Health systems statistics
Number of physicians per 10 000 population
Number of nurses and midwives per 10 000 population
Total number of health workers per 10 000 population
Nurses and midwives to physicians ratio
Rationale for use
The availability and composition of human resources for health is an important indicator of the strength of the health, even though there is no consensus about the optimal level of health workers for a population and the higher levels of density are not necessarily better. The nurse-physician ratio is an indicator of the health worker skills mix.
Definition
Physicians' density is the number of physicians per 10 000 population.
Nurse density is the number of nurses per 10 000 population.
Total number of health workers per 10 000 population is the total number of physicians, nurses and midwives
Nurse-physician ratio is the ratio of the number of nurses to physicians.
Associated terms
Physicians, nurses and midwives are defined on the basis of education, regulation, activities and tasks criteria (combined WHO and ILO classification system). This does not include auxiliary nurses. In some country statistics midwives are included in the reported numbers, in others they are not.
The 2004 Joint Learning Initiative report on human resources for health used three categories too identify low, medium and high density of health workers: less than 25, 25-50 and 50 or more health workers respectively per 10 000 population.
Data sources
Country reports to WHO regional offices or headquarters, based on administrative records such as databases of registered physicians/nurses in the country. In some countries data are obtained from the census, labour force or other surveys that include questions about occupations of the household members. Data on physicians and nurses data are generally the best human resource information available.
In the WHO Region of the Americas, the indicator "Number of nurses and midwives per 10 000" refers to nurses and nurses-midwives per 10 000. It does not include midwives.
Methods of estimation
No methods of estimation have been developed.
Disaggregation
By sex, age, and location (urban/rural) in some countries.
References
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WHO progress towards health for all. Statistics of Member States
WHO progress towards health for all. Statistics of Member States. Geneva, World Health Organization, 1994. -
International standard classification of occupations
International standard classification of occupations. ISCO-88. Geneva, International Labour Office, 1990.
Database
- Global Atlas: Human Resources for Health Information
- Regional Core Health Data Initiative
- European Health for all database (HFA-DB)
Comments
The accuracy and completeness of the human resource data in countries can be a problem because databases are not updated frequently, private sector data is often not included and definitions of workers vary.
Many low-income countries have trained cadres of health workers that have received extensive clinical training and perform many clinical functions of doctors. These 'assistant medical officers', clinical officers, etc. and they are not included in the database. Another challenge is the definition of nurse and midwife.
