Healthcare worker migration to wealthier countries from Africa, particularly at the height of the Covid-19 pandemic, left a gaping hole in health workforce numbers, the World Health Organisation has said.

“This serious shortage of health workers in Africa is undermining access to and provision of health services”, says the agency.

“Nearly all African countries that were already chronically suffering from low health workforce densities even before the pandemic have been left with increasing vulnerabilities,” added the health agency based on a report by the Expert Advisory Group titled WHO Global Code of Practice on International Recruitment of Health Personnel.

The health workforce status in WHO African Region findings of a cross-sectional study of 47 African countries finds that the region has a ratio of 1.55 health workers including physicians, nurses and midwives per 1,000 people.

The WHO health workforce support and safeguards list 2023 comprises 55 countries, with critical health workforce shortages contained in the 2023 World Health Report. In the triannual review, these countries face the most pressing health workforce challenges related to universal health coverage.

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In particular, these countries have a density of doctors, nurses and midwives below the global median and a universal health coverage service coverage index below the acceptable threshold.

Vulnerabilities to low health workforce

The WHO threshold density is 4.45 health workers per 1,000 people needed to deliver essential health services and achieve universal coverage.

Mauritius, Namibia, Seychelles and South Africa have surpassed the WHO health worker-to-population ratio.

The fourth progress report on the WHO Global Code of Practice on the International Recruitment of Health Personnel noted that the negative health, economic and social impact of Covid-19 coupled with the increasing demand for health and care workers in high-income countries, increased vulnerabilities within countries already suffering from low health workforce densities.

Accordingly, the Expert Advisory Group was reconvened to review all countries that operated with a low workforce density to consider how disruptions related to the Covid-19, particularly health-related vulnerabilities might require the revision and extension of safeguards against active international recruitment.