An additional 34.4 million doctors, nurses, midwives, dentists and pharmacists are needed to achieve moderate universal health coverage, where people can access essential health services without financial hardship. The greatest shortages are in South Asia and sub-Saharan Africa. Women have driven the expansion of the global health workforce over the past three decades, but significant staffing shortages remain, according to a new study published in the journal The Lancet Public Health.
The study reveals that the global workforce in the health sector has almost tripled, from 40.9 million in 1990 to 122.1 million in 2023. Women accounted for 71.4% of this growth and 68.9% of the total number of health workers in 2023.
Despite this progress, significant gaps remain in many regions, especially in South Asia and sub-Saharan Africa, where health systems continue to face some of the lowest staff densities in the world.
Based on estimates from the Global Burden of Disease (GBD) 2023, the study provides the first global estimates, disaggregated by sex, of 20 categories of health workers, or groups of specially trained health workers, such as doctors, nurses, midwives, pharmacists, dentists, and community health workers, in 204 countries and territories from 1990 to 2023.
It also offers the most comprehensive assessment of the global healthcare workforce to date.
WOMEN
Between 1990 and 2023, the global health workforce increased by more than 81 million workers, including 18.9 million nurses and 8.7 million doctors. Most regions experienced substantial growth during this period, although the pace of expansion varied across countries and health professions.
In 2023, the global health workforce was made up of 122.1 million workers, including 33.2 million nurses, 15.1 million doctors, 7.6 million community health workers, 6.8 million pharmacists and pharmacy assistants, and 6.1 million dentists and dental assistants.
Women accounted for almost 7 out of 10 health workers worldwide and constituted 80.7% of nurses, 96.0% of midwives and 89.5% of community health workers, while less than half of doctors were women.
Similar patterns were seen in dentistry and pharmacy, where women were more likely to work as assistants than as dentists or pharmacists.
UNIVERSAL COVERAGE
Despite considerable workforce growth, the researchers estimate that the world would need an additional 34.4 million health workers to reach a score of 80 out of 100 on the GBD’s Universal Health Coverage Effective Coverage Index, an indicator that represents moderate levels of universal health coverage.
This includes shortages of 23.9 million nurses and midwives, 7.1 million doctors, 1.8 million dentists and 1.6 million pharmacists. The shortage of health workers is greatest in South Asia, where an additional 2.6 million doctors and 10 million nurses and midwives would be needed to achieve moderate universal health coverage.
Sub-Saharan Africa also faces severe shortages in the main health professions, with a nursing density of 14.5 per 10,000 inhabitants, compared to 121.8 per 10,000 in high-income countries. Nationally, nursing density was as low as 3.2 per 10,000 in Chad and 3.3 in Madagascar, compared with 171.7 per 10,000 in Belgium and 161.4 in the United States.
