Health workers are the critical pathway to attaining the health target in Sustainable Development Goal (SDG) 3 (health and well-being). An adequate, equitably distributed, motivated and supported health workforce is essential for progress towards universal health coverage (UHC).1 The health workforce is also critical in emergency preparedness and response, and the delivery of integrated people-centered health services.1 While many countries have made progress in addressing HRH issues, several health workforce challenges remain that must be addressed to achieve a sustainable and effective health workforce. The World Health Organization (WHO) estimates a projected shortfall of 18 million health workers by 2030, mostly in low- and lower-middle-income countries. However, countries at all levels of socioeconomic development face, to varying degrees, difficulties in the education, employment, deployment, retention and performance of their workforce.2 The chronic under-investment in education and training of health workers in the countries and the mismatch between education and employment strategies in relation to health systems and population needs are contributing to continuous shortages. These are compounded by difficulties in deploying health workers to rural, remote and under-served areas. Whilst well over half of the developing world’s population 3.1 billion people or 45% of all humanity live in rural areas,3 most health workers live and work in urban areas. This distributional inequality in the health workforce is observed most acutely in low- and middle-income countries where the most severe health workforce shortages exist.4
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Zurn et al. (2021) studied this question.