The health worker production–population growth dynamic
Recent health workforce projections have focused on the year 2015, since this is the end date for achievement of the Millennium Development Goals. However, the United Nations’ publication of World population prospects: The 2010 revision (2011a) brought heightened attention to population growth over the coming decades. Previously, the UN projected that the global population would peak around midcentury at 9.1 billion and then stabilize through the end of the century (United Nations 2009). However, due to persistently high and, in some cases, increasing fertility rates in some countries and somewhat lower mortality rates than those used in the 2008 revision (United Nations 2011b), the 2010 revision projects that the population will continue climbing through the end of the 21st century and beyond. By 2100, the world’s population is estimated to reach 10.1 billion.
A country’s rate of population growth is the critical variable in health workforce planning that seeks to meet minimum thresholds for health worker density. Many of the 57 crisis countries have high and, in some cases, increasing annual rates of population growth. As a result, in the absence of concerted efforts to slow their population growth, these countries will require significant increases in the number of additional health workers needed over the coming decades. Small changes in a country’s annual rate of population growth can have an important impact on the total number of health workers required to achieve desired population coverage with essential health services. This effect is illustrated by the hypothetical example provided in Table 1.
As evidenced in Table 1, a country with a population of 100 million in 2000 requires 230,000 health workers to meet the threshold health worker density ratio. If the population continues to grow at its current rate of 2.4%, it will require an additional 533,600 health workers (assuming no loss of health workers over time) to meet the threshold density ratio in 2050. This corresponds to more than a 200% increase over the number required (230,000) in the year 2000. The other two population growth scenarios demonstrate the health workforce requirements in 2050 if the annual rate of population growth decreases or increases by 0.4 percentage points. An annual population growth rate of 2.0% will require a 172% increase in health workers over the time period, whereas an annual rate of population growth of 2.8% will require a 306% increase in health workers to meet threshold density requirements.
|
Crisis country X:
Year: 2000
Population: 100 million
Health workers needed: 230,000
Population growth rate: 2.4%
|
Population 2050 |
Health workers
needed 2050
|
Additional health
workers needed
2000–2050
|
% increase in
health workers
needed 2000–2050
|
|---|---|---|---|---|
|
Annual population growth rate
2000–2050: 2.0%
|
272 million | 625,200 | 395,200 | 172% |
|
Annual population growth rate
2000–2050: 2.4%
|
332 million | 763,600 | 533,600 | 232% |
|
Annual population growth rate
2000–2050: 2.8%
|
406 million | 932,700 | 702,700 |
306%
|