Implementing a decade of strengthening the health workforce in the WHO South-East Asia Region: achievements and way forward for primary health care

Abstract

Background Health workers are the cornerstone of primary health care (PHC) services, the delivery of an effective coronavirus disease 2019 (COVID-19) response and progress towards universal health coverage (UHC). In 2014, the World Health Organization (WHO) South-East Asia Region committed to the Decade for Health Workforce Strengthening 2015–2024, and UHC became a regional flagship with a focus on strengthening the health workforce. Since its inception, three rounds of monitoring with standardized indicators have been completed. Methods In 2019, data on human resources for health were collected through the National Health Workforce Accounts online platform by the country focal points; this was complemented by a regional online consultation in June 2020. A mid-term review report on the Decade for Health Workforce Strengthening was launched during the 73rd session of the Regional Committee in September 2020. Results The availability of doctors, nurses and midwives in the South-East Asia Region has increased by 21% since the decade began in 2014. Nine countries of the region are now above the 2006 WHO threshold of 22.8 doctors, nurses and midwives per 10 000 population, compared with only six countries in 2014. However, only two countries are above the 2016 revised WHO threshold of 44.5 doctors, nurses and midwives per 10 000 population, the density estimated to be needed to achieve the Sustainable Development Goals. Countries of the WHO South-East Asia Region have made progress to different extents during the past 5 years on strengthening governance of human resources for health, data, rural retention and health professional education. Discussion Addressing broader health workforce challenges and particularly PHC workforce challenges will require extra commitment and prioritization by governments for the second half of the decade. COVID-19 presents the necessity and an opportunity to increase long-term investment in the health workforce and in strengthening PHC in the South-East Asia Region.