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Health Labor Market Analysis in Botswana, Malawi, and Namibia

Project Summary

USAID’s global HRH2030 (Human Resources for Health in 2030) project provides technical assistance and leadership, to support low- and middle-income countries towards the advancement of global human resources for health (HRH). As a sub-contractor to Chemonics, ThinkWell is conducting country health labor market analyses in Botswana, Malawi, and Namibia. The purpose of the activity is to analyze the supply and demand factors that drive a country’s future capacity to expand and retain its health workforce, including absorbing donor-supported health workers, and to identify health labor market inefficiencies. The analysis will inform the development of HRH policies and PEPFAR and GFATM HRH investments, help countries to advocate for increased domestic resources for HRH, and support donors to plan for the transitioning of donor-supported health workers into the public or private sector.

Breaking New Ground

A health labor market analysis assesses the impact of policies, regulations, and financial and non-financial incentives that determine supply and demand decisions, including the geographic distribution and skills mix of health workers. In Malawi, a mixed methods approach of quantitative and qualitative analysis of both primary and secondary data will be used to shed light on market conditions that directly impact the ability to absorb and retain health workers now and in the future. Through key informant interviews, focus group discussions, and a survey of employers and employees in the public and private sectors, the analysis will shed light on issues for which previously only anecdotal (and sometimes contradictory) evidence was available.

Challenges

Given an annual average population growth of 3% and high HIV prevalence (8.8%), the health sector in Malawi has struggled to keep pace with rising demand for services. The health system remains fragile and continues to face severe challenges in critical areas of human resources for health (HRH), including quantity, size, absorption of health workers, geographic and health facility level distribution of health workers, skill mix, and health workforce management capacity. Malawi is one of 44 low-income countries in which the number of health workers is less than 23 per 10,000 population, a critical threshold below which essential health services are difficult to deliver.

Approach

To expand and more efficiently utilize the health workforce, in the context of limited resources, it is vital to gain a better understanding of the factors that influence demand and supply in the health labor market. By analyzing demand and supply, fiscal space, and the political economy, ThinkWell will assess Malawi’s capacity to expand and retain its health workforce, including absorbing donor-supported health workers. Additionally, it will identify opportunities for efficiency gains in health labor market processes.

Results

The analysis will inform the development of HRH policies, strategies, and plans; and support donors such as PEPFAR and the Global Fund in making strategic HRH investments.

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