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Project Summary

Under the Human Resources for Health 2030 (HRH2030) project, ThinkWell conducted a health labor market analysis in Malawi. The study analyzed the supply, demand, and fiscal space factors that drive a country’s capacity to expand and retain its health workforce. Our research also identified health labor market inefficiencies that informed the development of HRH policies and PEPFAR and The Global Fund to Fight AIDS, Tuberculosis and Malaria’s HRH investments.

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, we used a mixed methods approach of quantitative and qualitative analysis of both primary and secondary data to shed light on market conditions that directly impact the ability to absorb and retain health workers now and in the future.

Challenges

Given an annual average population growth of three percent and high HIV prevalence (nine percent), the health sector in Malawi struggles to keep pace with rising demand for services. In addition, the health system is fragile and faces 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 people, 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 was 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 assessed Malawi’s capacity to expand and retain its health workforce, including absorbing donor-supported health workers. Additionally, we identified opportunities for efficiency gains in health labor market processes.

Results

The analysis, completed from 2016-2018, informed the development of HRH policies, strategies, and plans. Our findings supported donors such as PEPFAR and The Global Fund to Fight AIDS, Tuberculosis and Malaria to make strategic HRH investments.

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