Conclusion and recommendation
As this technical brief has demonstrated, when high and low variants of population growth are taken into account, it becomes apparent that the health workforce crisis could worsen in a significant number of countries over the coming decades. However, this negative outcome is far from a fait accompli.
Many of the 57 crisis countries, particularly those in West and Central Africa, have very high levels of unmet need for family planning and very low levels of modern method contraceptive use among married women. These demographics are consistent with the UN’s observation under the 2010 revision that for a small set of 16 countries, ”fertility decline has been much slower than typically experienced in the past decades by other countries at similar levels of fertility” (United Nations 2011c). Among the 16 countries in this set, 14 are human resources for health crisis countries. Table 2 provides values for these countries’ annual rates of population growth, total fertility rate, contraceptive prevalence, and unmet need for family planning.
Although the population size of countries with high fertility and low contraceptive use will continue to grow, the rate at which these populations grow can be slowed. High rates of unmet need for family planning, which exist in many of the crisis countries listed in Table 2, provide an opportunity for intervention. Addressing factors associated with meeting men’s and women’s needs for family planning can significantly impact population growth as a result of lower fertility rates. Decreases in the annual rate of population growth can, in turn, result in fewer additional health workers needed to reach the threshold health worker density ratio.
In conclusion, we recommend that policy-makers and planners combine efforts to meet the family planning needs of the population through the provision of quality reproductive health services with a simultaneous investment in the health workforce. Doing so will have synergistic effects in meeting the health needs of families and mitigating the health workforce crisis in individual countries around the world.
| Country |
Population
growth rate1
|
Total fertility rate2 |
Contraceptive use
(modern methods)
among currently
married women
(15-49)3
|
Unmet need
for family
planning among
currently married
women ages 15-494
|
|---|---|---|---|---|
| Burkina Faso | 3.0% | 5.8 | 13% | 29% |
| Congo | 2.5% | 4.7 | 13% | 16% |
| Guinea | 2.2% | 5.3 | 6% | 21% |
| Guinea-Bissau | 2.1% | 5.1 | 14% | 25%5 |
| Kenya | 2.6% | 4.7 | 39% | 26% |
| Malawi | 3.1% | 5.7 | 42% | 28% |
| Mali | 3.0% | 6.4 | 6% | 31% |
| Niger | 3.5% | 7.0 | 5% | 16% |
| Nigeria | 2.5% | 5.7 | 10% | 20% |
| Rwanda | 3.0% | 4.6 | 45% | 38% |
| Somalia | 2.3% | 6.4 | 1% | 26%5 |
| Tanzania | 3.0% | 5.4 | 26% | 22% |
| Yemen | 3.1% | 5.3 | 19% | 24%5 |
| Zambia | 1.6% | 6.3 | 27% | 27% |
|
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