Using economic analysis in health workforce policy-making

The health workforce is an essential component in building responsive and efficient health care systems. Yet despite its importance, it remains in many countries the weakest building block of the health system and a major constraint to achieving universal health coverage goals. Most countries face either absolute shortages (not enough health workers) or relative shortages (skills imbalances)-sometimes both. Countries also face maldistribution, inadequate training capacity and a weak knowledge base, negative work environments, weak human resources management systems, poor working conditions, and inadequate financial and non-financial incentives. There is growing consensus among researchers, practitioners, and the research community that many of these problems have labour market roots. This paper reviews the main economic issues around key health workforce challenges and discusses the contributions that economic analysis can make to health workforce policy-making. It adopts a labour market framework to address the service delivery challenges countries face due to health workforce bottlenecks, and discusses the importance and contribution of the health workforce to general employment and economic growth. The use of an explicit economic framework helps to define policy responses that go beyond scaling up health workers' training, highlighting the importance also of the roles of incentives, preferences, and market failures.