Access to health Protection: Availability
Globally, there is a gap of 10.3 million health workers towards universal health protection
Universal coverage resulting in access to needed health care can only be achieved if the national legislation is fully implemented. This implies e.g. the availability of essential health services, a health workforce to deliver these services, infrastructure allowing individuals to reach health facilities, and medical goods and products to provide care responding to needs. In the absence of one or more of these components, effective access to health care will not be possible.
Negative health outcomes such as high maternal mortality rates are often directly related to the absence of adequate services. This is often due to insufficient numbers of health workers. Physicians, nurses and midwifery personnel are a prerequisite for the delivery of quality care services.
However, the health workforce is experiencing a global crisis: health workers are unequally distributed and often lacking decent working conditions, and there are simply not enough of them to meet the needs, especially in rural areas and urban slums. In numerous countries, as many as 10,000 people have to rely on services provided by five or fewer health workers. By contrast, in a high-income country such as Finland there are 269 health workers for 10,000 people. As a result, often health workers are stretched to their limits and seek jobs in countries with higher wage potential, greater resources and less demand for time. This in turn often further reduces the availability of health care, especially in rural areas, and contributes to a "brain drain" of skills and experience.
Shortage of skilled health workers, by country
The absence of health workers impacts on the access of the population to needed health care. ILO estimates that 82.5 per cent of the population in low income countries lacks access to care because of the absence of health workers. In high income countries, there is no staff related access deficit (SAD).
This calculation is based on an estimated need of 41.1 qualified health workers per 10,000 population for universal health coverage. The threshold reflects the median value of the number of nurses, physicians, midwifery etc per population in low vulnerable countries. Given their socio-economic characteristics and the health-financing mechanism applied, these countries are considered to be in a position to provide universal health coverage through a sufficient number of health workers enjoying decent working conditions. The threshold is met or exceeded by many countries, including some low and lower-middle-income countries. However, the deficit is significant in others. It amounts to 7.1 million health worker in Asia and 2.8 in Africa. The global deficit is 10.3 million health workers.
Key topics in health protection
Resources
Data on staff access deficits: The multiple dimensions of health coverage - Excel