World needs 34 million more health workers, Lancet study finds

The global health workforce has nearly tripled since 1990, driven largely by women who now make up almost 70% of all health workers. Yet the world remains short 34.4 million doctors, nurses, midwives, dentists, and pharmacists needed to deliver moderate universal health coverage, according to a study published this week in The Lancet Public Health.bioengineer+1

A Paradox of Growth and Scarcity

The analysis, based on the Global Burden of Disease Study 2023, found the workforce grew from 40.9 million in 1990 to 122.1 million in 2023. Women accounted for 71.4% of that increase, adding tens of millions of workers to health systems worldwide. Women represented 80.7% of nurses, 96% of midwives, and 89.5% of community health workers in 2023, but less than half of doctors globally.bioengineer

Despite this expansion, the researchers estimate an additional 23.9 million nurses and midwives, 7.1 million doctors, 1.8 million dentists, and 1.6 million pharmacists would be required for countries to reach a score of 80 out of 100 on the GBD universal health coverage effective coverage index. That figure is more than twice as high as previous World Health Organization estimates, which projected a shortfall of 11 million health workers by 2030.icthealth+2

Shortages Concentrated in South Asia and Sub-Saharan Africa

The deficits are sharpest in regions with rapidly growing populations and limited training infrastructure. South Asia would need an additional 2.6 million doctors and 10 million nurses and midwives, while Sub-Saharan Africa faces severe gaps across all major professions. Nursing density in Sub-Saharan Africa was estimated at 14.5 workers per 10,000 people, compared with 121.8 per 10,000 in high-income countries.bioengineer

"Women have transformed the global health workforce over the past three decades, but they continue to be concentrated in professions that generally offer lower pay and fewer opportunities for leadership," said Megan Knight, the study's lead author and a researcher at the Institute for Health Metrics and Evaluation.medicalxpress+1

Structural Reform Called For

The study's authors argue that closing the gap will require more than recruitment. Senior author Annie Haakenstad said the findings establish minimum workforce thresholds countries can use when planning investments in medical education, salaries, and retention. The researchers identified benchmarks of 23.8 doctors and 64.5 nurses and midwives per 10,000 people as densities associated with moderate coverage.bioengineer

The study frames the shortage not as a simple count of vacant positions but as a measure of the workforce needed to deliver effective care relative to population needs — a distinction that helps explain why workforce growth alone has not translated into equitable access to health services.sciencedirect