Many countries aim at universal health coverage. This requires a sufficient number of health workers for the delivery of health services to the sick. However, currently there is a shortfall of around 10.3 million health workers worldwide to ensure that all those in need receive health care. Deficits in the health workforce are particularly observed in low-income countries where, as a result, close to 90 per cent of the population has no access to health care. As a result avoidable deaths, for example in the case of difficult deliveries and unnecessary suffering due to long waiting lists for surgery are frequent in these countries.
According to estimates of the ILO’s World Social Protection Report, a country should have on average 41.1 health workers per 10,000 people to be able to provide essential health care to its entire population. But in many low-income countries this is far from a reality. For example, in countries like Haiti, Niger, Senegal and Sierra Leone, there are only five or fewer health workers available for as many as 10,000 people, compared to 269 in a high-income country such as Finland. Asia is the continent where most additional health workers are needed (7.1 million), followed by Africa (2.8 million).
A major reason for the significant shortage of health workers relates to the low level of salaries. In Sudan, Egypt and Myanmar, for instance, health sector wages are only 1 per cent above the poverty line of US$2 a day.
The global economic crisis led many countries to introduce fiscal consolidation policies as a way of reigning in public spending. As a result, the wages of civil servants – among them health workers – were cut or capped in as many as 98 countries, including 75 developing countries. According to the World Social Protection Report, public expenditure was cut in 122 countries, among them 82 developing countries.
More details are available at
Health Policy Coordinator
Social Protection Department
International Labour Organization
Route des Morillons 4
CH - 1211 Geneva 22