Optimizing Human Resource for Health Investment Using Workload

Improving population health outcomes depends on the availability, accessibility, acceptability, and quality of the health workforce. In 2022, Ethiopia had a very low health workforce density at 10 per 10,000 people, just below a quarter of the World Health Organization (WHO)'s threshold (45) for achieving universal health coverage (UHC). There is a workforce maldistribution that disfavors rural areas. The skill mix imbalance is also typified by a shortage of specialist doctors, nurses, and medical laboratory professionals. However, despite the need, many new health graduates have not been hired due to  workforce management challenges. The workforce planning was predominantly traditional and based on simple population ratios and health worker density benchmarks, without consideration of workload, staffing gaps, and disease burden. The country was challenged to optimize human resources for health (HRH) investments and overcome market failures.

To address the challenges, Jhpiego, in collaboration with the Ministry of Health (MOH), Public Service Commission, the Ministry of Labor, Ethiopian Standards Agency, professional associations, the private sector, and WHO, conducted studies through a Workload Indicator Staffing Needs (WISN) assessment and Health Labor Market Analysis (HLMA). The studies showed that the country needs a 55% increase in the number of available health workers that is critical to increase access of the population to quality health services. The findings have been used to revise the staffing standards for the country's primary health care units and tertiary hospitals. As a result, the MOH mobilized financial resources to hire newly graduated medical doctors through a matching fund approach, deploying 8,988 health workers in 2022 and 2023.