Roger Dobson, writing in the British Medical Journal, reports on findings published in the Bulletin of the World Health Organisation. According to the report Even if attrition rates within their health organisations were limited to premature deaths and other involuntary losses, current workforce training means it would take 36 years for numbers of doctors, nurses, and midwives to reach the World Health Organization's target of 2.28 professionals per 1000 population, according to a study based on 12 countries in sub-Saharan Africa.
The authors also say that some countries will never reach this target.
The health worker shortage in sub-Saharan Africa stems, says the report, from several causes, including past shortfalls in investment in training, international migration, career changes, premature retirement, morbidity, and premature mortality.
The study, described as the first to investigate whether current pre-service training can improve the situation, examined estimates of health worker inflow and outflow in selected sub-Saharan African countries; it took into account population increases and attrition as a result of premature death among health workers, retirement, resignation, and dismissal.
Problems with data availability meant that the study was restricted to two groups of health workers, doctors, and nurses and midwives combined, and to 12 countries—Central African Republic, Côte d'Ivoire, Democratic Republic of the Congo, Ethiopia, Kenya, Liberia, Madagascar, Rwanda, Sierra Leone, Uganda, the United Republic of Tanzania, and Zambia.
Results for the 12 countries combined show that for every 1000 doctors practising, 59 medical graduates are produced each year. Côte d'Ivoire has the highest graduation rate for doctors (14%).
For the 12 countries as a whole, the health sector is expected to lose some 2.4% of its doctors and 2.1% of its nurses and midwives because of premature mortality, and about 4-6% of both because of all causes combined, each year.
The researchers say that although boosting training is important, it is a longer term solution, and shorter term responses are needed to tackle some of the problems, including migration of health workers.
