The recent coronavirus disease 2019 (COVID-19) pandemic threw into sharp relief an issue that developing nations have been emphasizing for decades—the importance of a well-trained and resilient healthcare workforce that is able to meet the needs of sick and injured people across the world. An insufficient supply of healthcare workers means that hospital beds are full, wait times are long, patient safety is compromised, preventative care is missed, and the overall health and wellbeing of a population suffers. The United Nations highlighted the importance of this issue as part of the Sustainable Development Goals, specifically under Goal 3: Good Health and Wellbeing. The World Health Organization currently projects a shortage of up to 10 million healthcare workers by 2023, with the majority of the shortages taking place in lower or middle income countries. Without a vast increase in the stock of healthcare workers, meeting other international health priorities, and indeed, economic and social priorities, is near impossible
Workforce shortages in the healthcare workforce are unique among labor shortages in that healthcare workers require high intensity and costly training, often for long periods of time, and their training opportunities are limited by the resources of their national, regional, and local healthcare systems. Education in nursing and medicine takes many years of study, so there is no “quick fix” to the healthcare workforce shortage, especially when shortages are exacerbated by disease outbreaks, natural disasters, or human conflict. Education opportunities also rely on the healthcare infrastructure around the workers For example, hospitals can offer a higher acuity and higher quantity of training opportunities than a small local healthcare center. In addition, healthcare worker training is reliant on training by other healthcare workers. In effect, a shortage of nurses, midwives, or physicians begets shortages in the next generation of workers because training opportunities are even more limited. Many high income countries are currently contending with huge swaths of their healthcare workforces retiring as the Baby Boomer generation exits the workforce.
Cost to both the individual worker, the training site, and the broader regional or national healthcare infrastructure are also a limit on addressing the healthcare workforce shortage. Training as a healthcare worker is an opportunity cost; families may be reliant on a young person’s labor or income to run a family farm or business, and may not be able to afford to pay for healthcare education or afford to not have a family member stay home and work. In general, paying the tuition for healthcare education programs can be extremely prohibitive, even in high income countries, and many willing trainees are kept out of pipelines by the cost. Healthcare facilities and regional or national governments often take on some of the cost of training healthcare workers, but their capacity is limited by revenue and other budget priorities.
While there is an overall shortage of healthcare workers, it is also important to consider the distribution of healthcare workers and how to ensure effective dispersal of workers across low-income or rural regions. Training as a healthcare worker offers a higher degree or economic mobility, and there has long been a problem of “brain drain,” wherein workers who maybe from rural areas will congregate in urban settings, or even leave low income countries altogether to secure a higher quality of life elsewhere. The strategy to address the workforce shortage may need to consider how to incentivize workers to stay and work in rural and low income areas that may have the highest needs.
This committee is tasked with evaluating the current state of the global healthcare workforce shortage and assessing which strategies would best sustainably address the problem. The UN High-Level Commission on Health Employment and Economic Growth has previously issued ten recommendations that can serve as helpful guideposts for the committee, but may not be all encompassing. When preparing for this topic, delegates should consider the following questions:
- How can the distribution of healthcare workers be changed to improve global health coverage?
- By what means can healthcare workers be trained in developing nations?
- How can working conditions for healthcare workers be improved?