Area-based Network Allocations: A Solution to Mitigate the Shortage of Health Workforce

Abstract

This study reports the simulation results of area-based network allocations for the health workforce in all hospitals under the Office of the Permanent Secretary of the Ministry of Public Health. The objec­tive was to understand the workforce shortage status and results from alternative network allocations in the health regions to mitigate the shortage of health workforce.

As of September 1, 2019, the weighted shortage intensity index shows 31%, 29%, and 26% shortage on average for nurses, dentists, and medical doctors. This study found 80% of hospitals had nurses, dentists, and medical doctors less than the minimum manpower requirements. The weighted average shortages of nurses were 68 per hospital, and shortages of doctors and dentists are 10 and 3 per hospi­tal, respectively. The total shortages were 16,000 nurses, 3,400 doctors, and 1,000 dentists. There was a severe nurse shortage in sub-district health promoting hospitals and tertiary hospitals, but no shortage at secondary-level hospitals. Furthermore, the medical doctor shortage was severe at the secondary-level hospitals.

The empirical results show that area-based healthcare networking within the same hospital level could not mitigate the shortage due to high workforce scarcity. However, the networking of the prima­ry-level with the first-and middle-secondary-level hospitals in the same districts could alleviate the nurse shortage. This decreased the weighted shortage intensity index for nurses from an average of 69% in the primary hospitals (status quo) to an average of 25% (ex-ante). Similarly, the networking of middle and high levels of hospitals at the provincial and regional levels could also alleviate the shortage in medical doctors. However, the area-based networking alternatives could not mitigate the shortage in dentists and pharmacists.