Bangla Press Desk: Bangladesh continues to face a significant shortage of health professionals, with its overall health workforce density remaining below the South Asian average, according to a new global study published in The Lancet Public Health.
The comprehensive analysis, which provides the first global, sex-disaggregated estimates of 20 health worker cadres across 204 countries and territories from 1990 to 2023, estimated Bangladesh's total health workforce density at 56.7 per 10,000 population in 2023, compared with the South Asian average of 68.6.
The study, conducted by researchers including those affiliated with the Institute for Health Metrics and Evaluation (IHME), was published in The Lancet Public Health on August 18.
Bangladesh had an estimated 7.9 doctors and 5.7 nursing personnel per 10,000 population in 2023, while the density of pharmacists and pharmaceutical assistants was considerably higher at 11 per 10,000 people.
The country also had 7.1 community health workers, 1.7 midwifery personnel and 1.2 dentists and dental assistants per 10,000 population. Another 22.1 health workers per 10,000 people were classified under other health professions.
The relatively low density of doctors and nurses compared with pharmacists points to structural imbalances in Bangladesh's health workforce and highlights the need for greater investment in medical and nursing education, training and retention.
Talking to the FE, Ministry of Labour and Employment Secretary Md Abdur Rahman Tarafder said the strategy of encouraging diploma doctors at the upazila level could pay off if they were brought under government services.
Patients in upazila and rural areas are mostly dependent on MBBS doctors, so other professionals feel discouraged from joining the health workforce, he said.
Globally, the health workforce nearly tripled between 1990 and 2023, rising from 40.9 million to 122.1 million workers. Women accounted for more than 70 per cent of the net increase.
In 2023, women made up 80.7 per cent of nurses, 96 per cent of midwives and 89.5 per cent of community health workers globally, while accounting for less than half of physicians.
Despite the substantial expansion, major disparities persist across regions. High-income countries recorded the highest health worker density, while sub-Saharan Africa remained among the most underserved regions.
The study estimated that the world needs an additional 34.4 million health workers to achieve a Universal Health Coverage (UHC) effective coverage index score of 80 out of 100.
Nurses and midwives account for the largest share of the shortfall, with an additional 23.9 million needed globally. The world also needs 7.1 million more doctors, 1.8 million dentists and 1.6 million pharmacists to reach the benchmark.
South Asia faces one of the largest workforce gaps, requiring an estimated 10 million additional nurses and midwives and 2.6 million doctors to achieve the targeted level of health coverage.
The researchers called on countries to expand domestic training capacity, improve remuneration and working conditions, and strengthen policies to recruit and retain health professionals.
They also stressed the need for gender-responsive policies, including flexible working arrangements, paid maternity leave and mentorship programmes, to increase women's representation in leadership positions across the health sector.
The findings suggest that Bangladesh, despite having a sizable network of community health workers and a relatively high density of pharmacists, needs substantial investment in doctors, nurses and midwives to strengthen its health system and move closer to universal health coverage.
Dr Mainul Islam, professor of population sciences at the University of Dhaka, said budget allocation for developing the health workforce had been poor in previous years.
The sector has received less priority to consider the health sector workers as human capital, he said.
Proper implementation of the National Health Policy 2011 could help achieve the goal, he added.
