Intended for healthcare professionals


WHO to create international human resources database on health care

BMJ 2003; 326 doi: (Published 10 May 2003) Cite this as: BMJ 2003;326:1004
  1. Roger Dobson
  1. Abergavenny

    One in three countries in Africa and South East Asia has only one medical school for every 10 million people or more, a rate poorer than anywhere in Europe or the Americas, says a new report by researchers from the World Health Organization.

    Nine out of 10 countries in the same two regions have fewer than 50 doctors per 100000 inhabitants, and about half of the countries have a similar density of nurses and midwives.

    Such analyses and comparisons, however, may be subject to certain limitations, says the report. Classification of healthcare staff differs from country to country, and distinctions are unclear.

    The data fail to distinguish, for example, between professional nurses and midwives and their associate professional counterparts; nor do they distinguish clearly between those who are actively working in healthcare services and those who are not, says the report. And, importantly, no details exist on the numbers and characteristics of entrants or graduates in medical schools.

    The report outlines a series of major new WHO initiatives, which aim to provide better information to allow more meaningful international comparisons.

    “Despite the undoubted importance of human resources to the functions of health systems, there is little consistency between countries in how human resource strategies are monitored and evaluated,” say the authors, from WHO's department of health service provision. “In many countries there is no regular recording of the numbers and activities of all health personnel, and some emphasize only the public sector or can have variable accuracy for rural areas.”

    Human resources for health are key to managing and delivering health services, and in most countries these account for a high proportion of national health budgets, the authors say.

    The report outlines WHO's involvement in four major projects that will lead to an international human resources database, one of which is an electronic database, the Global Directory of Health Training Institutions.

    This will provide information on the status and trends of health education worldwide, by expanding the listing of medical schools; by including training institutions for other health professions, such as nursing, dentistry, and pharmacy; and by tracking the numbers and characteristics of entrants and graduates.

    Another project, the world health survey, which is being carried out in more than 70 countries from all regions, aims to provide a wide range of quantitative information that can be used to assess population health and health systems performance.

    Detailed assessments of healthcare staffing in six developing countries—Chad, Cîte d'Ivoire, Jamaica, Mozambique, Sri Lanka, and Zimbabwe—are also being undertaken.

    A fourth project is the creation of a meta-database of information sources on healthcare staff in a bid to identify distinguishing variables that will support consistent international and national comparisons.

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