Quintile distribution of health resourcing in Africa

Abstract Africa has a limited health workforce that tackles the morbidity of complex, variable and highly prevalent diseases, often with limited resourcing. This study assesses health worker resourcing in African regions and countries stratified in quintiles (Q). African countries were categorized according to five regions viz. Northern, Western, Central, Eastern and Southern Africa. Each region was assessed according to the distribution of the (medical) doctor and nurse (and midwife) density, nurse to doctor ratio, and hospital bed density, followed by ranking of the health resources and even distribution across Q i.e. Q1-5, with Q1 reflecting the best resourced, Q2-4 intermediate resourced and Q5 the most under-resourced countries in Africa. The doctor and nurse densities, nurse to doctor ratio, and hospital bed availability in Q1 African countries were all higher compared to Q2-5 African countries, reflecting better health resourcing. Both nurse densities and nurse to doctor ratios were higher in Q2 African countries relative to Q4 and Q5 African countries; with hospital bed availability in Q2 African countries higher compared to Q3-5 African countries, and in Q3 African countries compared to Q5 African countries. The best resourced African countries (Q1) were better geared to provide decent healthcare, particularly those meeting global standard thresholds, whereas the remaining countries (Q2-4), and particularly the most under-resourced (Q5) countries, lagged the best resourced African countries, and face extreme challenges in providing decent healthcare. Health resourcing across Africa requires urgent strengthening to enable better healthcare delivery.