Essential shifts in health workforce measurement: a human-centred approach.

Abstract

The health sector has faced long-standing challenges in drivers of worker behaviours and performance, such as job satisfaction, which have been worsened by COVID-19. Structural issues including high workloads and poor working conditions have long contributed to dissatisfaction among health workers. The pandemic escalated unsafe working conditions, causing workers' deaths, increasing burnout rates, and contributing to exodus from health-care jobs. To begin to address these challenges, systematising a human-centred approach to health workforce measurement, which emphasises the drivers of worker behaviour, is crucial. This approach requires a critical re-examination of historical metrics including those on absenteeism, caseload, and competence, which primarily characterise health workers as inputs into the health system. Transition should be made towards more human-centred measures of absence, workload, competency, and job satisfaction. The revision of the World Bank's Service Delivery Indicators health survey, a large-scale facility-based survey that provides within-country and cross-country information on health systems quality, showcases how revisiting widely used metrics through a human-centred lens is needed to yield more fit-for-purpose policy insights that identify health worker wellbeing as key to achieving global health goals.