title: Health workforce metrics pre- and post-2015: a stimulus to public policy and planning.
abstract: Evidence-based health workforce policies are essential to ensure the provision of high-quality health services and to support the attainment of universal health coverage (UHC). This paper describes the main characteristics of available health workforce data for 74 of the 75 countries identified under the 'Countdown to 2015' initiative as accounting for more than 95% of the world's maternal, newborn and child deaths. It also discusses best practices in the development of health workforce metrics post-2015.
  
  
  
  Using available health workforce data from the Global Health Workforce Statistics database from the Global Health Observatory, we generated descriptive statistics to explore the current status, recent trends in the number of skilled health professionals (SHPs: physicians, nurses, midwives) per 10 000 population, and future requirements to achieve adequate levels of health care in the 74 countries. A rapid literature review was conducted to obtain an overview of the types of methods and the types of data sources used in human resources for health (HRH) studies.
  
  
  
  There are large intercountry and interregional differences in the density of SHPs to progress towards UHC in Countdown countries: a median of 10.2 per 10 000 population with range 1.6 to 142 per 10 000. Substantial efforts have been made in some countries to increase the availability of SHPs as shown by a positive average exponential growth rate (AEGR) in SHPs in 51% of Countdown countries for which there are data. Many of these countries will require large investments to achieve levels of workforce availability commensurate with UHC and the health-related sustainable development goals (SDGs). The availability, quality and comparability of global health workforce metrics remain limited. Most published workforce studies are descriptive, but more sophisticated needs-based workforce planning methods are being developed.
  
  
  
  There is a need for high-quality, comprehensive, interoperable sources of HRH data to support all policies towards UHC and the health-related SDGs. The recent WHO-led initiative of supporting countries in the development of National Health Workforce Accounts is a very promising move towards purposive health workforce metrics post-2015. Such data will allow more countries to apply the latest methods for health workforce planning.
authors.affiliation: Instituto de Cooperación Social Integrare, calle Balmes 30, 3-1, 08007, Barcelona, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Pozo-Martin
authors.affiliation: Instituto de Cooperación Social Integrare, calle Balmes 30, 3-1, 08007, Barcelona, Spain. andrea.nove@icsintegrare.org.
authors.forename: Andrea
authors.initials: A
authors.lastname: Nove
authors.affiliation: Instituto de Cooperación Social Integrare, calle Balmes 30, 3-1, 08007, Barcelona, Spain.
authors.forename: Sofia Castro
authors.initials: SC
authors.lastname: Lopes
authors.affiliation: Health Systems and Innovations, WHO Headquarters, Geneva, Switzerland.|Global Health Workforce Network, WHO Headquarters, Geneva, Switzerland.
authors.forename: James
authors.initials: J
authors.lastname: Campbell
authors.affiliation: School of Nursing Midwifery and Health, University of Technology Sydney, Sydney, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Buchan
authors.affiliation: Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal.
authors.forename: Gilles
authors.initials: G
authors.lastname: Dussault
authors.affiliation: Health Systems and Innovations, WHO Headquarters, Geneva, Switzerland.
authors.forename: Teena
authors.initials: T
authors.lastname: Kunjumen
authors.affiliation: Global Health Workforce Network, WHO Headquarters, Geneva, Switzerland.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Cometto
authors.affiliation: Health Systems and Innovations, WHO Headquarters, Geneva, Switzerland.
authors.forename: Amani
authors.initials: A
authors.lastname: Siyam
mesh_terms: D003625:Data Collection / Q000592:standards*; D003906:Developing Countries; D005260:Female; D014943:Global Health; D006282:Health Personnel; D006285:Health Planning; D006291:Health Policy; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D008428:Maternal Mortality; D008880:Midwifery; D009726:Nurses / Q000600:supply & distribution*; D010820:Physicians / Q000600:supply & distribution*; D011247:Pregnancy; D011787:Quality of Health Care; D019472:Universal Health Insurance; D000078329:Workforce
keywords: Countdown; Data; Densities; Health systems; Health workforce; Low- and middle-income countries; Metrics; Sustainable development goals; Universal health coverage