Bulletin of the World Health Organization

The health worker shortage in Africa: are enough physicians and nurses being trained?

Yohannes Kinfu, Mario R Dal Poz, Hugo Mercer & David B Evans

Volume 87, Number 3, March 2009, 225-230

Table 2. Density of nurses and midwives and estimated annual nurse/midwife inflows and outflows for 12 African countriesa

Country Nurses and midwives per 1000 population Inflow per 1000 nurses and midwives Outflow per 1000 nurses and midwives
Scenario Ib Scenario IIc
Central African Republic 0.44 23 45 53
Côte d’Ivoire 0.60 27 40 48
Democratic Republic of the Congo 0.53 46 44 52
Ethiopia 0.21 105 43 51
Kenya 1.14 20 46 54
Liberia 0.30 71 44 52
Madagascar 0.32 49 50 58
Rwanda 0.43 22 36 44
Sierra Leone 0.36 66 46 54
Uganda 0.72 16 45 53
United Republic of Tanzania 0.35 40 48 56
Zambia 2.01 24 44 52
Total 0.55 66 45 53


a Authors’ calculations are based on a WHO survey (available at: http://www.afro.who.int/hrh-observatory/documentcentre/questionnnare/quesb_health_training_institutions.xls).
b Scenario I uses country-specific estimates of outflows due to mortality and retirement and an additional outflow estimate of 1.5% per annum due to resignation and dismissal obtained from a Zambian case study.
c Scenario II follows a procedure similar to the one used for Scenario I but uses a higher rate of outflow (2.3%) due to resignation and dismissal obtained from a Mozambican case study.

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