The Eastern Mediterranean Region has a low density of health workers compared to other WHO regions. While the number of medical schools and density of physicians and nurses has increased in recent decades, it has not kept pace with population growth. There are also imbalances in skill mix and distribution of health workers across countries in the region. Protracted crises have led to out-migration of health workers and violence against healthcare facilities. To address these health workforce challenges, the draft WHO regional framework calls for countries to develop strategic plans, increase investment in education and employment, strengthen collaboration and information systems, and enhance regional cooperation.

1. Health workforce development in the
Eastern Mediterranean Region
63rd Session of the WHO Regional Committee for
the Eastern Mediterranean
3-6 OCTOBER 2016, Cairo

2. EMR has low density of health workers…
0
10
20
30
40
50
60
70
80
South-East Asia Africa Eastern
Mediterranean
Americas Western Pacific Europe
Average density of physicians, nurses, midwives in WHO regions
Source: WHO Global Health Observatory

3. 0 10 20 30 40 50 60 70 80 90 100
Somalia
Afghanistan
Djibouti
Yemen
Sudan
Pakistan
Morocco
Egypt
Iraq
Iran
Syria
Palestine
Tunisia
Jordan
Lebanon
Libya
UAE
Oman
Bahrain
Saudi Arabia
Kuwait
Qatar
Moving from MDGs…….
Density of physicians, nurses and midwives, 2014 (or latest available year)
Source: EMR Health Observatory

4. SDGs and health workforce
3c substantially increase … the
recruitment, development,
training and retention of the
health workforce in developing
countries

5. Increased production capacity……
Trends in establishment of medical schools in EMR
0
20
40
60
80
100
120
Before 1950 1950-1974 1975-2000 After 2000
Public Private
Trends in medical schools by public
and private sectors

6. 0
5
10
15
20
25
30
2007 2008 2009 2010 2011 2012 2013 2014
Density/10,000Population
Group 1
Group 2
Group 3
0
10
20
30
40
50
60
2007 2008 2009 2010 2011 2012 2013 2014
Density/10,000Population
Group 1
Group 2
Group 3
Density of nurses and midwives
per 10,000 population in EMR
….. but not sufficient to keep pace with population growth
Density of physicians per 10,000 population in EMR
Source: EMR Health Observatory

7. Ratio of nurses & midwives to physicians, 2014 (or latest available year)
Skill mix varies among countries……
Source: EMR Health Observatory
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5

8. Imbalances in skill mix is increasing …
-2.0
-1.5
-1.0
-0.5
0.0
0.5
1.0
Change in the ratio of nurses&midwives/physicians in the EMR Member States from 2007 to 2014
Source: EMR Health Observatory

9. Working conditions?
Job satisfaction of
nurses in EMR
47% expressed
satisfaction on
working conditions
satisfied
Source: EMR Nursing and Midwifery Survey, 2014

10. Protracted crisis and health workforce…
• Out-migration of health workforce, interrupted
health professional education
• 594 reported acts of violence to health facilities and
health workers in 2014-2015 (82% in EMR)
• 2520 health workers injured or killed ( 86% in EMR)
Source: Report on attacks on health care in emergencies, WHO, 2016

11.  Overall shortages
 Health workforce mobility
 Imbalanced skill mix and distribution
 Inadequate/imbalanced production capacities
 Limited with employment capacities
 Challenges with HRH governance capacities and information
 Increasing involvement of non-state actors, insufficient
regulatory frameworks and capacities
Diverse countries with diverse health
workforce challenges in EMR..

12. Global Momentum and response
• Global Strategy on Human Resources for Health:
Workforce 2030
• UN High Level Commission on Health Employment
and Economic Growth
• Draft Regional Framework for Action for Health
Workforce Development

13. Draft Regional Framework for Action for Health
Workforce development
To ensuring access of all people in EMR to an
adequate, competent, well balanced,
motivated, and responsive health workforce
functioning within robust health systems
towards universal health coverage and SDGs

15. The way forward
• Develop and implement national health workforce strategic plans
• Increase investment in health workforce education and
employment
• Establish mechanisms for multi stakeholder collaboration,
engagement and policy dialogue (i.e. health workforce
committee/board)
• Establish/strengthen health workforce observatories (or similar
mechanisms) to improve health workforce information and
monitoring
• Regional sharing and cooperation to move forward health
workforce agenda

16. Thank you
16