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 3. Current density of physicians, nurses and midwives and required rate of workforce growth according to population growth rates in 12 African countriesa

Country Density of physicians, nurses and midwives per 1000 population Annual net rate of growth
Population growth rate % Required workforce growth per annum %
Scenario Ib Scenario IIc
Central African Republic 0.52 –0.7 –2.3 1.8 13.4
Côte d’Ivoire 0.73 7.5 5.9 2.2 10.4
Democratic Republic of the Congo 0.64 –1.3 –2.9 2.5 11.6
Ethiopia 0.24 8.7 7.1 2.6 20.4
Kenya 1.28 –2.5 –4.1 2.4 5.2
Liberia 0.33 4.6 3.0 4.6 17.7
Madagascar 0.61 4.0 2.4 3.0 12.0
Rwanda 0.48 –1.0 –2.6 4.9 14.2
Sierra Leone 0.39 1.7 0.1 2.6 16.1
Uganda 0.81 –2.3 –3.9 2.3 9.4
United Republic of Tanzania 0.37 4.1 2.5 3.2 16.4
Zambia 2.15 –3.8 –5.4 2.1 0.5
Total 0.64 3.2 –1.6 2.7 11.6


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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