Health labour market policies in support of universal health coverage: a comprehensive analysis in four African countries

Overview

In this paper, we use a health labour market framework to investigate the key indicators of the dynamics of the health labour market in Cameroon, Kenya, Sudan, and Zambia, and identify the main policies implemented in the past decade to address shortages and maldistribution of health workers in order to highlight the challenges to attaining universal health coverage. These four African countries were chosen because they had reliable and good quality data and the necessary institutional capacity to conduct the analysis, and the Ministry of Health was in each case willing to undertake the analysis.

The four countries differ in their overall level of economic development and their demographic and epidemiological profiles. In each of the countries, there are great inequalities in access to health services and difficulties in attaining universal health coverage. For example, in Cameroon, Kenya, and Zambia, the coverage of skilled birth attendance is less than 20% among the poorest segments of the population, compared with more than 80% for the rich.