Study highlights dangers of too few medical students

Ghana needs about US$480.39 million to finance the education of health professions to fill the needs-based gaps and correct mismatches by 2035, without which there will be a 33% shortage of essential health professionals, a situation that will negatively affect inter-professional team compositions and, ultimately, health care quality, a new study has found.

The study, ‘Modelling the supply and need for health professionals for primary health care in Ghana: Implications for health professions education and employment planning’, published in the journal PLOS One on 28 September found “potential value in linking population health needs to the required intake of students into health professions education institutions”.

It said Ghana’s supply in 2020 satisfies only about 67% of the aggregate need-based requirements for primary health care for the 11 categories of health professionals, but a gap of 33% (or roughly 73,203) remains.

“Without any corrective intervention, the aggregate needs-based shortage in supply will likely be 161,502 by 2035, with the supply of six out of the 11 health professionals (54.5%) failing to match 50% of the needs by 2035, but that of midwives will likely be oversupplied by 32% in 2035,” the study said.

The authors said priority areas for health professions education include scaling up the production of pharmacy technicians by 7.5% and general practitioners by 110%, while scaling down midwives by 15%.

They had built the study upon previous works, the authors said. The study had developed a needs-based analytical health workforce planning model in Microsoft Excel and which is suitable for sector-wide application in any country.

The authors depended on the existing stock of health professionals, the rate of labour flow (attrition), the education pipeline (number of admissions into health professions education institutions and pass rates) as their data sources for the supply analysis and costing. These were obtained from the respective professional regulatory bodies of the health professions.

The health professionals’ average income level was taken from the public sector single spine salary scale obtained from the Ghana Health Service.

In the absence of comprehensive data on the cost of training of health professionals, they depended on the average of annual fees paid by fee-paying students as published by two public universities (the University of Ghana’s College of Health Sciences and the University of Health and Allied Sciences) and one private university (Central University).

The study said the country faces “a double burden of disease whereby non-communicable diseases and their risk factors are at alarming levels, while communicable diseases are still a public health threat”.

It said the country had an estimated Universal Health Coverage (UHC) score of 47% in 2019 which meant that it compared sub-optimally against Africa’s average of 48%. In addition, up to 53% of its population health needs (which are tracked by UHC tracer indicators) were likely not to be met by the existing coverage of health services.

To deal with the shortage of health care professionals and improve upon the ever-changing pattern of the population’s health needs, the authors said, will “require investments across the different health system components”. However, aligning the health workforce production to the population health needs was imperative.