Health worker education, employment and equity: Aligning markets and strategies.

Abstract

A fit for purpose health workforce is essential for achieving universal health coverage and delivering on the 2030 Agenda for Sustainable Development. However, virtually all countries face challenges either in educating, employing or in retaining the health workforce they require to address population needs. The WHO estimates a global shortage of 11.1 million health workers by 2030. Some low- and middle-income countries have successfully expanded health workforce education and employment in recent years, leading to significant growth in workforce numbers. However, many graduates face job market absorption issues. Many high-income countries rely on international recruitment, with impacts on health systems in both sending and receiving countries. A comprehensive approach to health workforce strengthening must integrate education within health labour markets and health systems, to ensure effective returns on investment. The cost of health professions education remains poorly understood, with estimates ranging from USD $110 billion to $300 billion annually. Workforce retention strategies - such as decent employment, career development, and workplace safety - are critical. With five years remaining in the SDGs era, there is an opportunity - and an emerging consensus among countries at WHO's Executive Board in February 2025 - to accelerate action on the health and care workforce by 2030. Health workers must be prepared for the contexts in which they will practice, including a greater shift towards education and practice in primary and community care settings and contributions to public health functions, including emergency preparedness and response. Fundamental questions need to be asked, and gaps in the evidence must be addressed, to deepen understanding on what to teach, how to teach, whom to teach, how many to teach, and the underpinning science to guide cost, value and impact in health professions education.