We cannot save children’s lives, or reach the goal of Universal Health Coverage (UHC), without sufficient numbers of skilled and motivated health workers in the places where they are needed most. Investment in life-saving medicines, vaccines and technologies can only have the desired impact if we also invest in health workers, particularly the frontline health workers, who are trained and supported to deliver them.

Previous research by Save the Children has shown that a child is five-times more likely to survive to their fifth birthday if they live in a country with enough doctors, nurses and midwives.

All countries need to invest in a strong health workforce that is fit to prevent and treat the causes of maternal, newborn and child mortality. Whilst many countries have made progress in strengthening their health workforce, there is a global shortage of 7.2 million health workers and too many children continue to die because they can’t see a health worker when they need one. The time of birth and newborn period is a particularly vulnerable time for a mother and her baby but globally, around 45 million give birth without a skilled health worker present.

Save the Children’s 2011 report No Child Out of Reach identified four key areas where more progress must be made:

1. Recruit more health workers, particularly frontline health workers, with appropriate skills

2. Make better use of existing health workers to reach the most vulnerable children

3. Ensure all health workers are properly supported and paid a living wage

4. Deliver more funding for healthcare, in a more effective way

At the 3rd Global Forum on Human Resources for Health (HRH) in Recife, Brazil, the Global Health Workforce Alliance published a report that sets out a new agenda for all countries to build the health workforces needed to achieve UHC. As this report clearly states: there can be no health without a health worker.

If governments and development partners follow the recommendations in this report and implement the commitments made at the 3rd Global Forum, it will have a significant impact on efforts to reduce newborn and child mortality and achieve MDG 4. Everyone has a role to play: now is the time for action.

Find out more about the progress that different countries are making and what the report is calling for by following the links below:

  • Key statistics
  • Key findings
  • Report recommendations
  • 7.2 million – the current global shortage of skilled health workers (midwives, nurses and physicians)
  • 12.9 million – the estimated global shortage of skilled health workers by 2035
  • 53% – the proportion of countries that have regularly collected data about midwives, nurses and physicians over the past 20 years
  • 23 – the minimum number of skilled health workers needed to provide essential healthcare for 10,000 people
  • 83 – the number of countries that currently fall below this threshold
  • 59 – the number of skilled health workers per 10,000 people in Mexico, a country that reduced its maternal mortality rate to 50 per 100,000 live births
  • 118 – the number of countries that currently fall below this threshold and would need to significantly scale up the number of health workers to reach a similar maternal mortality rate as Mexico
  • 1 – the number of African countries that reported having taken steps to implement the WHO Code of Practice on International Recruitment of health workers at the 2013 World Health Assembly
  • Many countries have shown progress in strengthening health workforces thanks to strong political commitment and ensuring continuity in the implementation of HRH strategies within broader efforts to strengthen health systems.
  • Progress on human resources for health (HRH) for Universal Health Coverage (UHC) has been accomplished in all the countries profiled in the report, but the picture is not of unified and sustainable progress.
    Learn more here.
  • After a ‘decade of action’ on HRH the issue has received unprecedented attention but progress on global commitments has been slow.
    Learn more here .
  • As part of efforts to achieve UHC, all countries need to consider whether their health workforce is fit for purpose, and fit for practice.
    Learn more here.
  • Based on a number of different thresholds, the majority of countries are far from having a sufficient supply and stock of health workers, with the relevant competencies and skill-mix that corresponds to the health needs of the population.
    Learn more here.
  • The category of countries with a severe health worker ‘crisis’ has changed but this is due exclusively to changes in coverage of skilled birth attendance.
    Learn more here.
  • Many countries are not collecting regular data on their health workforce.
    Learn more here.
  • All countries profiled in the report have identified reducing imbalances in the geographical distribution of health workers as an important policy objective.
    Learn more here.
  • A health workforce must be acceptable to the population it serves. The gender of health workers in particular can be a critical factor for user demand and satisfaction.
    Learn more here.
  • The quality of health workers and the care they provide is a major challenge in all countries.
    Learn more here.
  • Numbers and densities of skilled health professionals are increasing, but not fast enough to keep up with population growth. New analysis of the workforce implications for achieving UHC estimates a global deficit of around 12.9 million skilled health workers by 2035.
    Learn more here.
  • A contemporary agenda for HRH has been proposed to underpin efforts to achieve UHC.
    Learn more here.

To national governments:


1. Recognize the centrality of the health workforce in translating the vision of universal health coverage into improved health care on the ground.
2. Assess the gap between the need for a health workforce, actual supply (stock, skills-mix, competencies) and the population´s demand for health services.
3. Formulate HRH policy objectives that reflect the vision for the health system and services.
4. Build the data, evidence base and strategic intelligence required to implement and monitor the policy objectives, and sustain effective management of HRH information systems.
5. Build and sustain the technical capacity to design, advocate for and implement HRH policies at national, regional and local levels.
6. Build political support at the highest level to ensure continuity in the pursuit of UHC.
7. Reform the governance and institutional HRH environment so it can support the achievement of UHC.
8. Cost the various scenarios of health workforce reforms and mobilise the necessary domestic and international resources to implement them.


To international partners:


9. Focus support, and report on official development assistance, on capacity building of health systems in countries that have committed to achieving UHC.
10. Address transnational issues such as international recruitment of health workers and strengthen global HRH governance, collaborative platforms and mechanisms.