70. Ghafourifard M77
  71. Ghashghaee A94
  72. Glucksman T1
  73. Goudarzi H97, 98
  74. Gupta RD99, 100
  75. Hamadeh RR101
  76. Hamidi S102
  77. Haro JM103, 104
  78. Hasanpoor E105
  79. Hay SI1, 3
  80. Hegazy MI106
  81. Heibati B107
  82. Henry NJ108
  83. Hole MK109
  84. Hossain N110
  85. Househ M111
  86. Ilesanmi OS14, 71
  87. Imaninasab MH112
  88. Irvani SSN113
  89. Islam SMS114, 115
  90. Jahani MA47
  91. Joshi A116
  92. Kalhor R95, 96
  93. Kayode GA117, 118
  94. Khalid N119
  95. Khatab K120, 121
  96. Kisa A122, 123
  97. Kochhar S4, 124
  98. Krishan K125
  99. Kuate Defo B126, 127
  100. Lal DK66
  101. Lami FH128
  102. Larsson AO129, 130
  103. Leasher JL131
  104. Legrand KE1
  105. Lim LL132, 133
  106. Mahotra NB134
  107. Majeed A135
  108. Maleki A79, 137
  109. Manjunatha N138
  110. Massenburg BB5
  111. Mestrovic T1, 139
  112. Mini GK140, 141
  113. Mirica A35
  114. Mirrakhimov EM142, 143
  115. Mohammad Y144
  116. Mohammed S52, 145
  117. Mokdad AH1, 3
  118. Morrison SD5
  119. Naghavi M1, 3
  120. Ndwandwe DE146
  121. Negoi I33, 148
  122. Negoi RI34, 149
  123. Ngunjiri JW150
  124. Nguyen CT151
  125. Nigatu YT152
  126. Onwujekwe OE153
  127. Ortegaaltamirano DV24
  128. Otstavnov N154
  129. Otstavnov SS154, 155
  130. Owolabi MO15, 72
  131. Pakhare AP116
  132. Pepito VCF31
  133. Perico N157
  134. Pham HQ158
  135. Pigott DM1, 3
  136. Pokhrel KN159
  137. Rabiee M160
  138. Rabiee N161, 162
  139. Rahimimovaghar V80
  140. Rawaf DL136, 163
  141. Rawaf S135, 164
  142. Rawal L165
  143. Remuzzi G157
  144. Renzaho AMN166, 167
  145. Resnikoff S168, 169
  146. Rezaei N81, 170
  147. Rezapour A26
  148. Rickard J171, 172
  149. Roever L173
  150. Sahu M1
  151. Samy AM12
  152. Sanabria J174, 175
  153. Santricmilicevic MM176, 177
  154. Saraswathy SYI178
  155. Seedat S179
  156. Senthilkumaran S180
  157. Servanmori E25
  158. Shaikh MA181
  159. Sheikh A10, 182
  160. Silva DAS184
  161. Stein C1, 3
  162. Stein DJ147
  163. Titova MV185, 186
  164. Topp SM187, 188
  165. Tovanipalone MR189, 190
  166. Ullah S191
  167. Unnikrishnan B51
  168. Vacante M49
  169. Valdez PR56, 192
  170. Vasankari TJ193, 194
  171. Venketasubramanian N195, 196
  172. Vlassov V156
  173. Vos T1, 3
  174. Yearwood JA197
  175. Yonemoto N198, 199
  176. Younis MZ200, 201
  177. Yu C202
  178. Zadey S204
  179. Zaman SB205, 206
  180. Zerfu TA183, 207
  181. Zhang ZJ203
  182. Ziapour A93
  183. Zodpey S65
  184. Lim SS1, 3
  185. Murray CJL1, 3
  186. Lozano R1, 3
Show Affiliations
Authors Affiliations
  1. 1. Institute for Health Metrics and Evaluation, School of Medicine, University of Washington, Seattle, WA, United States
  2. 2. Department of Applied Mathematics, School of Medicine, University of Washington, Seattle, WA, United States
  3. 3. Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
  4. 4. Department of Global Health, University of Washington, Seattle, WA, United States
  5. 5. Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, WA, United States
  6. 6. Department of Global Health and Population, T.H. Chan School of Public Health, Boston, MA, United States
  7. 7. Department of Research, Philippine Institute for Development Studies, Quezon City, Philippines
  8. 8. Harvard Medical School, Harvard University, Boston, MA, United States
  9. 9. T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
  10. 10. Division of General Internal Medicine, Harvard University, Boston, MA, United States
  11. 11. Department of Medicine, Ain Shams University, Cairo, Egypt
  12. 12. Department of Entomology, Ain Shams University, Cairo, Egypt
  13. 13. College of Medicine, University College Hospital, Ibadan, Nigeria
  14. 14. Department of Community Medicine, University College Hospital, Ibadan, Nigeria
  15. 15. Department of Medicine, University College Hospital, Ibadan, Nigeria
  16. 16. Department of Family Medicine, McMaster University, Hamilton, ON, Canada
  17. 17. Mayo Evidence-based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, MN, United States
  18. 18. John T. Milliken Department of Internal Medicine, Washington University in St. Louis, St. Louis, MO, United States
  19. 19. Clinical Epidemiology Center, US Department of Veterans Affairs (VA), St Louis, MO, United States
  20. 20. Murdoch Business School, Murdoch University, Perth, WA, Australia
  21. 21. Health Information Management and Technology Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
  22. 22. Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico
  23. 23. Health and Nutrition Research Center, National Institute of Public Health, Cuernavaca, Mexico
  24. 24. Health Systems Research Center, National Institute of Public Health, Cuernavaca, Mexico
  25. 25. Center for Health System Research, National Institute of Public Health, Cuernavaca, Mexico
  26. 26. Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
  27. 27. Department of Health Economics, Iran University of Medical Sciences, Tehran, Iran
  28. 28. Research Group in Hospital Management and Health Policies, Universidad de la Costa (University of the Coast), Barranquilla, Colombia
  29. 29. Research Group in Health Economics, University of Cartagena, Cartagena, Colombia
  30. 30. School of Medicine and Public Health, Ateneo De Manila University, Pasig City, Philippines
  31. 31. Center for Research and Innovation, Ateneo De Manila University, Pasig City, Philippines
  32. 32. Cardiology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
  33. 33. Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
  34. 34. Department of Anatomy and Embryology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
  35. 35. Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
  36. 36. Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines
  37. 37. Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong Special Administrative Region, Hong Kong
  38. 38. Department of Public Health, Birmingham City University, Birmingham, United Kingdom
  39. 39. Department of Health Policy Planning and Management, University of Health and Allied Sciences, Ho, Ghana
  40. 40. Department of Health Economics, Centre for Health Policy Advocacy Innovation & Research in Africa (CHPAIR-Africa), Accra, Ghana
  41. 41. Department of Hypertension, Medical University of Lodz, Lodz, Poland
  42. 42. Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
  43. 43. Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
  44. 44. Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  45. 45. Department of Epidemiology and Health Promotion, New York University, New York, NY, United States
  46. 46. Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, United States
  47. 47. Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
  48. 48. Mario Negri Institute for Pharmacological Research, Ranica, Italy
  49. 49. Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
  50. 50. Department of Internal Medicine, Manipal Academy of Higher Education, Mangalore, India
  51. 51. Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
  52. 52. Department of Health Care Management, Technical University of Berlin, Berlin, Germany
  53. 53. School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
  54. 54. Al Shifa School of Public Health, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
  55. 55. Internal Medicine Department, Hospital Italiano de Buenos Aires (Italian Hospital of Buenos Aires), Buenos Aires, Argentina
  56. 56. Argentine Society of Medicine, Buenos Aires, Argentina
  57. 57. Department of Health Care, Metropolitan Autonomous University, Mexico City, Mexico
  58. 58. Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
  59. 59. Associated Laboratory for Green Chemistry (LAQV), University of Porto, Porto, Portugal
  60. 60. Health, Nutrition and Population Global Practice, World Bank, Lusaka, Zambia
  61. 61. Department of Public Health, Texila American University, Georgetown, Guyana
  62. 62. Department of Community Medicine, Datta Meghe Institute of Medical Sciences, Sawangi, India
  63. 63. Saveetha Medical College, Saveetha University, Chennai, India
  64. 64. Center for Biomedicine and Community Health, VNU-International School, Hanoi, Viet Nam
  65. 65. Indian Institute of Public Health, Gurugram, India
  66. 66. Public Health Foundation of India, Gurugram, India
  67. 67. Indian Council of Medical Research, New Delhi, India
  68. 68. Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
  69. 69. Health Research Section, Nepal Health Research Council, Kathmandu, Nepal
  70. 70. Health Promotion and Education, University of Ibadan, Ibadan, Nigeria
  71. 71. Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
  72. 72. Department of Medicine, University of Ibadan, Ibadan, Nigeria
  73. 73. Development of Research and Technology Center, Ministry of Health and Medical Education, Tehran, Iran
  74. 74. Institute of Health Economics and Technology, Hanoi, Viet Nam
  75. 75. Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
  76. 76. Department of Health Policy and Management, Tabriz University of Medical Sciences, Tabriz, Iran
  77. 77. Department of Medical Surgical Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
  78. 78. National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran
  79. 79. Department of Environmental Health Engineering, Tehran University of Medical Sciences, Tehran, Iran
  80. 80. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
  81. 81. Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran
  82. 82. Pediatric Dentistry and Dental Public Health Department, Alexandria University, Alexandria, Egypt
  83. 83. Institute of Public Health, Charite Universitatsmedizin Berlin (Charite Medical University Berlin), Berlin, Germany
  84. 84. Institute of Gerontology, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
  85. 85. Department of Cell Biology and Biotechnology, K.A. Timiryazev Institute of Plant Physiology, Moscow, Russian Federation
  86. 86. Department of Medical Parasitology, Abadan University of Medical Sciences, Abadan, Iran
  87. 87. Faculty of Medicine, Abadan University of Medical Sciences, Abadan, Iran
  88. 88. Department of Dermatology, Kobe University, Kobe, Japan
  89. 89. Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, United States
  90. 90. Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC, United States
  91. 91. Infectious Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
  92. 92. Pediatric Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
  93. 93. Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
  94. 94. School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran
  95. 95. Institute for Prevention of Noncommunicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
  96. 96. Health Services Management Department, Qazvin University of Medical Sciences, Qazvin, Iran
  97. 97. Department of Respiratory Medicine, Hokkaido University, Sapporo, Japan
  98. 98. Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
  99. 99. Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, United States
  100. 100. Centre for Noncommunicable Diseases and Nutrition, BRAC University, Dhaka, Bangladesh
  101. 101. Department of Family and Community Medicine, Arabian Gulf University, Manama, Bahrain
  102. 102. School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
  103. 103. Research Unit, University of Barcelona, Barcelona, Spain
  104. 104. Biomedical Research Networking Center for Mental Health Network (CiberSAM), Barcelona, Spain
  105. 105. Department of Healthcare Management, Maragheh University of Medical Sciences, Maragheh, Iran
  106. 106. Department of Neurology, Cairo University, Cairo, Egypt
  107. 107. Center for Environmental and Respiratory Health Research, University of Oulu, Oulu, Finland
  108. 108. Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
  109. 109. Department of Pediatrics, University of Texas Austin, Austin, TX, United States
  110. 110. Department of Pharmacology, Bangladesh Industrial Gases, Tangail, Bangladesh
  111. 111. College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
  112. 112. Department of Public Health, Lorestan University of Medical Sciences, Khorramabad, Iran
  113. 113. Tabriz, Iran
  114. 114. Institute for Physical Activity and Nutrition, Deakin University, Burwood, VIC, Australia
  115. 115. Sydney Medical School, University of Sydney, Sydney, NSW, Australia
  116. 116. Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhopal, India
  117. 117. International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
  118. 118. Julius Centre for Health Sciences and Primary Care, Utrecht University, Utrecht, Netherlands
  119. 119. School of Food and Agricultural Sciences, University of Management and Technology, Lahore, Pakistan
  120. 120. Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, United Kingdom
  121. 121. College of Arts and Sciences, Ohio University, Zanesville, OH, United States
  122. 122. School of Health Sciences, Kristiania University College, Oslo, Norway
  123. 123. Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA, United States
  124. 124. Global Healthcare Consulting, New Delhi, India
  125. 125. Department of Anthropology, Panjab University, Chandigarh, India
  126. 126. Department of Demography, University of Montreal, Montreal, QC, Canada
  127. 127. Department of Social and Preventive Medicine, University of Montreal, Montreal, QC, Canada
  128. 128. Department of Community and Family Medicine, University of Baghdad, Baghdad, Iraq
  129. 129. Department of Medical Sciences, Uppsala University, Uppsala, Sweden
  130. 130. Department of Clinical Chemistry and Pharmacology, Uppsala University Hospital, Uppsala, Sweden
  131. 131. College of Optometry, Nova Southeastern University, Fort Lauderdale, FL, United States
  132. 132. Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  133. 133. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong
  134. 134. Department of Clinical Physiology, Tribhuvan University, Kathmandu, Nepal
  135. 135. Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
  136. 136. WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, United Kingdom
  137. 137. Environmental Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
  138. 138. Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengalore, India
  139. 139. University Centre Varazdin, University North, Varazdin, Croatia
  140. 140. Global Institute of Public Health, Ananthapuri Hospitals and Research Institute, Trivandrum, India
  141. 141. Women's Social and Health Studies Foundation, Trivandrum, India
  142. 142. Internal Medicine Programme, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
  143. 143. Department of Atherosclerosis and Coronary Heart Disease, National Center of Cardiology and Internal Disease, Bishkek, Kyrgyzstan
  144. 144. Internal Medicine Department, King Saud University, Riyadh, Saudi Arabia
  145. 145. Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
  146. 146. Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
  147. 147. Risk and Resilience in Mental Disorders Unit, South African Medical Research Council, Cape Town, South Africa
  148. 148. Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
  149. 149. Cardio-Aid, Bucharest, Romania
  150. 150. Department of Biological Sciences, University of Embu, Embu, Kenya
  151. 151. Institute for Global Health Innovations, Duy Tan University, Hanoi, Viet Nam
  152. 152. Institute for Mental Health and Policy, Centre for Addiction and Mental Health, Toronto, ON, Canada
  153. 153. Department of Pharmacology and Therapeutics, University of Nigeria Nsukka, Enugu, Nigeria
  154. 154. Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russian Federation
  155. 155. Department of Project Management, National Research University Higher School of Economics, Moscow, Russian Federation
  156. 156. Department of Health Care Administration and Economics, National Research University Higher School of Economics, Moscow, Russian Federation
  157. 157. Mario Negri Institute for Pharmacological Research, Bergamo, Italy
  158. 158. Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Viet Nam
  159. 159. HIV and Mental Health Department, Integrated Development Foundation Nepal, Kathmandu, Nepal
  160. 160. Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran
  161. 161. School of Engineering, Macquarie University, Sydney, NSW, Australia
  162. 162. Pohang University of Science and Technology, South Korea
  163. 163. University College London Hospitals, London, United Kingdom
  164. 164. Academic Public Health England, Public Health England, London, United Kingdom
  165. 165. School of Health, Medical and Applied Sciences, CQ University, Sydney, NSW, Australia
  166. 166. School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
  167. 167. Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
  168. 168. School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia
  169. 169. Brien Holden Vision Institute, Sydney, NSW, Australia
  170. 170. Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
  171. 171. Department of Surgery, University of Minnesota, Minneapolis, MN, United States
  172. 172. Department of Surgery, University Teaching Hospital of Kigali, Kigali, Rwanda
  173. 173. Department of Clinical Research, Federal University of Uberlandia, Uberlandia, Brazil
  174. 174. Department of Surgery, Marshall University, Huntington, WV, United States
  175. 175. Department of Nutrition and Preventive Medicine, Case Western Reserve University, Cleveland, OH, United States
  176. 176. Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  177. 177. School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
  178. 178. Thiruvananthapuram, India
  179. 179. Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
  180. 180. Emergency Department, Manian Medical Centre, Erode, India
  181. 181. Karachi, Pakistan
  182. 182. Centre for Medical Informatics, University of Edinburgh, Edinburgh, United Kingdom
  183. 183. Public Health Department, University of Edinburgh, Edinburgh, United Kingdom
  184. 184. Department of Physical Education, Federal University of Santa Catarina, Florianopolis, Brazil
  185. 185. Timiryazev Institute of Plant Physiology, Russian Academy of Sciences, Moscow, Russian Federation
  186. 186. Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Moscow, Russian Federation
  187. 187. James Cook University, Douglas, QLD, Australia
  188. 188. Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia
  189. 189. Department of Pathology and Legal Medicine, University of Sao Paulo, Ribeirao Preto, Brazil
  190. 190. Modestum Ltd., London, United Kingdom
  191. 191. Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Faisalabad, Pakistan
  192. 192. Velez Sarsfield Hospital, Buenos Aires, Argentina
  193. 193. UKK Institute, Tampere, Finland
  194. 194. Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
  195. 195. Raffles Neuroscience Centre, Raffles Hospital, Singapore
  196. 196. Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  197. 197. Nutrition Department, Gates Ventures, Seattle, WA, United States
  198. 198. Department of Neuropsychopharmacology, National Center of Neurology and Psychiatry, Kodaira, Japan
  199. 199. Department of Public Health, Juntendo University, Tokyo, Japan
  200. 200. Department of Health Policy and Management, Jackson State University, Jackson, MS, United States
  201. 201. School of Medicine, Tsinghua University, Beijing, China
  202. 202. Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
  203. 203. School of Medicine, Wuhan University, Wuhan, China
  204. 204. Duke Global Health Institute, Duke University, Durham, NC, United States
  205. 205. The School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
  206. 206. Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
  207. 207. College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia

Source: The Lancet Published:2022


Abstract

Background: Human resources for health (HRH) include a range of occupations that aim to promote or improve human health. The UN Sustainable Development Goals (SDGs) and the WHO Health Workforce 2030 strategy have drawn attention to the importance of HRH for achieving policy priorities such as universal health coverage (UHC). Although previous research has found substantial global disparities in HRH, the absence of comparable cross-national estimates of existing workforces has hindered efforts to quantify workforce requirements to meet health system goals. We aimed to use comparable and standardised data sources to estimate HRH densities globally, and to examine the relationship between a subset of HRH cadres and UHC effective coverage performance. Methods: Through the International Labour Organization and Global Health Data Exchange databases, we identified 1404 country-years of data from labour force surveys and 69 country-years of census data, with detailed microdata on health-related employment. From the WHO National Health Workforce Accounts, we identified 2950 country-years of data. We mapped data from all occupational coding systems to the International Standard Classification of Occupations 1988 (ISCO-88), allowing for standardised estimation of densities for 16 categories of health workers across the full time series. Using data from 1990 to 2019 for 196 of 204 countries and territories, covering seven Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) super-regions and 21 regions, we applied spatiotemporal Gaussian process regression (ST-GPR) to model HRH densities from 1990 to 2019 for all countries and territories. We used stochastic frontier meta-regression to model the relationship between the UHC effective coverage index and densities for the four categories of health workers enumerated in SDG indicator 3.c.1 pertaining to HRH: physicians, nurses and midwives, dentistry personnel, and pharmaceutical personnel. We identified minimum workforce density thresholds required to meet a specified target of 80 out of 100 on the UHC effective coverage index, and quantified national shortages with respect to those minimum thresholds. Findings: We estimated that, in 2019, the world had 104·0 million (95% uncertainty interval 83·5–128·0) health workers, including 12·8 million (9·7–16·6) physicians, 29·8 million (23·3–37·7) nurses and midwives, 4·6 million (3·6–6·0) dentistry personnel, and 5·2 million (4·0–6·7) pharmaceutical personnel. We calculated a global physician density of 16·7 (12·6–21·6) per 10 000 population, and a nurse and midwife density of 38·6 (30·1–48·8) per 10 000 population. We found the GBD super-regions of sub-Saharan Africa, south Asia, and north Africa and the Middle East had the lowest HRH densities. To reach 80 out of 100 on the UHC effective coverage index, we estimated that, per 10 000 population, at least 20·7 physicians, 70·6 nurses and midwives, 8·2 dentistry personnel, and 9·4 pharmaceutical personnel would be needed. In total, the 2019 national health workforces fell short of these minimum thresholds by 6·4 million physicians, 30·6 million nurses and midwives, 3·3 million dentistry personnel, and 2·9 million pharmaceutical personnel. Interpretation: Considerable expansion of the world's health workforce is needed to achieve high levels of UHC effective coverage. The largest shortages are in low-income settings, highlighting the need for increased financing and coordination to train, employ, and retain human resources in the health sector. Actual HRH shortages might be larger than estimated because minimum thresholds for each cadre of health workers are benchmarked on health systems that most efficiently translate human resources into UHC attainment. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Experts (# of related papers)
Other Related Docs