State of the health workforce in the WHO African Region: decade review of progress and opportunities for policy reforms and investments.

Introduction: An adequate health workforce is one of the cornerstones of a healthy nation. Over the last two decades, Africa has gained momentum in mitigating critical health workforce gaps, but urgent actions are still needed to accelerate progress towards universal health coverage and ensuring health security. This analysis provides an overview of the health workforce in the WHO African Region for the last decade.

Methods: Data were extracted and triangulated from the National Health Workforce Accounts (NHWA), health labour market analyses, countries' human resources for health (HRH) profiles, HRH strategic plans and annual reports. A descriptive analysis of health worker stock, training capacity and unemployment levels was undertaken. The density of health workers was calculated per 10 000 population for each country and examined by occupational groups and income levels of the countries to provide a more comprehensive understanding of the health workforce dynamics.

Results: The stock of the health workforce progressively increased from 1.6 million in 2013 to 4.3 million in 2018 and 5.1 million in 2022. The stock of doctors, nurses, midwives, dentists and pharmacists was 2.6 million in 2022, representing a threefold increase over 10 years, with an annual growth rate of 13%. The density of these five health workforce occupations grew by 1.9% per annum between 2018 and 2022, from 11.14 per 10 000 in 2013 to 26.82 per 10 000 in 2022. The health professions education capacity in the region increased by 70%, with the annual education output growing from 148 357 graduates in 2018 to over 255 000 in 2022. The comprehensiveness of the findings can be attributed to improvement in health workforce data availability and quality as more countries implement the NHWA. The improvements in the health workforce in the region are also partly attributable to increasing investments in the capacity of health professions education institutions to produce more health workers, and use of evidence in planning, decision-making and high-level advocacy at various levels to invest in health workers.

Conclusion: This study provides crucial insights for policy reforms and investments to enhance the health workforce, which is essential to achieving universal health coverage and ensuring health security. While progress is notable, countries with unique challenges need targeted analyses and continuous support to develop the necessary number and skills of health workers in the African region.