Publication:
The Labor Market for Health Workers in Africa : New Look at the Crisis

Loading...
Thumbnail Image
Files in English
English PDF Revised (5.27 MB)
13,424 downloads
Text file revised (914.25 KB)
1,056 downloads
Published
2013-04-17
ISSN
Date
2013-06-10
Author(s)
Soucat, Agnes
Abstract
Health systems in Sub-Saharan Africa have changed profoundly over the last 20 years. The economic crisis of the 1980s and 1990s rattled public health care systems, which were largely holdovers from the colonial and postcolonial eras. The later wave of structural adjustments and public sector reforms wrought further change. As African economies opened to market based approaches, the private sector became a sizable source of health care service. Today about half the health expenditures in Africa are private, and private providers play a major role in the delivery of outpatient services. This is draws on the lessons, knowledge, and data gathered by the World Bank's Africa Region Human Resources for Health Program. For the first time, the various complexities of Human Resources for Health (HRH) labor markets are addressed comprehensively in one volume. Given the increasing demand in countries for strong health workforces that can help achieve universal health coverage; we hope this book will be beneficial to researchers, policy makers, and practitioners who are trying to develop evidence-based HRH interventions to achieve this end.
Link to Data Set
Citation
Soucat, Agnes; Scheffler, Richard. Soucat, Agnes; Scheffler, Richard, editors. 2013. The Labor Market for Health Workers in Africa : New Look at the Crisis. Directions in development human development;. © World Bank. http://hdl.handle.net/10986/13824 License: CC BY 3.0 IGO.
Associated URLs
Associated content
Report Series
Report Series
Other publications in this report series
  • Publication
    Democratic Republic of Congo Urbanization Review
    (Washington, DC: World Bank, 2018) World Bank; Ranarifidy, Dina
    The Democratic Republic of Congo has the third largest urban population in sub-Saharan Africa (estimated at 43% in 2016) after South Africa and Nigeria. It is expected to grow at a rate of 4.1% per year, which corresponds to an additional 1 million residents moving to cities every year. If this trend continues, the urban population could double in just 15 years. Thus, with a population of 12 million and a growth rate of 5.1% per year, Kinshasa is poised to become the most populous city in Africa by 2030. Such strong urban growth comes with two main challenges – the need to make cities livable and inclusive by meeting the high demand for social services, infrastructure, education, health, and other basic services; and the need to make cities more productive by addressing the lack of concentrated economic activity. The Urbanization Review of the Democratic Republic of Congo argues that the country is urbanizing at different rates and identifies five regions (East, South, Central, West and Congo Basin) that present specific challenges and opportunities. The Urbanization Review proposes policy options based on three sets of instruments, known as the three 'I's – Institutions, Infrastructures and Interventions – to help each region respond to its specific needs while reaping the benefits of economic agglomeration The Democratic Republic of the Congo is at a crossroads. The recent decline in commodity prices could constitute an opportunity for the country to diversify its economy and invest in the manufacturing sector. Now is an opportune time for Congolese decision-makers to invest in cities that can lead the country's structural transformation and facilitate greater integration with African and global markets. Such action would position the country well on the path to emergence.
  • Publication
    Strengthening Competitiveness In Bangladesh—Thematic Assessment
    (Washington, DC: World Bank, 2016-07-15) Kathuria, Sanjay; Malouche, Mariem Mezghenni; Kathuria, Sanjay; Malouche, Mariem Mezghenni
    This is volume 2 of a three-volume publication on Bangladesh’s trade prospects. Bangladesh’s ambition is to build on its very solid growth and poverty reduction achievements, and accelerate growth to become a middle income country by 2021, and share prosperity more widely amongst its citizens. This includes one of its greatest development challenges: to provide gainful employment to the over 2 million people that will join the labor force each year over the next decade. Moreover, only 54.1 million of its 94 million working age people are employed. Bangladesh needs to use its labor endowment even more intensively to increase growth and, in turn, to absorb the incoming labor. The Diagnostic Trade Integration Study identifies the following actions centered around four pillars to sustain and accelerate export growth: (1) breaking into new markets through a) better trade logistics to reduce delivery lags ; as world markets become more competitive and newer products demand shorter lead times, to generate new sources of competitiveness and thereby enable market diversification; and b) better exploitation of regional trading opportunities in nearby growing and dynamic markets, especially East and South Asia; (2) breaking into new products through a) more neutral and rational trade policy and taxation and bonded warehouse schemes; b) concerted efforts to spur domestic investment and attract foreign direct investment, to contribute to export promotion and diversification, including by easing the energy and land constraints; and c) strategic development and promotion of services trade; (3) improving worker and consumer welfare by a) improving skills and literacy; b) implementing labor and work safety guidelines; and c) making safety nets more effective in dealing with trade shocks; and (4) building a supportive environment, including a) sustaining sound macroeconomic fundamentals; and b) strengthening the institutional capacity for strategic policy making aimed at the objective of international competitiveness to help bring focus and coherence to the government’s reform efforts. This second volume provides in-depth analysis across seven cross-cutting themes that underpin most of the findings of pillars 1 and 2 above.
  • Publication
    At a Crossroads
    (World Bank, Washington, DC, 2017-05-02) Ferreyra, Maria Marta; Avitabile, Ciro; Botero Álvarez, Javier; Haimovich Paz, Francisco; Urzúa, Sergio
    Higher education (HE) has expanded dramatically in Latin America and the Caribbean (LAC) since 2000. While access became more equitable, quality concerns remain. This volume studies the expansion, as well as HE quality, variety and equity in LAC. It investigates the expansion’s demand and supply drivers, and outlines policy implications.
  • Publication
    An Investment Framework for Nutrition
    (Washington, DC: World Bank, 2017-04-12) Shekar, Meera; Kakietek, Jakub; Dayton Eberwein, Julia; Walters, Dylan
    The report estimates the costs, impacts and financing scenarios to achieve the World Health Assembly global nutrition targets for stunting, anemia in women, exclusive breastfeeding and the scaling up of the treatment of severe wasting among young children. To reach these four targets, the world needs $70 billion over 10 years to invest in high-impact nutrition-specific interventions. This investment would have enormous benefits: 65 million cases of stunting and 265 million cases of anemia in women would be prevented in 2025 as compared with the 2015 baseline. In addition, at least 91 million more children would be treated for severe wasting and 105 million additional babies would be exclusively breastfed during the first six months of life over 10 years. Altogether, achieving these targets would avert at least 3.7 million child deaths. Every dollar invested in this package of interventions would yield between $4 and $35 in economic returns, making investing in early nutrition one of the best value-for-money development actions. Although some of the targets—especially those for reducing stunting in children and anemia in women—are ambitious and will require concerted efforts in financing, scale-up, and sustained commitment, recent experience from several countries suggests that meeting these targets is feasible. These investments in the critical 1000 day window of early childhood are inalienable and portable and will pay lifelong dividends – not only for children directly affected but also for us all in the form of more robust societies – that will drive future economies.
  • Publication
    Leveraging the Potential of Argentine Cities
    (Washington, DC: World Bank, 2016-10-18) Muzzini, Elisa; Eraso Puig, Beatriz; Anapolsky, Sebastian; Lonnberg, Tara; Mora, Viviana
    Argentina’s path to economic prosperity is through efficient, sustainable and economically thriving cities. Not only are cities a spatial concentration of people, but also they generate agglomeration economies by concentrating ideas, talent, and knowledge. Argentina is one of the most urbanized countries in Latin America, with 90 percent of Argentine people currently living in cities. Argentina’s cities are geographically and economically diverse, and its largest urban area – Metropolitan Buenos Aires – is one of Latin America’s urban giants. Argentine cities need to address three main challenges to leverage their economic potential. Argentina’s current patterns of urban development are characterized by (a) high primacy and unbalanced regional development, (b) limited global economic footprint of urban economies, with employment concentrated in nontradable and resource intensive sectors, and (c) unplanned low-density urban expansion. Argentine cities thus face the challenges of moving toward a more balanced regional development, transitioning from local to global cities, and from urban sprawl to articulated densities to take full advantage of the benefits of agglomeration economies. To address these challenges, Argentina needs the leadership of the federal government; the coordinating power of provinces; and the capacity of empowered, financially sound municipalities. Argentine cities also need system-wide policy reforms in areas such as territorial planning, municipal finance, housing, urban transport, and local economic development. Leveraging the Potential of Argentine Cities: A Framework for Policy Action aims to deepen our empirical understanding of the interplay between urbanization and agglomeration economies in Argentina by asking the following: (a) What are the main trends and spatial patterns of Argentina’s urbanization that underlie agglomeration economies?, (b) Are urban policies leveraging or undermining the benefits of agglomeration economies?, and (c) Are Argentine cities fully reaping the benefits of agglomeration economies to deliver improvements in prosperity and livability? By addressing such questions and exploring their implications for action, this study provides a conceptual framework, empirical data, and strategic directions for leveraging the potential of Argentine cities.
Journal
Journal Volume
Journal Issue

Related items

Showing items related by metadata.

  • Publication
    Timor-Leste Health Sector Review : Appendices
    (Washington, DC, 2006-10-06) World Bank
    The Timor-Leste health sector review describes the accomplishments made by the government of Timore-Leste in the health sector since it separated from Indonesia, and analyzes the challenges still facing the government moving forward. Infant and maternal mortality, and malnutrition, are still important battles. Underutilization of services, and poor quality of services when available, are also reasons for the poor health quality indicators. Improving the quality or effectiveness of health services is difficult. However, now that most of the basic health care infrastructure is in place, the time is right for the Ministry of Health (MOH) to develop a system to monitor and upgrade the quality of health care services, starting with public sector services. One initiative put forth is health education delivered through various channels, which would make households better aware of the risks associated with certain health conditions or symptoms and the importance of using the available health services from government and NGO facilities. A second type of potential intervention is the introduction of conditional cash transfers, whereby the Government pays a subsidy to households in exchange for certain behaviors beneficial to society, such as having their children immunized. Carrying out the various interventions described above would require that the Government increased its spending on health services further.
  • Publication
    Paying Primary Health Care Centers for Performance in Rwanda
    (World Bank, Washington, DC, 2010-01) Basinga, Paulin; Gertler, Paul J.; Soucat, Agnes L.B.; Binagwaho, Agnes; Soucat, Agnes L.B.; Sturdy, Jennifer R.; Vermeersch, Christel M.J.
    Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by providing incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities' input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes.
  • Publication
    Health Service Delivery and Utilization in Timor-Leste : A Qualitative Study
    (Washington, DC, 2005-05) World Bank
    This report was written as part of a broader Health Sector Review in Timor-Leste currently being undertaken by the World Bank. Timor-Leste struggles with a burden of disease since independence. Poor health is related to environmental sanitation, poverty, food security, a shortage of doctors, and the difficulty of reaching some rural communities. Some problems are specific to Timor-Leste: violence during the Indonesian occupation, the destruction of the health care sector, and a situation of medical pluralism in which long-established practices of traditional healers co-exist with recent biomedical services. One obstacle the health sector faces is client low utilization of health services. The 2003 Demographic and Health Survey (DHS) reports that about a fifth of poor households have never used the health care facility closest to their house. While it is clear that many households are unwilling or unable to access health care, the reasons for these barriers are poorly understood. One aim of this report is to help fill this gap in knowledge by providing contextual information on health seeking behavior. A second aim is to shed light on human resource challenges in the health sector.
  • Publication
    Health Service Delivery and Utilization in Timor-Leste : A Qualitative Study
    (Washington, DC, 2005-05) World Bank
    This report was written as part of a broader Health Sector Review in Timor-Leste currently being undertaken by the World Bank. Timor-Leste struggles with a burden of disease since independence. Poor health is related to environmental sanitation, poverty, food security, a shortage of doctors, and the difficulty of reaching some rural communities. Some problems are specific to Timor-Leste: violence during the Indonesian occupation, the destruction of the health care sector, and a situation of medical pluralism in which long-established practices of traditional healers co-exist with recent biomedical services. One obstacle the health sector faces is client low utilization of health services. The 2003 Demographic and Health Survey (DHS) reports that about a fifth of poor households have never used the health care facility closest to their house. While it is clear that many households are unwilling or unable to access health care, the reasons for these barriers are poorly understood. One aim of this report is to help fill this gap in knowledge by providing contextual information on health seeking behavior. A second aim is to shed light on human resource challenges in the health sector.
  • Publication
    Healthy Partnerships : How Governments Can Engage the Private Sector to Improve Health in Africa
    (World Bank, 2011) International Finance Corporation
    Health systems across Africa are in urgent need of improvement. The public sector should not be expected to shoulder the burden of directly providing the needed services alone, nor can it, given the current realities of African health systems. Therefore to achieve necessary improvements, governments will need to rely more heavily on the private health sector. Indeed, private providers already play a significant role in the health sector in Africa and are expected to continue to play a key role, and private providers serve all income levels across sub- Saharan Africa's health systems. The World Health Organization (WHO) and others have identified improvements in the way governments interact with and make use of their private health sectors as one of the key ingredients to health systems improvements. Across the African region, many ministries of health are actively seeking to increase the contributions of the private health sector. However, relatively little is known about the details of engagement; that is, the roles and responsibilities of the players, and what works and what does not. A better understanding of the ways that governments and the private health sector work together and can work together more effectively is needed. This Report assesses and compares the ways in which African governments are engaging with their private health sectors. Engagement is defined, for the purposes of this report, to mean the deliberate, systematic collaboration of the government and the private health sector according to national health priorities, beyond individual interventions and programs. With effective engagement, one of the main constraints to better private sector contributions can be addressed, which in turn should improve the performance of health systems overall.

Users also downloaded

Showing related downloaded files

  • Publication
    World Bank Annual Report 2024
    (Washington, DC: World Bank, 2024-10-25) World Bank
    This annual report, which covers the period from July 1, 2023, to June 30, 2024, has been prepared by the Executive Directors of both the International Bank for Reconstruction and Development (IBRD) and the International Development Association (IDA)—collectively known as the World Bank—in accordance with the respective bylaws of the two institutions. Ajay Banga, President of the World Bank Group and Chairman of the Board of Executive Directors, has submitted this report, together with the accompanying administrative budgets and audited financial statements, to the Board of Governors.
  • Publication
    Digital Africa
    (Washington, DC: World Bank, 2023-03-13) Begazo, Tania; Dutz, Mark Andrew; Blimpo, Moussa
    All African countries need better and more jobs for their growing populations. "Digital Africa: Technological Transformation for Jobs" shows that broader use of productivity-enhancing, digital technologies by enterprises and households is imperative to generate such jobs, including for lower-skilled people. At the same time, it can support not only countries’ short-term objective of postpandemic economic recovery but also their vision of economic transformation with more inclusive growth. These outcomes are not automatic, however. Mobile internet availability has increased throughout the continent in recent years, but Africa’s uptake gap is the highest in the world. Areas with at least 3G mobile internet service now cover 84 percent of Africa’s population, but only 22 percent uses such services. And the average African business lags in the use of smartphones and computers as well as more sophisticated digital technologies that catalyze further productivity gains. Two issues explain the usage gap: affordability of these new technologies and willingness to use them. For the 40 percent of Africans below the extreme poverty line, mobile data plans alone would cost one-third of their incomes—in addition to the price of access devices, apps, and electricity. Data plans for small- and medium-size businesses are also more expensive than in other regions. Moreover, shortcomings in the quality of internet services—and in the supply of attractive, skills-appropriate apps that promote entrepreneurship and raise earnings—dampen people’s willingness to use them. For those countries already using these technologies, the development payoffs are significant. New empirical studies for this report add to the rapidly growing evidence that mobile internet availability directly raises enterprise productivity, increases jobs, and reduces poverty throughout Africa. To realize these and other benefits more widely, Africa’s countries must implement complementary and mutually reinforcing policies to strengthen both consumers’ ability to pay and willingness to use digital technologies. These interventions must prioritize productive use to generate large numbers of inclusive jobs in a region poised to benefit from a massive, youthful workforce—one projected to become the world’s largest by the end of this century.
  • Publication
    Argentina Country Climate and Development Report
    (World Bank, Washington, DC, 2022-11) World Bank Group
    The Argentina Country Climate and Development Report (CCDR) explores opportunities and identifies trade-offs for aligning Argentina’s growth and poverty reduction policies with its commitments on, and its ability to withstand, climate change. It assesses how the country can: reduce its vulnerability to climate shocks through targeted public and private investments and adequation of social protection. The report also shows how Argentina can seize the benefits of a global decarbonization path to sustain a more robust economic growth through further development of Argentina’s potential for renewable energy, energy efficiency actions, the lithium value chain, as well as climate-smart agriculture (and land use) options. Given Argentina’s context, this CCDR focuses on win-win policies and investments, which have large co-benefits or can contribute to raising the country’s growth while helping to adapt the economy, also considering how human capital actions can accompany a just transition.
  • Publication
    Classroom Assessment to Support Foundational Literacy
    (Washington, DC: World Bank, 2025-03-21) Luna-Bazaldua, Diego; Levin, Victoria; Liberman, Julia; Gala, Priyal Mukesh
    This document focuses primarily on how classroom assessment activities can measure students’ literacy skills as they progress along a learning trajectory towards reading fluently and with comprehension by the end of primary school grades. The document addresses considerations regarding the design and implementation of early grade reading classroom assessment, provides examples of assessment activities from a variety of countries and contexts, and discusses the importance of incorporating classroom assessment practices into teacher training and professional development opportunities for teachers. The structure of the document is as follows. The first section presents definitions and addresses basic questions on classroom assessment. Section 2 covers the intersection between assessment and early grade reading by discussing how learning assessment can measure early grade reading skills following the reading learning trajectory. Section 3 compares some of the most common early grade literacy assessment tools with respect to the early grade reading skills and developmental phases. Section 4 of the document addresses teacher training considerations in developing, scoring, and using early grade reading assessment. Additional issues in assessing reading skills in the classroom and using assessment results to improve teaching and learning are reviewed in section 5. Throughout the document, country cases are presented to demonstrate how assessment activities can be implemented in the classroom in different contexts.
  • Publication
    Digital-in-Health
    (Washington, DC: World Bank, 2023-08-18) World Bank
    Technology and data are integral to daily life. As health systems face increasing demands to deliver new, more, better, and seamless services affordable to all people, data and technology are essential. With the potential and perils of innovations like artificial intelligence the future of health care is expected to be technology-embedded and data-linked. This shift involves expanding the focus from digitization of health data to integrating digital and health as one: Digital-in-Health. The World Bank’s report, Digital-in-Health: Unlocking the Value for Everyone, calls for a new digital-in-health approach where digital technology and data are infused into every aspect of health systems management and health service delivery for better health outcomes. The report proposes ten recommendations across three priority areas for governments to invest in: prioritize, connect and scale.