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Global trends and career development of human resources for paediatrics: a systematic review
Xiaokang Yao1, Zishuo Wang2, Tao Xiong1
1Division of Human Resources, The First People's Hospital of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China.
Insights
Global paediatric workforce trends show growth but persistent challenges in distribution and early-career equity. Research must prioritize career-stage data for equitable planning, especially in underrepresented low-income countries.
Area of Science:
- Global Health
- Medical Workforce Studies
- Pediatrics
Background:
- The pediatric workforce is crucial globally, yet empirical evidence on workforce trends across career stages is limited.
- Existing national reports lack comprehensive synthesis of pediatric staff availability, distribution, and progression.
- This study addresses the gap by systematically synthesizing global trends in the pediatric workforce.
Purpose of the Study:
- To systematically synthesize evidence on global trends in the pediatric workforce.
- To examine trends in availability, distribution, and career progression across different career stages.
- To identify disparities within the pediatric workforce, particularly concerning career stages and geographic location.
Main Methods:
- A systematic literature search was conducted across CENTRAL, Embase, MEDLINE, and Scopus databases (November 2025).
- Primary studies reporting on pediatric workforce trends were included and data were narratively synthesized.
- Risk of bias was assessed using Joanna Briggs Institute tools.
Main Results:
- 35 studies from high- and upper-middle-income countries were included; no low- or lower-middle-income countries were eligible.
- Workforce supply increased in high-income countries, driven by subspecialty growth, but geographic imbalances (e.g., rural areas) persisted.
- Early-career pediatricians reported higher burdens and dissatisfaction; women comprised most of the workforce but were underrepresented in leadership.
Conclusions:
- Despite workforce growth in high-income countries, challenges in distribution, retention, and equity persist, especially for early-career professionals.
- The evidence base significantly underrepresents low- and lower-income countries.
- Future research should focus on career-stage specific data to support equitable global pediatric workforce planning.
Background:
The paediatric workforce plays a central role in health systems worldwide. National reports and studies have described its size and structure, as well as the retention of staff within the paediatric workforce. However, there have been few syntheses of empirical evidence examining workforce trends across career stages, and none have focused specifically on paediatric staff. We aimed to systematically synthesise evidence on the global trends of the availability, distribution, career progression, and differences across career stages among the paediatric workforce.
Methods:
We searched CENTRAL, Embase, MEDLINE, and Scopus between 1 and 20 November 2025 for primary studies reporting on the above-mentioned trends within the paediatric workforce. We extracted and narratively synthesised the related data, and assessed the risk of bias of included studies using Joanna Briggs Institute tools.
Results:
We included 35 studies from high-income and upper-middle-income countries, with no low- or lower-middle-income countries being eligible. Workforce supply increased steadily over time in high-income countries, driven largely by subspecialty growth. However, geographic imbalances persisted, with low representation of paediatric staff in rural areas. In terms of career stage, early-career paediatricians reported higher workload burden, dissatisfaction, and career uncertainty compared with their senior counterparts. Women progressively came to account for most of the workforce, although men continued to predominate in leadership positions. Evidence from upper-middle-income countries focused primarily on training preparedness and early-career experiences.
Conclusions:
Despite growth in the size of the paediatric workforce in high-income countries, challenges related to distribution, retention, and equity persist, particularly during early career stages. Importantly, the evidence base on this topic heavily underrepresents low- and lower-income countries. Future research should prioritise career-stage specific data to support equitable global workforce planning.
Registration:
PROSPERO: CRD420261283831.
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