Optimizing the health workforce for Universal Health Coverage: a framework for analysis and action

Area of Science:

• Health Policy and Systems Research
• Human Resources for Health (HRH) Optimization
• Global Health Equity

Background:

• Suboptimal human resources for health (HRH) density in low- and middle-income countries (LMICs) hinders healthcare delivery and SDG targets.
• Optimizing HRH is essential across all economic contexts, not solely dependent on income levels.
• Nigeria serves as a case study for developing a practical HRH optimization framework for LMICs.

Purpose of the Study:

• To present a practical framework for optimizing the health workforce in LMICs.
• To assess HRH challenges and identify optimization strategies in Nigeria.
• To guide LMICs in improving health service delivery through effective HRH management.

Main Methods:

• A qualitative approach was employed to apply a synthesized HRH optimization framework.
• Data collection involved reviewing relevant documents and conducting key informant interviews at national and state levels in Nigeria.
• The framework integrated elements from the International HRH Action Framework, WHO HRH Assessment Guidelines, and WHO Health System Governance Action Plan for UHC.

Main Results:

• Nigeria's HRH landscape is complex, with implementation challenges for policies like Task Shifting and National HRH Policy.
• Institutional capacity for HRH optimization exists in some states but is limited by staffing and funding.
• Political interference, data integration issues, and systemic challenges in planning, recruitment, and motivation impede HRH optimization and equitable healthcare access.

Conclusions:

• The developed HRH optimization framework effectively assesses and plans strategies for health workforce improvement in LMICs.
• Nigeria's experience demonstrates the framework's utility in identifying optimization opportunities.
• LMICs can leverage this framework to address HRH shortages and enhance health service delivery and equity.