Women accounted for nearly 70 per cent of the global health workforce in 2023, yet the world still faced a shortage of 34.4 million health workers needed to achieve moderate levels of universal health coverage, according to a new global analysis.
The study, published in The Lancet Public Health, covered 204 countries and territories from 1990 to 2023. It found that the global health workforce grew from 40.9 million workers in 1990 to 122.1 million in 2023, an increase of more than 81 million.
Women drove 71.4 per cent of that growth, with their participation increasing particularly in nursing, midwifery and community health work.
The research estimated that women made up 68.9 per cent of all health workers in 2023. They accounted for 80.7 per cent of nurses, 96 per cent of midwives and 89.5 per cent of community health workers, compared with 43.9 per cent of doctors.
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Despite this growth, researchers estimated a global shortfall of 34.4 million health workers. This included 23.9 million nurses and midwives, 7.1 million doctors, 1.8 million dentists and 1.6 million pharmacists.
The shortages were particularly severe in South Asia and sub-Saharan Africa. South Asia was estimated to require an additional 2.6 million doctors and 10 million nurses and midwives, while sub-Saharan Africa needed 2.5 million more doctors and 5.7 million additional nurses and midwives. The region also faced shortages of about 600,000 dentists and 500,000 pharmacists.
The study found wide disparities in the availability of health workers between countries. Nursing density in 2023 was estimated at 3.2 workers per 10,000 people in Chad and 3.3 in Madagascar, compared with 171.7 in Belgium and 161.4 in the United States.
The researchers also found considerable variation in gender distribution across professions and countries.
Women accounted for more than 70 per cent of doctors in Russia and some countries in Eastern Europe and Central Asia. In contrast, women represented between 20 and 30 per cent of doctors in countries including Ethiopia, Mali and Chad, as well as Afghanistan, Pakistan and Japan.
The researchers said women remained concentrated in occupations with fewer opportunities to advance into leadership positions, creating a disparity between the gender composition of the health workforce and leadership of health systems.
They also identified inadequate remuneration, workplace violence and harassment, disparities in leadership opportunities and caregiving responsibilities as factors that could discourage women from entering or remaining in the health workforce.
The analysis drew on data from population surveys, censuses, administrative sources and scientific literature. It provided sex-disaggregated estimates for 20 health-worker cadres across 204 countries and territories over the 1990–2023 period.
The researchers said the findings underscored the need for sustained investment in health-worker education, recruitment and retention, alongside policies that address working conditions and gender disparities.
The study added that sex-disaggregated workforce data are essential for health-system planning and for ensuring that the growing contribution of women to healthcare is reflected in workforce policies and leadership.
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