Health workforce importance in achieving universal health coverage (UHC): the case of North Macedonia

Abstract

Introduction: The Sustainable Development Goals (SDGs) place focus on health, goal 3: “ensuring healthy lives and promoting well-being for all and all ages“. The importance of the health workforce in the context of the SDGs emphasizes the critical need to “substantially increase health financing and the recruitment, development, training and retention of the health workforce”. Overall, the core of the SDGs is achieving Universal Health Coverage (UHC). Aim: The study aims to provide a critical review and contribute to a better understanding the role of health workforce in achieving health coverage in North Macedonia. Method: Data was collected from annual reports on health workforce published by the National Institute for Public Health, “Global health workforce statistics database“- WHO, as well as from the Macedonian Doctors’ Chamber for data on health workforce mobility. Analytical and descriptive methods were used to present the results. Results: Health workforce density in North Macedonia is 3.79/1000 population, which is less than the minimum threshold of 4.45 per 1000 population set by the World Health Organization to meet the SDG health targets and has declined since 2010 when it was 4.8/1000 population. Analyzed data shows an increase on medical doctors from 2010 (267/100000) to 2017 (299 per 100000 population), however the minimum EU standards for quality healthcare services of 360 medical doctors per 100000 population are not fulfilled. Moreover, in the last 8 years almost 10% of the registered licensed medical doctors emigrated from the country and the medical brain drain is an unyielding trend. Conclusion: The major challenges in the health system pertaining health workforce are related to number, quality, distribution and career path. Future demographic and epidemiological changes will have consequences in which the healthcare systems respond to patient needs. Imperative action and strategy are needed to prevent health professional shortage and allocation of human resources in order to achieve universal health coverage by 2030.