The needs-based health workforce planning method: a systematic scoping review of analytical applications

Although the theoretical underpinnings and analytical framework for needs-based health workforce planning are well developed and tested, its uptake in national planning processes is still limited. Towards the development of open-access needs-based planning model for national workforce planning, we conducted a systematic scoping review of analytical applications of needs-based health workforce models. Guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses-extension for Scoping Reviews (PRISMA-ScR) checklist, a systematic scoping review was conducted. A systematic search of peer-reviewed literature published in English was undertaken across several databases. Papers retrieved were assessed against predefined inclusion criteria, critically appraised, extracted and synthesized. Twenty-five papers were included, which showed increasing uptake of the needs-based health workforce modelling, with 84% of the studies published within the last decade (2010-20). Three countries (Canada, Australia and England) accounted for 48% of the publications included whilst four studies (16%) were based on low-and-middle-income countries. Only three of the studies were conducted in sub-Saharan Africa. Most of the studies (36%) reported analytical applications for specific disease areas/programs at sub-national levels; 20% focused on the health system need for particular categories of health workers, and only two (8%) reported the analytical application of the needs-based health workforce approach at the level of a national health system across several disease areas/programs. Amongst the studies that conducted long-term projections, the time horizon of the projection was an average of 17 years, ranging from 3 to 33 years. Most of these studies had a minimum time horizon of 10 years. Across the studies, we synthesized six typical methodological considerations for advancing needs-based health workforce modelling. As countries aspire to align health workforce investments with population health needs, the need for some level of methodological harmonization, open-access needs-based models and guidelines for policy-oriented country-level use is not only imperative but urgent.