The Role of Data in Strengthening Health Workforce

Posted on November 21, 2024 Posted By: Countdown Admin Categories: What's New

This post expands on comments made by Cheikh Faye and others during a webinar organized by The Partnership for Maternal, Newborn and Child Health in November 2024. Dr. Faye is director of the West Africa office for the African Population and Health Research Center and director of Countdown to 2030.

Theme of the Webinar

The health workforce is the backbone of reproductive, maternal, newborn, child and adolescent health (RMNCAH) services. Yet, it faces a monumental crisis. In many countries, shortages, unequal distribution, and limited capacity severely undermine the delivery of essential services. For example, sub-Saharan Africa, home to some of the highest maternal and child mortality rates, bears a disproportionate burden of the projected global shortfall of 10 million health workers by 2030. Countries with fragile health systems often lack enough skilled birth attendants, community health workers, and pediatricians to meet even basic needs. This directly impacts service coverage and quality, resulting in preventable deaths and missed opportunities for care.

Watch the webinar:

Other speakers included Rajat Kholsa from PMNCH, Mekdes Daba from Ethiopia’s Ministry of Health, James Campbell from the World Health Organization (WHO), Yassah Nupolu Lavelah from Liberia’s Ministry of Health, Anne Beatrice Kihara from the International Federation of Gynaecology and Obstretrics (FIGO), Naveen Thacker from the International Pediatric Association (IPA), Sandra Oyarzo Torres from the International Confederation of Midwives, Patrick Too from the Council of International Neonatal Nurses, and Asmita Acharya from Laerdal Global Health.

Data must be at the heart of workforce planning if we are to reduce maternal and child mortality.

Without reliable data, we cannot assess where health workers are most needed, identify skill gaps, or assess the quality of care being delivered. For example, geo-mapping the distribution of health workers alongside maternal and child mortality data can help us target investments to underserved areas. Data is also critical for evaluating workforce performance and measuring the impact of interventions. For instance, data on service coverage and outcomes can guide training programs and resource allocation to maximize impact. Investment should follow this evidence. This means financing targeted recruitment, fair remuneration, and continuous professional development for health workers. It also includes integrating digital health tools to enhance data collection and analysis at all levels. By aligning workforce planning with real-time data, we can ensure equitable access to quality care and accelerate progress toward ending preventable maternal and child deaths.

Cheikh Faye at a Countdown meeting in 2023.

Identifying gaps and priorities

Data-driven planning helps identify where maternal and child mortality rates are highest and where health workforce shortages are most acute. For example, spatial mapping of health facilities and workforce availability can reveal underserved regions, enabling targeted interventions.
The Countdown to 2030 initiative provides comprehensive country profiles that synthesize data on reproductive, maternal, newborn, and child health (RMNCAH) indicators. These profiles enable countries to better understand their unique challenges and prioritize interventions accordingly.

Targeting Investments for Maximum Impact

Investments informed by data ensure resources are directed to areas of greatest need, such as increasing the number of skilled health workers in remote communities.
Countdown-supported analyses highlighted the need for more health extension workers in regions with high neonatal mortality. This led to targeted recruitment and training initiatives.

Monitoring and Evaluating Performance

Data allows for tracking workforce performance, service coverage, and health outcomes over time. This ensures accountability and guides course corrections.

Advocating for Policy Change

Evidence generated from data can be used to advocate for policy reforms and increased budgets for the health workforce.
In Uganda, Countdown analyses provided evidence on how investments in community health workers improved postnatal care uptake, leading to policy revisions that scaled up the program.

Several systemic and contextual barriers related to health workforce hinder RMNCAH progress:

Funding gaps restrict health workforce recruitment, training, motivation and retention.
Poor working conditions such as high workloads, low pay, and limited career opportunities, contribute to burnout and high attrition rates.
Leadership and governance bottlenecks sometimes result in inconsistent workforce policies and planning, exacerbated by conflicts, climate disasters, and pandemics.
Gender inequities in the health workforce in sub-Saharan Africa are pervasive, and impact both the composition and functioning of health systems.

Specific example of how gender inequities play a role:

Unequal Representation in Leadership and Decision-Making – While women constitute the majority of the health workforce in sub-Saharan Africa, especially in roles like nursing and midwifery, they are underrepresented in senior leadership and decision-making positions in health ministries, hospitals, and professional organizations.
Pay Disparities – Women often earn less than their male counterparts, even when performing the same roles. Gender pay gaps persist across various cadres of health workers.
Limited Career Progression Opportunities – Women face barriers to career advancement, including fewer opportunities for specialized training, professional development, and mentoring. Additionally, balancing work with family responsibilities often limits their ability to pursue additional roles or further education.
Workplace Harassment and Violence – Female health workers are more likely to face workplace harassment, abuse, or violence, especially in conflict zones or remote areas. This creates unsafe working environments and affects their well-being and productivity.
Burden of Unpaid Work – Female health workers frequently shoulder the double burden of professional responsibilities and unpaid domestic care, leading to burnout and limiting their availability for full-time or demanding roles.

We must rethink our approach in several ways:

Sustainably finance the health workforce. National governments and partners need to prioritize workforce funding as an investment, not a cost, leveraging domestic resources and innovative financing mechanisms.
Strengthen workforce governance and accountability. This includes setting realistic workforce development plans, improving regulation, and creating safe, equitable environments for health workers.
Integrate health workforce needs into broader systems strengthening to ensure alignment with universal health coverage (UHC) and health rights frameworks.

Inclusive partnerships are critical to accelerating progress:

Governments must lead in integrating health workforce strategies into national development agendas.
Donors and multilateral organizations need to align funding and technical assistance with workforce priorities to maximize impact.
Civil society and professional associations should advocate for workforce welfare and equity, ensuring accountability to the communities we serve.
The private sector can support through innovations, training, and leveraging digital solutions.

In closing, achieving the SDG targets for MNCH is possible but requires urgent, collaborative, and sustained action. Let us commit to empowering the health workforce as the cornerstone of health systems that deliver not only survival but also dignity and a high quality of life for all. By leveraging data-driven planning, countries can ensure investments in the health workforce are strategic and equitable, addressing root causes of maternal and child mortality. The Countdown to 2030 initiative exemplifies how data-informed decision-making strengthens health systems and accelerates progress toward achieving SDG targets.

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